bluuebunny/crossref_metadata_2025 huggingface dataset:
Antibodies against endothelial cells and cardiolipin in young patients with peripheral atherosclerotic disease
Authors: NITYANAND S. , BERGMARK C. , DE FAIRE U. , SWEDENBORG J. , HOLM G. , Lefvert Ann Kari
Published: August 2009

Abstract. Objectives. To investigate the prevalence of anti‐cardiolipin and antiendothelial cell antibodies in patients operated on for atherosclerotic peripheral vascular disease before 50 years of age. The hypothesis to be tested was whether antibodies associated with an immune/inflammatory damage to the vascular wall were associated also with early atherosclerosis.

Design. A case‐control study.

Setting. Departments of surgery and an immunological research laboratory, and routine laboratories of two tertiary referral hospitals.

Subjects. All patients operated for atherosclerotic peripheral vascular disease before 50 years of age. Sixty‐two patients (33 males, 29 females), and 67 age‐ and sex‐matched controls participated. The diagnosis of atherosclerosis was made on the basis of the clinical presentation and angiographic visualization of the diseased vasculature.

Main outcome measures. Subjects were compared for the prevalence of anticardiolipin and antiendothelial cell antibodies, altered serum lipoprotein levels, smoking, diabetes, hypertension, and signs of inflammation.

Results. Antibodies against endothelial cells and cardiolipin were found in 12.9 and 14.5% of the patients, respectively, which was higher than observed in the control group (P < 0.05). Sixty per cent of patients with antibodies were females. Conventional risk factors were more often noted in the patient group. However, patients with antibodies against endothelial cell and/or cardiolipin had a lower prevalence of hyperlipidaemia/dyslipidaemia when compared to patients without these antibodies (P < 0.05).

Conclusions. Antibodies against endothelial cells and cardiolipin are present in a subset of patients with clinical and angiographic diagnosis of severe premature atherosclerotic peripheral vascular disease. The lower occurrence of hyperlipidaemia/dyslipidaemia in patients with autoantibodies, in comparison to patients without the antibodies, suggests that these antibodies have a role in vascular damage.
Medical ethics – when to stop treatment
Authors: STANLEY J. M.
Published: August 2009

Abstract. Several misunderstandings regarding the question of when to stop treatment are examined by considering two frameworks for sorting out the different dimensions of the question. One framework addresses what is meant, and what is not meant, by ‘stopping treatment’. The other plots various strategies of stopping treatment on a continuum of increasing degrees of invasiveness. While significant disagreements remain at important points, there is evidence of an emerging consensus in Western medicine: (1) that palliative care and counselling through the dying process should be increased whenever curative or life‐sustaining treatment is curtailed; (ii) that any treatment that is not curative, but merely life‐sustaining, should be stopped whenever a patient makes an authentic request to have it stopped; (iii) that genuinely futile treatment should not be offered even if requested; (iv) that much more thought and discussion is required to achieve a workable agreement about the definitions of ‘futile’ and ‘inappropriate’ treatment; and (v) that assistance in dying, although profoundly problematic, is no longer unthinkable.
Physical, functional and conditional interactions between ArcAB and phage shock proteins upon secretin‐induced stress in Escherichia coli
Authors: Jovanovic Goran , Engl Christoph , Buck Martin
Published: August 2009

The phage shock protein (Psp) system found in enterobacteria is induced in response to impaired inner membrane integrity (where the Psp response is thought to help maintain the proton motive force of the cell) and is implicated in the virulence of pathogens such as Yersinia and Salmonella. We provided evidence that the two‐component ArcAB system was involved in induction of the Psp response in Escherichia coli and now report that role of ArcAB is conditional. ArcAB, predominantly through the action of ArcA regulated genes, but also via a direct ArcB–Psp interaction, is required to propagate the protein IV (pIV)‐dependent psp‐inducing signal(s) during microaerobiosis, but not during aerobiosis or anaerobiosis. We show that ArcB directly interacts with the PspB, possibly by means of the PspB leucine zipper motif, thereby allowing cross‐communication between the two systems. In addition we demonstrate that the pIV‐dependent induction of psp expression in anaerobiosis is independent of PspBC, establishing that PspA and PspF can function as a minimal Psp system responsive to inner membrane stress.
Intracontinental subduction: a possible mechanism for the Early Palaeozoic Orogen of SE China
Authors: Faure Michel , Shu Liangshu , Wang Bo , Charvet Jacques , Choulet Flavien , Monie Patrick
Published: August 2009

The Early Palaeozoic Orogen of SE China consists of three litho‐tectonic elements, from top to bottom: a sedimentary Upper Unit, a metamorphic Lower Unit and a gneissic basement. The boundaries between these units are flat lying, south directed, ductile decollements. The lower one is coeval with an amphibolite facies metamorphism (M1). The belt is reworked by migmatite–granite domes, high‐temperature metamorphism (M2) and granitic plutons related to post‐orogenic crustal melting. We date here the syn‐M1 ductile shearing at 453 ± 7 Ma by U‐Th/Pb method on monazite. Previous ages and our new 40Ar/39Ar ages of biotites and muscovites show that the metamorphic rocks experienced syn‐M2 exhumation from 440 to 400 Ma. The Early Palaeozoic Orogen of SE China is an intracontinental belt in which decollements accommodated the north‐directed subduction of the Cathaysian continent. This orogen is an example of intracontinental subduction that was not preceded by oceanic subduction.
Association study of MICA and MICB in Alzheimer’s disease
Authors: Quiroga I. , Lehmann D. J. , Barnardo M. C. N. M. , Fuggle S. , Cortina‐Borja M. , Warden D. R. , Smith A. D.
Published: August 2009

Following the replication of the association of the human leucocyte antigen (HLA) allele, HLA‐B*07, with Alzheimer’s disease (AD) in the cohort of the Oxford Project to Investigate Memory and Ageing (OPTIMA) in a previous study, we examined whether that association could be due to linkage disequilibrium with MICA or MICB alleles. We found a possible association of MICA*00801 heterozygotes with AD in subjects positive for the ɛ4 allele of apolipoprotein E. This finding was supported by Hardy–Weinberg analysis, by stratified association analysis and by interaction analysis, but did not survive correction for multiple testing. In any case, these results do not explain our previously reported association of HLA‐B*07 with AD.
Complementary DNA sequences encoding the multimammate rat MHC class II DQ α and β chains and cross‐species sequence comparison in rodents
Authors: Goüy de Bellocq J. , Leirs H.
Published: August 2009

Sequences of the complete open reading frame (ORF) for rodents major histocompatibility complex (MHC) class II genes are rare. Multimammate rat (Mastomys natalensis) complementary DNA (cDNA) encoding the α and β chains of MHC class II DQ gene was cloned from a rapid amplifications of cDNA Emds (RACE) cDNA library. The ORFs consist of 801 and 771 bp encoding 266 and 256 amino acid residues for DQB and DQA, respectively. The genomic structure of Mana‐DQ genes is globally analogous to that described for other rodents except for the insertion of a serine residue in the signal peptide of Mana‐DQB, which is unique among known rodents.
The identification of a new HLA‐DPB1 allele (*1302) in one family and the detection of a recombination event between the DR and the DQ regions in another Caucasian T1DGC family
Authors: Moonsamy P. , Bonella P. , Goodwin G. , Dolan L. , Erlich H. A. ,   for the T1DGC
Published: August 2009

The analysis of families collected by the T1DGC and typed at high resolution for the HLA class I and class II loci provided an opportunity for identifying new alleles and rare recombination events. In one American Caucasian family, a novel allele (HLA‐DPB1*1302), detected as an unusual pattern of probe binding, was identified in the mother and in one child. Amplicons from both individuals were sequenced and a new variant of DPB1*1301 with an A‐>T mutation [TAC to TTC in codon 64, (amino acid 35); Y to F] was confirmed. In another American Caucasian family, one child inherited an unusual haplotype, DRB1*1501‐DQA1*0102‐DQB1*0609‐DPA1*0103‐DPB1*0601 resulting from a recombination between the DRB1 loci on the maternal chromosomes DRB1*1501‐DQA1*0102‐DQB1*0602‐DPA1*0103‐DPB1*0401 and DRB1*1302‐DQA1*0102‐DQB1*0609‐DPA1*0103‐DPB1*0601.
New strategies for cancer gene therapy: Progress and opportunities
Authors: Cao Siyu , Cripps Allan , Wei Ming Q
Published: August 2009

1. To date, cancer persists as one of the most devastating diseases worldwide. Problems such as metastasis and tumour resistance to chemotherapy and radiotherapy have seriously limited the therapeutic effects of existing clinical treatments.

2. To address these problems, cancer gene therapy has been developing over the past two decades, specifically designed to deliver therapeutic genes to treat cancers using vector systems. So far, a number of genes and delivery vehicles have been evaluated and significant progress has been made with several gene therapy modalities in clinical trials. However, the lack of an ideal gene delivery system remains a major obstacle for the successful translation of regimen to the clinic.

3. Recent understanding of hypoxic and necrotic regions within solid tumours and rapid development of recombinant DNA technology have reignited the idea of using anaerobic bacteria as novel gene delivery systems. These bacterial vectors have unique advantages over other delivery systems and are likely to become the vector of choice for cancer gene therapy in the near future.

4. Meanwhile, complicated tumour pathophysiology and associated metastasis make it hard to rely on a single therapeutic modality for complete tumour eradication. Therefore, the combination of cancer gene therapy with other conventional treatments has become paramount.

5. The present review introduces important cancer gene therapy strategies and major vector systems that have been studied so far with an emphasis on bacteria‐mediated cancer gene therapy. In addition, exemplary combined therapies are briefly reviewed.
Endoscopic cyclophotocoagulation for the treatment of glaucoma: an Asian experience
Authors: Yip Leonard W , Yong Shao O , Earnest Arul , Ji Jian , Lim Boon A
Published: August 2009

Abstract

Background: To describe the efficacy and safety of endoscopic cyclophotocoagulation in Asian patients with glaucoma.

Methods: Retrospective case series. Consecutive cases of endoscopic cyclophotocoagulation performed by one surgeon during the study period were included. Patients' records were reviewed for clinical and demographic factors, treatments, intraocular pressure (IOP), visual acuity and any complications.

Results: Twenty‐nine eyes of 29 patients were treated. Their mean age was 73.6 ± 9.4 years. The mean follow‐up duration was 15.9 ± 8.9 months. Eleven patients had primary open‐angle glaucoma, two normal tension glaucoma, six chronic angle‐closure glaucoma, five neovascular glaucoma, four secondary open‐angle glaucoma and one secondary angle‐closure glaucoma. Twenty patients had endoscopic cyclophotocoagulation combined with cataract surgery. Mean pretreatment IOP was 21.8 ± 6.6 mmHg. Mean post‐treatment IOP at 18 months (n = 17) was 16.2 ± 4.1 mmHg (P = 0.02) and 17.9 ± 4.9 mmHg (P = 0.18) at 24 months (n = 10). The mean number of anti‐glaucoma medications pretreatment was reduced from 2.0 ± 1.0 to 0.9 ± 0.9 at 18 months post‐treatment (P = 0.04) and 1.2 ± 0.8 at 24 months (P = 0.13). The overall success rate based on IOP reduction of 20% or greater at last follow‐up was 48.3%. Visual acuity was reduced in five eyes. Complications included one case each of hyphaema, bullous keratopathy, transient pigment dispersion and iris burn.

Conclusion: Endoscopic cyclophotocoagulation may have a treatment role in Asian patients with glaucoma. The success rate appears poorer than previously reported in Caucasian populations. The treatment effect appeared to wane between 18 and 24 months post‐treatment.
Effect of small notch and absorbed hydrogen on the fatigue fracture in two‐step stress test within fatigue limit diagram
Authors: KONDO Y. , EDA H. , KUBOTA M.
Published: August 2009

It is usually regarded as a common understanding that fatigue failure would not occur if all stresses were kept within fatigue limit diagram. However, it was shown that fatigue failure occurred in some special cases of variable amplitude loading condition even when all stresses were kept within fatigue limit diagram in the case of small‐notched specimen. The cause of such a phenomenon was examined using two‐step stress pattern for low alloy steel SCM440H. In the case of constant stress amplitude loading, non‐propagating crack was formed only at low mean stress and not formed at high mean stress. However, in the case of two‐step stress pattern in which the first step stress was chosen as R =−1 and the second step stress was with high mean stress, a non‐propagating crack was formed by the first step stress. This crack functioned as a pre‐crack for the second step stress with high mean stress. Consequently, fatigue failure occurred by the stresses within fatigue limit diagram. In this study, the effect of notch size and shape were examined. The effect of absorbed hydrogen was also investigated. Absorption of 0.3 ppm hydrogen caused more reduction of fatigue limit.
Continuous infusion of ropivacaïne: an optimal postoperative analgesia regimen for iliac crest bone graft in children
Authors: OUAKI JULIE , DADURE CHRISTOPHE , BRINGUIER SOPHIE , RAUX OLIVIER , ROCHETTE ALAIN , CAPTIER GUILLAUME , CAPDEVILA XAVIER
Published: August 2009

Background:  Postoperative analgesia of iliac crest (IC) donor site can be performed by on site infiltrations of local anesthetics (LA) or morphine. Single injections or continuous infusions of LA proved their efficacy in adults, but was not reported in children. We prospectively evaluated the interest of a continuous infusion of 0.2% ropivacaïne at the IC donor site in terms of postoperative pain relief and rescue analgesics consumption.

Methods:  Sixteen consecutive patients, aged from 4 to 16 years scheduled for maxillar alveolar graft with IC bone, were included. After IC bone graft surgery under general anesthesia, they received a 0.2–0.4 ml·kg−1 bolus of 0.2% ropivacaïne through the IC catheter; then a continuous infusion of 0.2% ropivacaïne at 0.125 ml·kg−1·h−1 was administrated for 48 h with disposable elastomeric pumps. Children systematically received paracetamol (15 mg·kg−1 four times a day) and niflumic acid (40 mg·kg−1 twice a day). Postoperative pain was evaluated using a Visual Analog Scale (>7 years old) or Children and Infants Postoperative Pain Score (between 4 and 7 years old) every 4 h until H48. Doses of rescue analgesics and adverse events (LA toxicity, catheter’s removal, nausea–vomiting) were also noted. Three months after surgery a blinded clinical research assistant reviewed all children and assessed functional recovery, neuropathic chronic pain symptoms or local complications.

Results:  The median value of IC graft pain scores was 0 during whole studied period. Of the patients, 31.2% did not require any rescue analgesics and 43.8% needed only once. No adverse events related to LA and no removal of catheter were noted. One child had nausea in the 48‐h postoperative period, and one child had neuropathic pain symptoms at 3 months at the donor site.

Conclusion:  Continuous infusion of 0.2% ropivacaïne through an IC catheter is an optimal and safe technique of regional postoperative analgesia after bone graft harvest in children.
A survey of pediatric caudal extradural anesthesia practice
Authors: MENZIES ROBERT , CONGREVE KATE , HERODES VEIKO , BERG SIMON , MASON DAVID G.
Published: August 2009

Background:  Caudal extradural blockade is one of the most commonly performed procedures in pediatric anesthesia. However, there is little information available on variations in clinical practice.

Objectives:  To perform a survey of members of the Association of Paediatric Anaesthetists of Great Britain and Ireland who undertake caudal anesthesia.

Methods:  An ‘online’ World Wide Web questionnaire collected information on various aspects of clinical practice. The survey ran from April to June 2008.

Results:  There were 366 questionnaires completed. The majority of respondents had >5 years of pediatric experience and performed up to ten caudal extradural procedures a month. The commonest device used was a cannula (69.7%) with 68.6% using a 22G device. There was a trend toward the use of a cannula in those anesthetists with <15 years experience, while those with >15 years experience tended to use a needle. Most anesthetists (91.5%) did not believe that there was a significant risk of implantation of dermoid tissue into the caudal extradural space. The majority used a combination of clinical methods to confirm correct placement. Only 27 respondents used ultrasound. The most popular local anesthetics were bupivacaine (43.4%) and levobupivacaine (41.7%). The most common additives were clonidine (42.3%) and ketamine (37.5%). The caudal catheter technique was used by 43.6%. Most anesthetists (74%) wear gloves for a single shot caudal injection.

Conclusions:  This survey provides a snapshot of current practice and acts a useful reference for the development of enhanced techniques and new equipment in the future.
Ascomycetes associated with ectomycorrhizas: molecular diversity and ecology with particular reference to the Helotiales
Authors: Tedersoo Leho , Pärtel Kadri , Jairus Teele , Gates Genevieve , Põldmaa Kadri , Tamm Heidi
Published: August 2009

Mycorrhizosphere microbes enhance functioning of the plant–soil interface, but little is known of their ecology. This study aims to characterize the ascomycete communities associated with ectomycorrhizas in two Tasmanian wet sclerophyll forests. We hypothesize that both the phyto‐ and mycobiont, mantle type, soil microbiotope and geographical distance affect the diversity and occurrence of the associated ascomycetes. Using the culture‐independent rDNA sequence analysis, we demonstrate a high diversity of these fungi on different hosts and habitats. Plant host has the strongest effect on the occurrence of the dominant species and community composition of ectomycorrhiza‐associated fungi. Root endophytes, soil saprobes, myco‐, phyto‐ and entomopathogens contribute to the ectomycorrhiza‐associated ascomycete community. Taxonomically these Ascomycota mostly belong to the orders Helotiales, Hypocreales, Chaetothyriales and Sordariales. Members of Helotiales from both Tasmania and the Northern Hemisphere are phylogenetically closely related to root endophytes and ericoid mycorrhizal fungi, suggesting their strong ecological and evolutionary links. Ectomycorrhizal mycobionts from Australia and the Northern Hemisphere are taxonomically unrelated to each other and phylogenetically distant to other helotialean root‐associated fungi, indicating independent evolution. The ubiquity and diversity of the secondary root‐associated fungi should be considered in studies of mycorrhizal communities to avoid overestimating the richness of true symbionts.
Prospective evaluation of a colorectal cancer nurse follow‐up clinic
Authors: Jeyarajah S. , Adams K. J. , Higgins L. , Ryan S. , Leather A. J. M. , Papagrigoriadis S.
Published: August 2009

Aim  Colorectal Nurse Specialist (CNS) clinics for postoperative follow up of colorectal cancer aim to maintain clinical efficacy while reducing costs. We prospectively studied the efficacy and financial implications of such a clinic.

Method  This was a prospective study of all patients attending CNS clinics over 3 years. A lower‐risk protocol for patients with Dukes A was used over 3 years and a higher‐risk protocol for patients with Dukes B, C or D was used over 5 years. Department of Health Pricing Charts were used to cost the follow‐up protocols, and adjustment was performed to calculate the cost of each quality adjusted life year (QALY) gained.

Results  One hundred and ninety‐three patients entered into this nurse‐led follow‐up protocol implemented by the CNS clinic between 2005 and 2007. The Dukes stages and proportions of patients in each stage were as follows: stage A, 13%; stage B, 8%; stage C, 36.3%; and stage D, 9.3%. Ninety‐seven per cent underwent curative treatment and 2.6% had palliative treatment. Twenty‐one per cent of patients developed recurrent disease. Overall actuarial 5‐year survival was 80% and recurrences had a 30% 5‐year actuarial survival. The total cost per patient for 3 years of follow up was £1506 and £1179 for lower‐risk rectal and nonrectal cancers, respectively. The adjusted cost for each QALY gained for lower‐risk tumours was £1914. The total cost per patient with higher‐risk tumours was £1814 and £1487 for rectal and nonrectal tumours, respectively. The adjusted cost for each QALY gained was £2180 for higher‐risk tumours.

Conclusions  This clinic demonstrated cost‐effective detection of recurrent disease. Computed tomography (CT) was the most sensitive alert test. As all recurrences were detected within 4 years, we suggest that this is the indicated time to follow up.
Stages of Organizational Transformation in Transition Economies: A Dynamic Capabilities Approach
Authors: Dixon Sarah E. A. , Meyer Klaus E. , Day Marc
Published: August 2009

abstract

How do organizations previously dominated by the state develop dynamic capabilities that would support their growth in a competitive market economy? We develop a theoretical framework of organizational transformation that explains the processes by which organizations learn and develop dynamic capabilities in transition economies. Specifically, the framework theorizes about the importance of, and inter‐relationships between, leadership, organizational learning, dynamic capabilities, and performance over three stages of transformation. Propositions derived from this framework explain the pre‐conditions enabling organizational learning, the linkages between types of learning and functions of dynamic capabilities, and the feedback from dynamic capabilities to organizational learning that allows firms in transition economies to regain their footing and build long‐term competitive advantage. We focus on transition contexts, where these processes have been magnified and thus offer new insights into strategizing in radically altered environments.
The Multiple Effects of Business Planning on New Venture Performance
Authors: Burke Andrew , Fraser Stuart , Greene Francis J.
Published: August 2009

abstract

We investigate the multiple effects of writing a business plan prior to start‐up on new venture performance. We argue that the impact of business plans depends on the purpose for and circumstances in which they are being used. We offer an empirical methodology which can account for these multiple effects while disentangling real impact effects from selection effects. We apply this to English data where we find that business plans promote employment growth. This is found to be due to the impact of the plan and not selection effects.
Global Financial Transmission of Monetary Policy Shocks*
Authors: Ehrmann Michael , Fratzscher Marcel
Published: August 2009

The paper analyses the transmission of US monetary policy shocks to global equity markets and the macroeconomic determinants of the underlying transmission process. We show that there is a substantial cross‐country heterogeneity in reactions across 50 equity markets worldwide, with returns falling on average around 2.7% in response to a 100 basis point tightening of US monetary policy, but ranging from a zero response in some to a reaction of 5% or more in other markets. As to the determinants of the strength of transmission to individual countries, we test the relevance of their macroeconomic policies and the role of real and financial integration. We find that in particular the degree of global integration of countries – and not a country's bilateral integration with the United States – is a key determinant for the transmission process.
When Battlefields become Marketplaces: Migrant Workers and the Role of Civil Society and NGO Activism in Thailand
Authors: Pangsapa Piya
Published: August 2009

The vast majority of migrant workers in Thailand are employed predominantly in low‐paying occupations commonly described as “3‐D jobs” (dangerous, dirty, and difficult). Currently, there are nearly two million documented and undocumented migrant workers, mostly from neighbouring Burma, Lao People’s Democratic Republic, and Cambodia, employed in various industries, including domestic service, throughout the country. While over half a million migrants are officially registered to work in the country, both documented and undocumented migrant workers remain unprotected primarily due to the lack of concrete measures to monitor, implement and enforce laws regarding working and living conditions. Regardless of where they are employed, migrant workers face common problems: low wages; harmful working conditions, poor living conditions; discrimination and harassment, the threat of arrest and deportation; and lack of access to basic resources such as medical care and legal assistance. Based on preliminary research conducted in the summer of 2005, this article looks at the situation of migrant factory and domestic workers in Thailand and explores the ways in which local activists, NGOs, community‐based organisations, and international bodies have been looking to assist and protect migrant workers. Successful migrant workers’ struggles and ongoing efforts of mobilization have been made possible with the help of these support groups, and raise the possibility that union and NGO activity have the potential to improve the situation of migrants in Thailand. This also raises the question of whether advocacy groups should be acting in lieu of the state rather than alongside the state, especially when it appears that they are fulfilling their civic duty as enforcer and monitor of migrant workers’ problems.
Adaptation of the Threshold IMT® with double spring load allows higher inspiratory pressure for muscle training
Authors: Fregonezi Guilherme A. F. , Azevedo Ingrid G. , Araujo Thaise L. , Dias Fernando A. L. , Resqueti Vanessa R.
Published: August 2009

Purpose:  We aimed to evaluate the functionality of an adapted inspiratory muscle training device designed to allow pressures higher than 41 cmH2O that can be precisely controlled. The adaptation was made in a commercially available Threshold IMT® device, and the opening pressures and linearity of load were evaluated in an experimental setting.

Methods:  The original IMT Threshold® device was modified by inserting a second spring load juxtaposed to the original spring and then the modified device was coupled to a system designed to assess the range of opening pressures. Linear regression was used to test the correlation between the visual pressure scale of the original device and the opening pressure load obtained from the adapted device.

Results:  For the modified device, we found a range of load from 13·9 ± 0·7 to 85·6 ± 0·7 cmH2O. Linear regression analysis of our data found an excellent relation between the modified device’s opening pressure and the preset opening pressure marked on the visual scale in the original device, y = −1·275 + 2·08x, r2 = 0·99 and P = 0·0001.

Conclusion:  The Threshold IMT® adaptation proposed here is simple, affordable, precise, safe and allows for a high degree of reproducibility. It also achieves pressures higher than 41 cmH2O that can be used when training inspiratory muscles.
AFPAK Drone Strikes Are Only Game in Town
Authors: PANETTA LEON
Published: August 2009

President Barack Obama has extended the hand of engagement to the Muslim and Arab world, while warning Israel against new settlements in occupied Palestine and hedging his bets with remote drone strikes against Al‐Qaida and the Taliban in Pakistan. The new CIA director, a military historian and the Somali‐born feminist Ayaan Hirsi Ali assess his strategy.
From Colonial Air Attacks to Drones in Pakistan
Authors: SATIA PRIYA
Published: August 2009

President Barack Obama has extended the hand of engagement to the Muslim and Arab world, while warning Israel against new settlements in occupied Palestine and hedging his bets with remote drone strikes against Al‐Qaida and the Taliban in Pakistan. The new CIA director, a military historian and the Somali‐born feminist Ayaan Hirsi Ali assess his strategy.
Obama Is No Better Than Bush
Authors: EL SAADAWI NAWAL
Published: August 2009

President Barack Obama has extended the hand of engagement to the Muslim and Arab world, while warning Israel against new settlements in occupied Palestine and hedging his bets with remote drone strikes against Al‐Qaida and the Taliban in Pakistan. The new CIA director, a military historian and the Somali‐born feminist Ayaan Hirsi Ali assess his strategy.
The iPod and the Queen, the Kindle and the King
Authors: ALI AYAAN HIRSI
Published: August 2009

President Barack Obama has extended the hand of engagement to the Muslim and Arab world, while warning Israel against new settlements in occupied Palestine and hedging his bets with remote drone strikes against Al‐Qaida and the Taliban in Pakistan. The new CIA director, a military historian and the Somali‐born feminist Ayaan Hirsi Ali assess his strategy.
Current Status of Academic Emergency Medicine within Academic Medicine in the United States
Authors: Gallagher E. John , Goldfrank Lewis R. , Anderson Gail V. , Barsan William G. , Levy Richard C. , Sanders Arthur B. , Strange Gary R. , Trott Alexander T.
Published: August 2009

ABSTRACT

Objective: To characterize the status of emergency medicine within U.S. academic medical centers.

Methods: All accredited emergency medicine residency programs and all four‐year allopathic medical schools in the United States were identified. Institutions were defined as academic medical centers based upon NIH research grant funding. These institutions were ranked using five measures of academic stature: a survey of medical school deans, a survey of internal medicine residency directors, level of research funding, characteristics of the student body, and an unweighted composite variable reflecting overall academic stature. The relationship between institutional academic stature and an empiric scale of institutional affiliation with emergency medicine was assessed.

Results: Sixty‐two institutions were designated academic medical centers. These medical schools captured 90% of all NIH grant monies awarded in fiscal year 1990. Twenty‐six of 87 emergency medicine residency programs (30%) were closely affiliated with one of these medical schools. Within academic medical centers, the presence of a residency or an academic department of emergency medicine was inversely associated with the medical school deans' ranking (p < 0.005), research rank (p < 0.001), and composite academic rank (p < 0.0001).

Conclusion: The majority of emergency medicine residency programs (70%) are not closely affiliated with institutions receiving the bulk (90%) of NIH resources for research. Within the institutions receiving the majority of NIH funding, there is a quantitatively and statistically significant inverse association of institutional emergency medicine affiliation and institutional academic rank.
Substance Use and Alcohol Abuse in Emergency Medicine Training Programs, by Resident Report
Authors: McNamara Robert M. , Sanders Arthur B. , Ling Louis , Witzke Donald B. , Bangs Kathleen A.
Published: August 2009

ABSTRACT

Objective: To determine the prevalence of substance use and alcohol abuse among emergency medicine residents.

Method: The study instrument was an anonymous, self‐report survey that assessed the use of 13 substances and included the CAGE questions for measuring alcohol abuse. The survey was administered to emergency medicine residents at the time of the American Board of Emergency Medicine's annual In‐Service Examination.

Results: Alcohol was the substance most commonly used by emergency medicine residents for nonmedical reasons. Using the CAGE score, 4.9% of residents were classified as alcoholic and another 7.6% as suspect for alcoholism, rates similar to those for housestaff of all specialties as reported in earlier studies. Instruction related to physician impairment during training in their emergency medicine residency was reported by only 36% of the respondents.

Conclusions: Emergency medicine residents report a low rate of illicit substance use and do not appear to misuse alcohol differently than other housestaff. Interpretation of these results must be tempered with the potential for underreporting that may occur with a voluntary self‐report survey of a sensitive nature.

Acad. Emerg. Med. 1994; 1:47–53.
Retropharyngeal and Bowel Hematomas in an Anticoagulated Patient
Authors: Sinert Richard , Scalea Thomas
Published: August 2009

ABSTRACT

As the indications for oral anticoagulation therapy increase, the number of patients being treated with anticoagulants and at risk for complications also will rise. Major bleeding episodes have been reported to occur in approximately 2–4% of patients being treated with oral anticoagulants. The case report of a patient with concurrent spontaneous retropharyngeal and small‐bowel hematomas from overanticoagulation with warfarin is presented. The authors review the subtle presentation of retropharyngeal hematomas, common medications that may enhance warfarin anticoagulation, and therapy of potentially life‐threatening hematomas. Airway management and possible surgical therapies to treat the complications of hematomas are discussed. Depending upon the indication for the initial anticoagulation, interim anticoagulation with heparin may be indicated.

Acad. Emerg. Med. 1994; 1:67–72.
Can Money and Morality Mix in Medicine?
Authors: Caplan Arthur L.
Published: August 2009

ABSTRACT

The escalation of health care costs in the United States has become a problem now that business and taxpayers are paying larger shares of these costs. Many believe that the only way to cope with rising costs is to institute explicit rationing of access to health care services. Proposals to ration based upon age, “sin” exclusions, physician gatekeeper incentives, patient ability to pay, and community values all have shortcomings. An alternative approach to controlling costs that emphasizes efficiency by cutting administrative and malpractice overhead costs and universally providing those medical services that have proven patient benefit is proposed. Physicians must take a more active role in the debate to ensure that patient needs are met and that expenditures are directed toward effective therapies.
Activity and impulsive action are controlled by different genetic and environmental factors
Authors: Loos M. , Van Der Sluis S. , Bochdanovits Z. , Van Zutphen I. J. , Pattij T. , Stiedl O. ,   Neuro‐BSIK Mouse Phenomics consortium, Smit A. B. , Spijker S.
Published: August 2009

Both impulsivity in operant tasks and locomotor activity in a novel open field are known to predict the development of addiction‐related behavior in rodents. In this study, we investigated to what extent impulsivity in the five‐choice serial reaction time task and various measures of novelty exploration are controlled by shared genetic and environmental factors in 12 different inbred mouse strains. No genetic correlation was observed between the level of impulsivity and levels of activity, a low correlation was observed with traditional measures of anxiety‐like behavior (impulsive strains tend to be less anxious) and a highly significant correlation was found between impulsivity and specific aspects of movement. Furthermore, we found that impulsivity and all measures of novelty exploration were under control of different environmental factors. Interestingly, in the dorsal medial prefrontal cortex, a brain region involved in impulsivity and activity in novelty exploration tests; these behavioral measures correlated with the expression of different genes (respectively, Frzb, Snx5, BC056474 and the previously identified Glo1). Taken together, our study shows that impulsivity and activity in novelty exploration tests are genetically and environmentally distinct, suggesting that mouse models of these behaviors provide complementary insights into the development of substance abuse disorder.
The Emerging Era of Novel Tropical Forests
Authors: Lugo Ariel E.
Published: August 2009

In 1966 Eugene P. Odum delivered a speech before the Ecological Society of America that transformed the way ecologists looked at succession. His comparison of mature and successional systems lead ecologists to place secondary forests in an inferior position relative to mature ones to the point that today, prominent tropical biologists argue for and against the conservation value of secondary forests. Nevertheless, we live in the era of secondary forests that is rapidly giving way to a new era of novel tropical forests. Research in Puerto Rico documents the emergence of novel forests, which are different in terms of species composition, dominance, and relative importance of species from forests that were present before the island was deforested. These novel forests emerged without assistance. They are a natural response to the new environmental conditions created by human activity. Natural processes have remixed or reassembled native and introduced plant and animal species into novel communities adapted to anthropogenic environmental conditions. Novel forests are expected to protect soils, cycle nutrients, support wildlife, store carbon, maintain watershed functions, and mitigate species extinctions. The dawn of the age of tropical novel forests is upon us and must not be ignored.
The Calculated Ionization Potential and Electron Affinity of Cationic Cyanine Dyes
Authors: Delgado Juan C. , Ishikawa Yasuyuki , Selsby Ronald G.
Published: August 2009

The ionization potential (IP) and electron affinity (EA) of the isolated single dye molecule and a hypothetical isolated J‐aggregated dimer are calculated as an energy difference between separately minimized ground and ionized states. Three quantum methods are employed: density functional theory (DFT) Gaussian03 B3LYP/6‐311G** (++G**); DFT using Dmol3; and a modification of CNDO/S, called CNDO/S‐Δζ, which is developed for rapid calculation of the IP and EA. Results indicate that for the monomer, 1,1′‐dimethyl‐2,2′carbocyanine chloride, the vertical IP and EA are 6.2 ± 0.1 and 1.90 ± 0.05 eV, respectively. This is consistent with the threshold IP and EA predicted by the Yianoulis and Nelson “Statistical Model” of spectral sensitization. For the isolated J‐aggregated dimer, whose configuration is consistent with being adsorbed on a dielectric substrate, the calculations predict a value of 5.2 ± 0.2 and 2.35 ± 0.05 eV for the IP and EA, respectively. Significant charge density is removed from the halide anion in the ionization process. The HOMO of the dye molecule is an MO associated with the halide anion. Calculation of theisolated entitiesis a necessary preliminary step in the study of the IP and EA of theadsorbeddye monomer and aggregate.
The Research‐Informed Clinician: A Guide to Training the Next‐Generation MFT
Authors: Karam Eli A. , Sprenkle Douglas H.
Published: August 2009

The gap between clinical research and practice is a major challenge facing marriage and family therapy (MFT) training programs. Until now, the answer to bridge this gap has primarily been the Boulder Scientist‐Practitioner Model. Although realistic for doctoral students, it may not be a good fit for MFT master’s students who have primarily clinical career ambitions—which we believe is a legitimate and positive career choice. The following article articulates a “research informed” perspective as opposed to the scientist‐practitioner framework as a research‐training model for clinically oriented MFT master’s programs. After articulating the similarities and differences between these two approaches, the authors outline 10 practical ideas to integrate research into programs that desire to remain clinical in focus, but also research informed.
The Families and Democracy and Citizen Health Care Project
Authors: Doherty William J. , Mendenhall Tai J. , Berge Jerica M.
Published: August 2009

This article describes and updates the work of the Families and Democracy and Citizen Health Care Project, which engages with community concerns in order to effect change on many system levels. The project draws on family therapy's tradition of interest in larger social issues and adds democratic public theory and community organizing strategies. Since 1999 we have developed 14 citizen initiatives with a wide range of groups on a diverse set of problem areas. We describe the overall project and several of its initiatives, we address research and evaluation issues, and we outline opportunities for marriage and family therapists to learn how to do this work in their own communities.
A Prospective, Randomized, Double‐Blinded, Placebo‐Controlled Study of Human Intravenous Immunoglobulin for the Acute Management of Presumptive Primary Immune‐Mediated Thrombocytopenia in Dogs
Authors: Bianco D. , Armstrong P.J. , Washabau R.J.
Published: August 2009

Background:Immune‐mediated thrombocytopenia (IMT) is a common hematologic disorder in dogs. Human intravenous immunoglobulin (hIVIG) may have a beneficial effect in canine IMT.

Hypothesis:A single hIVIG infusion (0.5 g/kg) in dogs with presumed primary IMT (pIMT) is a safe adjunctive emergency treatment to accelerate platelet count recovery and shorten hospitalization time without increasing the cost of patient care.

Animals:Eighteen client‐owned dogs with a presumptive diagnosis of pIMT.

Methods:Prospective, randomized, double‐blinded, placebo‐controlled clinical trial.

Results:There were no identifiable immediate or delayed adverse reactions associated with hIVIG administration over a 6‐month period. The median platelet count recovery time for the hIVIG group was 3.5 days (mean ± SD: 3.7 ± 1.3 days; range, 2–7 days) and 7.5 days (mean ± SD: 7.8 ± 3.9 days; range, 3–12 days) for the placebo group. The median duration of hospitalization for hIVIG group was 4 days (mean ± SD: 4.2 ± 0.4 days; range, 2–8 days) and 8 days (mean ± SD: 8.3 ± 0.6 days; range, 4–12 days) for the placebo group. There was no significant difference between groups with respect to expense of initial patient care, whereas significant reduction in platelet count recovery time (P= .018) and duration of hospitalization (P= .027) were detected in the hIVIG group.

Conclusions and Clinical Importance:Compared with corticosteroids alone, adjunctive emergency therapy of a single hIVIG infusion was safe and associated with a significant reduction in platelet count recovery time and duration of hospitalization without increasing the expense of medical care in a small group of dogs with presumed pIMT.
The Use of a Nano- and Microporous Surface Layer to Enhance Boiling in a Plate Heat Exchanger
Authors: Furberg Richard , Palm Björn , Li Shanghua , Toprak Muhammet , Muhammed Mamoun
Published: August 2009

Presented research is an experimental study of the performance of a standard plate heat exchanger evaporator, both with and without a novel nano- and microporous copper structure, used to enhance the boiling heat transfer mechanism in the refrigerant channel. Various distance frames in the refrigerant channel were also employed to study the influence of the refrigerant mass flux on two-phase flow heat transfer. The tests were conducted at heat fluxes ranging between 4.5 kW/m2 and 17 kW/m2 with 134a as refrigerant. Pool boiling tests of the enhancement structure, under similar conditions and at various surface inclination angles, were also performed for reasons of comparison. The plate heat exchanger with the enhancement structure displayed up to ten times enhanced heat transfer coefficient in the refrigerant channel, resulting in an improvement in the overall heat transfer coefficient with over 100%. This significant boiling enhancement is in agreement with previous pool boiling experiments and confirms that the enhancement structure may be used to enhance the performance of plate heat exchangers. A simple superposition model was used to evaluate the results, and it was found that, primarily, the convective boiling mechanism was affected by the distance frames in the standard heat exchanger. On the other hand, with the enhanced boiling structure, variations in hydraulic diameter in the refrigerant channel caused a significant change in the nucleate boiling mechanism, which accounted for the largest effect on the heat transfer performance.
Effect of Thermal Modulation on the Onset of Electrothermoconvection in a Dielectric Fluid Saturated Porous Medium
Authors: Rudraiah N. , Gayathri M. S.
Published: August 2009

An electroconvection in a horizontal dielectric fluid saturated with a densely packed porous layer is investigated under the simultaneous action of vertical electric field and vertical temperature gradient when the walls of the layer are subjected to time periodic temperature modulation. The dielectric constant is assumed to be a linear function of temperature. A regular perturbation method based on small amplitude of applied temperature field is used to compute the critical values of Rayleigh number and wave number. The shift in the critical Rayleigh number is calculated as a function of frequency of modulation, electric Rayleigh number, Prandtl number, and Darcy number, and their effects on the critical Rayleigh number are discussed. The situations which are favorable for the design of artificial organs without the side effect of hemolysis are explained.
The Modeling of Form Drag in a Porous Medium Saturated by a Power-Law Fluid
Authors: Nield D. A.
Published: August 2009

The alternative ways of modeling form drag in a porous medium saturated by a power-law fluid in current usage are discussed. It is argued that the best alternative is to use the same expression as that used in the case of a Newtonian fluid, but with a modified Forchheimer coefficient.
Recent Studies of Adaptive Tuned Vibration Absorbers/Neutralizers
Authors: Kela Lari , Vähäoja Pekka
Published: August 2009

This article gathers together the most recent articles of adjustable tuned vibration absorbers. The tuned vibration absorber was invented over 100 years ago, and its adjustability is also already well-known. However, concentration of this review was only on articles published since the year 2000 in peer reviewed journals, except from certain elementary books and some previous review articles in order to keep up with the current events in this broad field. First a brief inspection of the theory of tuned vibration absorbers (TVAs) is presented. After that mechanical TVAs are presented more carefully. In the same chapter the following are also handled: virtual absorbers, absorbers with adjustable damping, and Helmholtz resonators. Own chapter is allocated for multiple TVAs whose idea is to replace adjustability by adding several TVAs to primary system to damp out vibrations in the wide frequency band. The review section is completed by presenting smart material TVAs, which include, e.g., piezoelectric materials, shape-memory alloys, electrorheological and magnetorheological materials of fluids. An adjustable Helmholtz resonator in a low pressure hydraulic system is presented in Sec. 5. Experiments verify the efficiency of the damping character of the adjustable Helmholtz resonator whose resonant frequency can be varied.