bluuebunny/crossref_metadata_2025 huggingface dataset:
Barriers to blood donation in African communities in Australia: the role of home and host country culture and experience
Authors: Polonsky Michael Jay , Renzaho André M.N. , Brijnath Bianca
Published: February 2011

BACKGROUND: An influx of African migrants and refugees can strain a host country's blood services, because often migrants have unique blood needs that cannot be sourced from local donors. To increase blood donation by the new migrants, host country blood services need to understand how blood and blood donations are viewed by immigrant communities, because recruitment models that are not culturally adapted may have limited success.

STUDY DESIGN AND METHODS: Nine focus groups representing a cross‐section of Australian‐based African communities were conducted in multiple languages, facilitated by bilingual workers. The qualitative protocol was guided by the literature on blood donation by African migrants and communities in Africa. Thematic analysis identified the relevance of issues previously included in the literature and whether other issues facilitated or prohibited blood donation.

RESULTS: Home country cultural issues were not generally raised as barriers to donation, and respondents were positively disposed toward donation. Home country experiences shaped respondents' views in Australia. Participants focused on assisting “individuals in need,” rather than giving to a blood service that many viewed with suspicion because of issues in their home country. There was a lack of knowledge about the donation process in Australia. More importantly, respondents perceived that their blood would not be wanted, based on a perception of host country mistrust and discrimination.

CONCLUSION: Developing an intervention that encourages migrants to donate blood needs to be culturally focused. It appears that addressing perceptions based on home country experiences is essential. Overcoming a general perception of discrimination is beyond any blood service, but there can be an attempt to ensure that blood donation is seen as an inclusive process—blood from everyone, for everyone.
Infusion of allogeneic natural killer cells in a patient with acute myeloid leukemia in relapse after haploidentical hematopoietic stem cell transplantation
Authors: Nguyen Stéphanie , Béziat Vivien , Norol Françoise , Uzunov Madalina , Trebeden‐Negre Hélène , Azar Nabih , Boudifa Ali , Bories Dominique , Debré Patrice , Vernant Jean‐Paul , Vieillard Vincent , Dhédin Nathalie
Published: February 2011

BACKGROUND: Allogeneic donor natural killer (NK)‐cell infusion (NK‐DLI) is a promising immunotherapy for patients with hematologic disorders.

CASE REPORT: This report describes the case of a patient who received a single haploidentical NK‐DLI for a relapse of acute myeloid leukemia (AML) after haploidentical hematopoietic stem cell transplantation. He underwent a cytoreductive, immunosuppressive regimen before NK‐DLI and received high‐dose interleukin‐2 in vivo for 8 weeks afterward.

RESULTS: No major adverse effect was observed. Prospective phenotypic and functional studies of the NK cells showed major expansion of infused NK cells and, more importantly, of the alloreactive KIR2DL1+KIR2DL2/DL3–NKG2A– subset, which reached 117 × 106 cells/L on Day +14 after NK‐DLI, the greatest expansion of infused alloreactive NK cells reported so far. Infused NK cells conserved their lytic capacities against K562 target cells and primary AML‐mismatched blasts.

CONCLUSION: We review the literature to clarify these data and to detail the indications for allogeneic NK‐DLI, the criteria for determining the most suitable donor, the types of conditioning regimens, and the procedures for selecting and activating NK cells.
A Study of the Diffusion of Alternative Fuel Vehicles: An Agent‐Based Modeling Approach*
Authors: Zhang Ting , Gensler Sonja , Garcia Rosanna
Published: February 2011

This paper demonstrates the use of an agent‐based model (ABM) to investigate factors that can speed the diffusion of eco‐innovations, namely alternative fuel vehicles (AFVs). The ABM provides the opportunity to consider the interdependencies inherent between key participants in the automotive industry: manufacturers, consumers, and governmental agencies. Agent‐based models allow for tackling these interdependencies in a very elegant way. Because ABMs allow convenient modeling of the interactions between multiple agents, each with unique optimization goals, it provides a method for understanding consumer and manufacturer response to diverse environmental changes. Grounding the agent‐based model on empirical data further improves the validity of the model results. We use choice‐based conjoint data of more than 7,000 respondents to elicit heterogeneous consumer preferences. Further, information about manufacturers' cost structure is available from an established vehicle design tool, AVCEM. In three experiments, mechanisms are considered for speeding the adoption of AFVs: technology push, market pull, and regulatory push. Simulation results support the idea that technology push can be an important mechanism for speeding the diffusion of AFVs. Market pull, that is, word of mouth, also has a positive impact on the diffusion of AFVs and increases the social good by decreasing the preference for fuel‐inefficient vehicles. Furthermore, word of mouth leads to a higher willingness to pay for AFVs, which indicates that the perceived value of AFVs increases with word of mouth. In contrast, a governmental push that focuses on the manufacturers (fuel economy mandates) leads to a decrease in the social good (air pollution improvement) because market share for fuel‐inefficient vehicles increases. This article provides insights into how to set up an ABM to evaluate factors that influence the diffusion of alternative fuel vehicles. These insights can be applied to other types of eco‐innovations.
Opinion Leaders' Role in Innovation Diffusion: A Simulation Study
Authors: van Eck Peter S. , Jager Wander , Leeflang Peter S. H.
Published: February 2011

This study investigates the critical role that opinion leaders (or influentials) play in the adoption process of new products. Recent existing reseach evidence indicates a limited effect of opinion leaders on diffusion processes, yet these studies take into account merely the network position of opinion leaders without addressing their influential power. Empirical findings of our study show that opinion leaders, in addition to having a more central network position, possess more accurate knowledge about a product and tend to be less susceptible to norms and more innovative. Experiments that address these attributes, using an agent‐based model, demonstrate that opinion leaders increase the speed of the information stream and the adoption process itself. Furthermore, they increase the maximum adoption percentage. These results indicate that targeting opinion leaders remains a valuable marketing strategy.
Simulating the Cinema Market: How Cross‐Cultural Differences in Social Influence Explain Box Office Distributions
Authors: Broekhuizen Thijs L. J. , Delre Sebastiano A. , Torres Anna
Published: February 2011

This paper uses a mixed method approach to show how cross‐cultural differences in social influences can explain differences in distributions of market shares in different markets. First, we develop a realistic agent‐based model that mimics the behavior of movie visitors and incorporates the social influences visitors exert on each other before and after visiting movies. The simulation results indicate that market inequalities are determined by social influences. In particular, we find that the social influence derived from the intended behaviors of others (coordinated consumption effect) has a stronger effect on market inequalities than the social influence derived from the past behavior of others (imitation effect). Second, we empirically validate the simulation results by conducting a cross‐national survey that makes use of the cross‐cultural differences in Hofstede's collectivism‐individualism index as a proxy for the level of social influence present in a market. The results of this field study, performed in China, the Netherlands, Italy, and Spain, empirically show that social influences differ across countries, and that these differences can explain the apparent differences in the dispersion of movies' market shares. The empirical survey further contributes to understanding the role of social influence by revealing a U‐shaped relationship between Hofstede's collectivism‐individualism index score and the degree of social influence.
Recovery of Pacemakers and Defibrillators for Analysis and Device Advance Directives: Electrophysiologists’ Perspectives
Authors: LOGANI SACHIN , GOTTLIEB MAIA , VERDINO RALPH J. , BAMAN TIMIR S. , EAGLE KIM A. , KIRKPATRICK JAMES N.
Published: February 2011

Background: Following high‐profile device failures, the Heart Rhythm Society emphasized the need for postmarketing surveillance by recommending that physicians return all explanted devices to the manufacturer for analysis.

Methods: We conducted a national survey of electrophysiologists (EPs) regarding recovery for analysis of explanted pacemakers and implantable cardioverter defibrillators (devices), and attitudes toward device‐specific advance directives to facilitate return of devices. Online survey invitations were sent in four waves from December 2008 to June 2009 to 300 e‐mail addresses from the Heart Rhythm Society member database.

Results: From 250 invitations, there were 95 responses (38%). Demographics included average age 50 years (range, 31–87); 95% male; 81% Caucasian. Only 23% reported returning all explanted devices to the manufacturers. Of all the respondents, 32% discarded >10 devices/year as medical waste, 42% stored devices in a box in the electrophysiology lab, and 10% donated at least 1 device/year to charity for reuse overseas. Sixty‐seven percent felt that it would not be helpful to have an advance directive specifying what the patient would want done with their device postmortem.

Conclusions: Few EPs return all explanted devices or send interrogation reports to the manufacturers, though nearly all said it was easy to do so. A majority either dispose of explanted devices as medical waste or store them in laboratories or offices, and a small percentage donate for reuse in underserved nations or to veterinary hospitals. This study suggests a need for initiatives such as educational campaigns to increase the retrieval and return of devices, either for analysis or reuse. (PACE 2011; 659–665)
Indications and Outcome of Implantable Cardioverter‐Defibrillators for Primary and Secondary Prophylaxis in Patients with Noncompaction Cardiomyopathy
Authors: CALISKAN KADIR , SZILI‐TOROK TAMAS , THEUNS DOMINIC A.M.J. , KARDOS ATTILA , GELEIJNSE MARCEL L. , BALK AGGIE H.M.M. , VAN DOMBURG RON T. , JORDAENS LUC , SIMOONS MAARTEN L.
Published: February 2011

Prophylactic ICDs for Noncompaction Cardiomyopathy. Background: Noncompaction cardiomyopathy (NCCM) is a rare, primary cardiomyopathy, with initial presentation of heart failure, emboli, or arrhythmias, including sudden cardiac death. Implantable cardioverter‐defibrillators (ICDs) are frequently used for primary and secondary prevention in different cardiomyopathy patients, but data about ICD in NCCM are scarce. The aim of this study was, therefore, to investigate ICD indications and outcomes in NCCM patients.

Methods and Results: We collected prospective data from our NCCM cohort (n = 77 pts, mean age: 40 ± 14 years). ICD was implanted in 44 (57%) patients with NCCM according to the current ICD guidelines for nonischemic cardiomyopathies: in 12 for secondary prevention (7 × ventricular fibrillation, 5 × sustained ventricular tachycardia [VT]) and in 32 patients for primary prevention (heart failure/severe LV dysfunction). During a mean follow‐up of 33 ± 24 months, 8 patients presented with appropriate ICD shocks due to sustained VT after median 6.1 [1–16] months. This included 4 of 32 (13%) patients in the primary prevention group and 4 of 12 (33%) in the secondary prevention group (P = 0.04). 9 patients presented with inappropriate ICD therapy: 6 (19%) in the primary and 3 (25%) in the secondary prevention group, at a median follow‐up of 4 (2–23) months.

Conclusions: In our cohort of NCCM patients, an ICD was frequently implanted for primary or secondary prevention of sudden cardiac death. At follow‐up, frequent appropriate ICD therapy was observed in both groups, supporting the application of current ICD guidelines for primary and secondary prevention of sudden cardiac death in NCCM. (J Cardiovasc Electrophysiol, Vol. 22, pp. 898‐904, August 2011)
Time‐ and Frequency‐Domain Characteristics of Atrial Electrograms During Sinus Rhythm and Atrial Fibrillation
Authors: CHANG SHENG‐HSIUNG , ULFARSSON MAGNUS , CHUGH AMAN , YOSHIDA KENTARO , JONGNARANGSIN KRIT , CRAWFORD THOMAS , GOOD ERIC , PELOSI FRANK , BOGUN FRANK , MORADY FRED , ORAL HAKAN
Published: February 2011

Ablation and Spectral Characteristics of Fibrillation. Background: Complex fractionated atrial electrograms (CFAE) have been considered to be helpful during catheter ablation of atrial fibrillation (AF). The purpose of this study was to analyze the characteristics of CFAEs recorded during sinus rhythm (SR) and AF, and to determine their relationship to perpetuation of AF and clinical outcome.

Methods and Results:
Antral pulmonary vein isolation (APVI) was performed in 34 consecutive patients (age = 59 ± 10 years) with paroxysmal AF who presented in SR. Time‐ and frequency‐domain characteristics of electrograms recorded from the same sites in the coronary sinus (CS) were analyzed during SR and AF, before and during isoproterenol infusion. There was a modest correlation in fractionation index (FI: change in the direction of depolarization, r = 0.40, P = 0.001) and complexity index (CI: change in the polarity of depolarization, r = 0.41, P = 0.001), but not in the dominant frequency (DF) between SR and AF. There was no relationship between the DF and CI or FI during AF. Isoproterenol was associated with an increase in DF during AF (6.6 ± 0.9 vs 5.1 ± 0.6 Hz, P < 0.001) but had no effect on CI or FI (P = 0.6). A higher CI (58.3 ± 21.0/s vs 38.0 ± 21.0/s, P < 0.01), and FI (123.5 ± 44.8/s vs 75.6 ± 44.6/s, P < 0.01) during AF were associated with a lower likelihood of termination of AF during APVI and a higher probability of recurrent AF after ablation. Ratio of FI during AF to SR was also higher when AF persisted than terminated after APVI (29.7 ± 12.4 vs 19.1 ± 9.7, P = 0.002). However, time‐ or frequency‐domain parameters during SR were not predictive of termination or clinical outcome.

Conclusions:
Structural and functional properties of the atrial myocardium during AF contribute to electrogram complexity, which may indicate the presence of extra‐PV mechanisms of AF that are not eliminated by APVI. Mapping of complex electrograms in SR is not likely to be sufficient to identify drivers of AF. (J Cardiovasc Electrophysiol, Vol. 22, pp. 851‐857, August 2011)
Phytosanitary Applications of Irradiation
Authors: Hallman Guy J.
Published: February 2011

Abstract:  Phytosanitary treatments are used to disinfest agricultural commodities of quarantine pests so that the commodities can be shipped out of quarantined areas. Ionizing irradiation is a promising phytosanitary treatment that is increasing in use worldwide. Almost 19000 metric tons of sweet potatoes and several fruits plus a small amount of curry leaf are irradiated each year in 6 countries, including the United States, to control a number of plant quarantine pests. Advantages over other treatments include tolerance by most fresh commodities, ability to treat in the final packaging and in pallet loads, and absence of pesticide residues. Disadvantages include lack of acceptance by the organic food industries and logistical bottlenecks resulting from current limited availability of the technology. A regulatory disadvantage is lack of an independent verification of treatment efficacy because pests may be found alive during commodity inspection, although they will not complete development or reproduce. For phytosanitary treatments besides irradiation, the pests die shortly after the treatment is concluded. This disadvantage does not hamper its use by industry, but rather makes the treatment more difficult to develop and regulate. Challenges to increase the use of phytosanitary irradiation (PI) are cost, because commercial use has not yet reached an optimum economy of scale, lack of facilities, because of their cost and current inability to feasibly locate them in packing facilities, lack of approved treatments for some quarantine pests, and concern about the process by key decision makers, such as packers, shippers, and retailers. Methods for overcoming these challenges are discussed.
Effect of bovine bone and collagen membranes on healing of mandibular bone blocks: a prospective randomized controlled study
Authors: Cordaro Luca , Torsello Ferruccio , Morcavallo Sara , di Torresanto Vincenzo Mirisola
Published: February 2011

Aim: The aim of the present study was to evaluate if the use of deprotenized bovine bone mineral (DBBM) and collagen barrier membranes (CM) in combination with mandibular bone block grafts could reduce bone block graft resorption during healing.

Methods: A prospective randomized controlled study has been designed. Twenty‐two ridges presenting horizontal alveolar deficiency (crest width <4 mm) and at least two adjacent missing teeth were included in the study. In the control group, one or multiple mandibular blocks were used to gain horizontal augmentation of the ridge. In the test group, DBBM granules were added at the periphery and over the graft. The reconstructions were covered by two layers of CM. Implants were placed 4 months after grafting. Direct measurements of crest width were performed before and immediately after bone augmentation, and immediately before implant placement.

Results: Statistical analysis showed no significant differences in crest width between test and control groups at baseline and immediately after grafting. Mean augmentation at first surgery in the test group was 4.18 vs. 4.57 mm in the control group. Final gain obtained at the time of implant placement was 3.93 mm in the test and 3.67 mm in the control groups. The difference in mean graft resorption between test and control sites was statistically significant (0.25 mm in the test group vs. 0.89 mm in the control group, P=0.03).

Complications seem to occur more often in the test group (complications recorded in three cases in the test group vs. one complication recorded in the control group). In all cases, implants could be placed in the planned sites and a total of 55 implants were placed (28 in the test group and 27 in the control group). All implants could be considered successfully integrated at the 24‐month follow‐up visit.

Conclusion: The results from this study showed that the addition of bovine bone mineral and a CM around and over a mandibular bone block graft could minimize graft resorption during healing. On the other hand, the use of bone substitutes and barrier membranes in combination with block grafts increased the frequency of complications and the difficulty of their management.

To cite this article:
 Cordaro L, Torsello F, Morcavallo S, Mirisola di Torresanto V. Effect of bovine bone and collagen membranes on healing of mandibular bone blocks: a prospective randomized controlled study. Clin. Oral Impl. Res. 22, 2011; 1145–1150. doi: 10.1111/j.1600‐0501.2010.02093.x
Evaluation of a blended learning course for teaching oral radiology to undergraduate dental students
Authors: Kavadella A. , Tsiklakis K. , Vougiouklakis G. , Lionarakis A.
Published: February 2011

Aims:  The purpose of this study was to develop and implement a blended course (a combined face‐to‐face and online instruction) on undergraduate oral radiology and evaluate it by comparing its educational effectiveness (derived from students’ performance and answers to questionnaires) to a conventional course’s. Students’ attitudes concerning the blended methodology were also registered.

Methodology:  An original course was developed and implemented, and its electronic version was uploaded to an e‐learning educational platform. The course was attended by two groups of final‐year students, who were taught by either the conventional face‐to‐face methodology or the blended learning methodology. Students answered a series of questionnaires, before and after following the course, regarding their perceptions, attitudes and evaluation of the course. Additionally, they completed knowledge assessment tests and their grades (before and after the course) were compared. Educational effectiveness of the course was determined by analysing the results of the questionnaires and the tests.

Results:  Students in the blended group performed significantly better than their colleagues of the conventional group in the post‐course knowledge test, and female students of the blended group performed better than male students. Students evaluated high the course content, organisation, educational material, and the blended group students additionally appreciated the course design and clarity of instructions. Students’ attitudes towards elements of blended learning (effectiveness, motivation and active engagement) were very positive. Most of the blended group students, who attended the face‐to‐face meeting (approx. 91%), evaluated it as helpful for summarising the subject and clarifying difficult issues.

Conclusions:  Blended learning is effective and well evaluated by dental students and can be implemented in undergraduate curriculum for teaching oral radiology.
A large‐scale approach can help detect general processes driving the dynamics of brown trout populations in extensive areas
Authors: Alonso Carlos , García de Jalón Diego , Álvarez Javier , Gortázar Javier
Published: February 2011

Abstract – Most studies on the population dynamics of stream‐living salmonids have been conducted at the scale of a reach, a stream or a river basin. This can lead to overestimating the importance of local factors acting on a reduced scale compared to the more general factors that drive the dynamics of several populations. Two models were built on the basis of a data set from 60 sampling stations representing separated populations inhabiting a large heterogeneous area encompassing 18 years of quantifications. Our analyses showed the following: (i) Population growth rate (pgr) of a set of independent brown trout populations can be described by means of a single model; (ii) the youngest and the oldest year classes of these populations seem to be limited by the same constraints; (iii) there is a climatic control of the recruitment because of spring weather conditions, but also the abundance of oldest age class may be controlled by the climate, (iv) there is a nonlinear positive effect of winter North Atlantic Oscillation on pgr; (v) there is a 3‐year lagged positive feedback tracing the upward trend of a stock‐recruitment curve, and 1‐year lagged negative feedback showing the downward trend of the curve; (vi) a strong cohort has a positive effect on the whole population that can be detected throughout the time. Our fitted models allowed to predict the mean population densities at a regional scale with <10% error and shed light onto the main factors and associated ecological processes that control these large‐scale dynamics.
Colonization and extinction dynamics of an annual plant metapopulation in an urban environment
Authors: Dornier Antoine , Pons Virginie , Cheptou Pierre‐Olivier
Published: February 2011

The metapopulation framework considers that the spatiotemporal distribution of organisms results from a balance between the colonization and extinction of populations in a suitable and discrete habitat network. Recent spatially realistic metapopulation models have allowed patch dynamics to be investigated in natural populations but such models have rarely been applied to plants. Using a simple urban fragmented population system in which favourable habitat can be easily mapped, we studied patch dynamics in the annual plant Crepis sancta (Asteraceae). Using stochastic patch occupancy models (SPOMs) and multi‐year occupancy data we dissected extinction and colonization patterns in our system. Overall, our data were consistent with two distinct metapopulation scenarios. A metapopulation (sensu stricto) dynamic in which colonization occurs over a short distance and extinction is lowered by nearby occupied patches (rescue effect) was found in a set of patches close to the city centre, while a propagule rain model in which colonization occurs from a large external population was most consistent with data from other networks. Overall, the study highlights the importance of external seed sources in urban patch dynamics. Our analysis emphasizes the fact that plant distributions are governed not only by habitat properties but also by the intrinsic properties of colonization and dispersal of species. The metapopulation approach provides a valuable tool for understanding how colonization and extinction shape occupancy patterns in highly fragmented plant populations. Finally, this study points to the potential utility of more complex plant metapopulation models than traditionally used for analysing ecological and evolutionary processes in natural metapopulations.
Prevention of erosive/abrasive enamel wear due to orange juice modified with dietary supplements
Authors: Wegehaupt FJ , Günthart N , Sener B , Attin T
Published: February 2011

Oral Diseases (2011) 17, 508–514

Objective:  The aim of this study was to evaluate the erosive/abrasive enamel wear after contact with orange juices modified with different dietary supplements.

Methods:  A total of 96 bovine enamel samples were prepared and allocated to eight groups (1–8; n = 12). Samples were eroded (120 s) in 200 ml of the following eight solutions: 1: water (control), 2: orange juice, 3: water + calcium effervescent tablet, 4: orange juice + calcium effervescent tablet, 5: water + 0.75 g acid/base regulating powder (Probase), 6: water + 0.375 g Probase, 7: orange juice + 0.75 g Probase and 8: orange juice + 0.375 g Probase. After erosion, the samples were brushed with 40 brushing strokes (load 2.5 N). Enamel wear was measured using surface profilometry after 20 and 40 cycles of erosion/abrasion respectively.

Results:  Highest mean enamel wear (±SD) after 20 and 40 cycles of erosion/abrasion was observed for the unmodified orange juice (group 2) (0.605 ± 0.240 μm; 1.375 ± 0.496 μm respectively). The enamel wear in all other groups (3–8) was significantly lower (P < 0.0001 respectively) with no significant difference within these groups and compared with water (control).

Conclusion:  Erosive/abrasive enamel wear induces by orange juice and tooth brushing could be reduced significantly by modification with free available dietary supplements.
Beta‐defensins: what are they REALLY doing in the oral cavity?
Authors: Diamond G , Ryan LK
Published: February 2011

Oral Diseases (2011) 17, 628–635

Initially identified as broad‐spectrum antimicrobial peptides, the members of the β‐defensin family have increasingly been observed to exhibit numerous other activities, both in vitro and in vivo, that do not always relate directly to host defense. Much research has been carried out in the oral cavity, where the presence of commensal bacteria further complicates the definition of their role. In addition to direct antimicrobial activity, β‐defensins exhibit potent chemotactic activity for a variety of innate immune cells, as well as stimulating other cells to secrete cytokines. They can also inhibit the inflammatory response, however, by the specific binding of microbe‐associated molecular patterns. These patterns are also able to induce the expression of β‐defensins in gingival epithelial cells, although significant differences are observed between different species of bacteria. Together these results suggest a complex model of a host‐defense related function in maintenance of bacterial homeostasis and response to pathogens. This model is complicated, however, by numerous other observations of β‐defensin involvement in cell proliferation, wound healing and cancer. Together, the in vitro, in vivo and human studies suggest that these peptides are important in the biology of the oral cavity; exactly how is still subject to speculation.
HCMV gB genotype and its association with cytokine levels in hematopoietic stem cell transplantation
Authors: Correia‐Silva JF , Resende RG , Arão TC , Abreu MHNG , Teixeira MM , Bittencourt H , Silva TA , Gomez RS
Published: February 2011

Oral Diseases (2011) 17, 530–537

Background:  Glycoprotein B (gB) has been implicated in determining the pathogenicity and clinical outcomes of human cytomegalovirus (HCMV) disease.

Objective:  The purpose of this study was to assess the prevalence of gB genotypes in allogeneic hematopoietic stem cell transplantation (allo‐HSCT) and the relationship between it and cytokine levels in saliva and blood samples. The impact of these parameters on patients’ survival was also investigated.

Methods:  Samples were obtained from 63 patients receiving an allo‐HSCT. HCMV gB genotyping was carried out by multiplex nested PCR. The cytokine levels were assessed using ELISA assay.

Results:  A single or mixed genotype infection was detected in the saliva and blood of 36/63 and 52/63 subjects, respectively. Patients with gB2 in their saliva showed lower IL‐10 levels in comparison with patients without gB2. Reduced blood levels of IFN‐γ and IL‐1β were also found in recipients with the HCMV gB4 genotype compared with patients without it. Decreased IL‐1β and increased IL‐10 blood levels were associated with lower survival. However, HCMV gB genotypes have no impact on patient outcome.

Conclusion:  Decreased IL‐1β and increased IL‐10 levels in the blood are associated with lower survival. HCMV genotypes are associated with different cytokine levels in saliva and blood.
Development of smooth pursuit eye movements in very preterm infants: 1. General aspects
Authors: Strand‐Brodd Katarina , Ewald Uwe , Grönqvist Helena , Holmström Gerd , Strömberg Bo , Grönqvist Erik , von Hofsten Claes , Rosander Kerstin
Published: February 2011

Aim:  To investigate early oculo‐motor development in a population‐based cohort of very preterm infants.

Methods:  Early oculo‐motor development was prospectively studied by measuring smooth pursuit eye movements at 2 and 4 months corrected age in a population of very preterm infants born in Uppsala County 2004–2007. Eighty‐one preterm infants were studied, and 32 healthy term infants constituted the control group.

Results:  The study group consisted of infants with a mean gestational age of 28 + 5 weeks. At 2 and 4 months corrected age, infants born very preterm showed lower gain (p < 0.001) and proportion of smooth pursuit eye movements (p < 0.001) compared to the control group. The boys showed higher gain of smooth pursuit eye movements at both 2 and 4 months corrected age, compared to girls.

Conclusions:  Oculo‐motor development measured by smooth pursuit eye movements is delayed in very preterm infants at 2 and 4 months corrected age. This might be a risk factor or early indicator of later perceptual and behavioural impairment.
Designing new UK‐WHO growth charts: implications for health staff use and understanding of charts and growth monitoring
Authors: Wright Charlotte M. , Sachs Magda , Short John , Sharp Laura , Cameron Kirsty , Moy Robert J.
Published: February 2011

New pre‐school UK charts have been produced incorporating the new World Health Organization growth standards based on healthy breastfed infants. This paper describes the process by which the charts and evidence‐based instructions were designed and evaluated, and what it revealed about professional understanding of charts and growth monitoring. A multidisciplinary expert group drew on existing literature, new data analyses and parent focus groups as well as two series of chart‐plotting workshops for health staff. The first series explored possible design features and general chart understanding. The second evaluated an advanced prototype with instructions, using plotting and interpretation of three separate scenarios on the old charts, compared with the new charts. The first plotting workshops (46 participants) allowed decisions to be made about the exact chart format, but it also revealed widespread confusion about use of adjustment for gestation and the plotting of birthweight. In the second series (78 participants), high levels of plotting inaccuracy were identified on both chart formats, with 64% of respondents making at least one major mistake. Significant neonatal weight loss was poorly recognized. While most participants recognized abnormal and normal growth patterns, 13–20% did not. Many respondents had never received any formal training in chart use. Growth charts are complex clinical tools that are, at present, poorly understood and inconsistently used. The importance of clear guidelines and formal training has now been recognized and translated into supporting educational materials (free to download at http://www.growthcharts.rcpch.ac.uk).
Cloning, expression and characterization of a new aspartate aminotransferase from Bacillus subtilis B3
Authors: Wu Hui‐Jun , Yang Yang , Wang Shuai , Qiao Jun‐Qing , Xia Yan‐Fei , Wang Yu , Wang Wei‐Duo , Gao Sheng‐Feng , Liu Jun , Xue Peng‐Qi , Gao Xue‐Wen
Published: February 2011

In the present study, we report the identification of a new gene from the Bacillus subtilis B3 strain (aatB3), which comprises 1308 bp encoding a 436 amino acid protein with a monomer molecular weight of 49.1 kDa. Phylogenetic analyses suggested that this enzyme is a member of the Ib subgroup of aspartate aminotransferases (AATs; EC 2.6.1.1), although it also has conserved active residues and thermostability characteristic of Ia‐type AATs. The Asp232, Lys270 and Arg403 residues of AATB3 play a key role in transamination. The enzyme showed maximal activity at pH 8.0 and 45 °C, had relatively high activity over an alkaline pH range (pH 7.0–9.0) and was stable up to 50 °C. AATB3 catalyzed the transamination of five amino acids, with l‐aspartate being the optimal substrate. The Km values were determined to be 6.7 mm for l‐aspartate, 0.3 mm for α‐ketoglutarate, 8.0 mm for l‐glutamate and 0.6 mm for oxaloacetate. A 32‐residue N‐terminal amino acid sequence of this enzyme has 53% identity with that of Bacillus circulans AAT, although it is absent in all other AATs from different organisms. Further studies on AATB3 may confirm that it is potentially beneficial in basic research as well as various industrial applications.

Database
 The nucleotide sequence data have been deposited in the GenBank database under accession Numbers AY040867.1
Avoiding in Hospital Delays and Eliminating the Three-Hour Effect in Thrombolysis for Stroke
Authors: Köhrmann Martin , Schellinger Peter D. , Breuer Lorenz , Dohrn Maike , Kuramatsu Joji B. , Blinzler Christian , Schwab Stefan , Huttner Hagen B.
Published: February 2011

Background

Intravenous thrombolysis for acute stroke is more efficient the earlier the treatment is initiated. In-hospital delays account for a significant proportion of avoidable time loss before treatment is initiated. Paradoxically, studies have reported longer door-to-needle times the earlier the patients arrive (‘three-hour effect’).

Hypothesis

We hypothesized that a standardized thrombolysis procedure carried out in a specialized neurological emergency room can minimize in-hospital delays and erase the ‘three-hour effect’.

Methods

Onset-to-door and door-to-needle times of 246 consecutive thrombolysis patients were analyzed. A standardized protocol designed to minimize in-hospital delays was tested using a resident-based stroke team within a neurological emergency room. Correlation of onset-to-door and door-to-needle times was measured as well as differences in treatment times for daytime versus night hours and weekend vs. weekday. Outcome, rate of symptomatic intracranial hemorrhage and mortality were compared with the results of SITS-MOST.

Results

Median door-to-needle time was 25 min compared with a mean of 68 min in SITS-MOST. door-to-needle time did not correlate with onset-to-door time (Pearson's r=−0·097; P=0·13) and patients arriving within 90 min from symptom onset showed comparable door-to-needle times with patients arriving within 90–180 min. Neither treatment on weekends nor during night hours led to significant in-hospital treatment delays. Outcome and safety parameters were comparable with those observed in SITS-MOST.

Conclusions

By applying a standardized and diligently monitored thrombolysis protocol, carried out by a specialized stroke team within a neurological emergency room, in-hospital delays can be minimized. This allows improvement of door-to-needle times irrespective of the time to arrival and treatment during off-hours.
The Effect of Veratrine and Aconitine on the Excitability of Sensory Units in the Tooth of the Cat
Authors: Haegerstam Glenn
Published: February 2011

Intradental sensory nerve impulse activity was recorded by means of electrodes inserted into dentinal cavities In the tooth of the cat. Impulses of different amplitudes was recorded. Local application of aconitine (10‐3 g/ml) and veratrine (10‐3 g/ml) induced nerve impulse activity. A rapid increase in the temperature of the tooth surface to 45–47°C, which is known to induce fluid, movements in the dentinal tubuli, did not induce any nerve impulse activity. However, after pretreatment of a tooth cavity with veratrine a rapid increase in the temperature of the tooth surface gave rise to nerve impulse activity. Steady state impulse activity induced by brief local application of aconitine was influenced by a rapid increase in the temperature of the tooth; during the increase in temperature impulses of low amplitude increased in frequency while impulses of high amplitude were blocked. Furthermore, reduced pressure applied to the exposed dentin, which also induces fluid movements in the dentin, gave rise to nerve impulse activity. Thus the sensory units in the tooth are stimulated by dentinal fluid movements and alkaloids known to excite mechanoreceptors increase their excitability. It is therefore suggested that the intradental sensory nerve endings are mechanosensitive structures.
Renal Renin Output during Continuous Intracarotid Infusions of Iso‐ and Hypertonic Sodium Chloride Solutions in the Rat
Authors: Ericson A.‐C. , Lindbom L.‐O. , Ulfendahl H. R.
Published: February 2011

On male Sprague Dawley rats isotonic NaCl during control and 1 M NaCl were infused either into the carotid artery or i.v. Glomerular filtration rate, sodium output and plasma renin activity were determined. Five of 19 animals reacted with no increase in sodium output for 1 M NaCl and are treated as a different group from the animals reacting with an increased sodium output. For the animals reacting with an increased sodium output a decrease in plasma renin activity was found together with an increase in glomerular filtration rate. In both groups the plasma sodium was constant. The animals not reacting with an increased sodium output had a higher initial plasma renin activity, which did not change during 1 M NaCl infusion. The responses were equal for both intracarotid and i.v. infusions but with a somewhat longer delay before the response occurred with i.v. infusions. These results might be explained by a central nervous effect and by a direct renal effect. Also during 1 M NaCl infusion a possible extracellular volume expansion, derived from water withdrawal from the cells into the extracellular space might occur.
Effect of Adrenaline on the Release of Cyclic AMP by the Rat Diaphragm
Authors: Edén Staffan , Rosberg Sten , Isaksson Olle , Kostyo Jack L.
Published: February 2011

An investigation was made of the effect of adrenaline on the tissue level and release of cyclic AMP (CAMP) into the incubation medium by the isolated rat diaphragm preparation. Adrenaline, added in vitro, caused a dose‐dependent biphasic increase in the tissue level of the nucleotide. A significant elevation of the level of cAMP in the tissue was observed throughout a 60 min incubation period in the presence of 0.01, 0.1 and 10μg/ml of adrenaline. The hormone also produced a small but significant increase in the release of cAMP into the incubation medium. The accumulation of cAMP in the incubation medium ceased after 10 min of incubation in the presence of adrenaline, although the tissue level of the nucleotide remained considerably elevated throughout the entire incubation period. Theophylline potentiated the effect of adrenaline on both the accumulation of cAMP in the tissue and in the incubation medium. Theophylline by itself also increased the tissue level of cAMP slightly. It is concluded from the present study that the elimination of cAMP from the rat diaphragm muscle by release of the nucleotide from the cells is small.
Mg2+‐ and Ca2+‐Stimulated ATPase at the Outer Surface of Human Peripheral Lymphocytes and Hematopoietic Cell Lines. Correlation between Enzyme Activity and Immunoglobulin Secretion
Authors: ÅGren G. , Nilsson K. , Ronquist G.
Published: February 2011

A Mg2+‐ and Ca2+‐dependent ATPase at the outer surface of human peripheral lymphocytes and hematopoietic cell lines has been studied. The enzyme activity varied about 60 fold between the extremes of the cell lines tested. There was no simple relationship between surface‐ATPase activity and cell surface area. Nor was the presence of villi or any other morphological characteristic at the cell surface decisive for the degree of surface‐ATPase activity. A correlation was, however, found between the ATPase activity and a phenomenon probably involving a contractile process namely immunoglohulin secretion, but it was not possible to establish an interdependence of these cell characteristics.
Influence of Adipose Tissue Blood Flow on the Lipolytic Response to Circulating Noradrenaline at Normal and Reduced pH
Authors: Hjemdahl Paul , Fredholm Bertil B.
Published: February 2011

Hypercapnic acidosis (pH 7.0) inhibits the lipolytic response of canine subcutaneous adipose tissue to i.v. infused noradrenaline (NA) by 80 per cent or more. The response to sympathetic nerve stimulation, on the other hand, is only reduced by 1040 per cent during acidosis. The fate of intravenously infused 3H‐labelled NA (0.35 ug × kg‐1× min‐1 for 30 min) was not significantly altered by acidosis. The rate of disappearance of unmetabolized NA from the arterial plasma after an infusion was the same at pH 7.4 and 7.0 and the calculated increase in circulating NA during infusions was 4 ng/ml at both pH:s. I.v. infusion of Na increases adipose tissue blood flow, an effect which is attenuated by acidosis. There was a significant correlation (p< 0.001) between adipose tissue blood flow and the lipolytic response at normal pH. Preventing the NA‐induced increase in blood flow by constant flow perfusion reduced the lipolytic response at normal pH. The degree of inhibition by acidosis of the lipolytic response to i.v. NA was significantly reduced (from 79 to 56 per cent, p < 0.05) when the adipose tissue was perfused at constant flow. These data suggest that adipose tissue blood flow is important in determining the lipolytic response to i.v. NA, probably by influencing the delivery of NA to the tissue. The marked inhibition by acidosis of lipolysis due to i.v. infused NA therefore appears to be the combined effect of a direct antilipolytic effect of acidosis and a decreased delivery of N A to the adipose tissue due to the attenuated blood flow response.
γ‐Aminobutyric Acid Release from Neurons and Glia
Authors: Sellström Å. , Hamberger A.
Published: February 2011

Release of 3H‐GABA into the medium from bulk‐isolated glial cells, neuronal perikarya and synaptosomes has been studied, using a continuous perfusion system. The fractions were incubated with 3H‐GABA and spontaneous efflux of label in the presence and absence of aminooxyacetic acid (AOAA) was recorded. Unlabelled GABA at riiicromolar concentrations markedly stimulated 3H‐GABA efflux from glia, synaptosomes and neurons. 3H‐GABA from all fractions was also markedly sensitive to stimulation by ouahain. Glutamate was effective in stimulating the spontaneous efflux in the presence of AOAA, while superfusion with a calcium‐deprived medium only slightly stimulated the 3H‐GABA efflux from neurons and glia.
Experimental Wounds: Science and Violence in Mid-Century America
Authors: Lindee Susan
Published: February 2011

Taken from a published report on wound ballistics research during World War II, Figure 1 depicts the abdomen of a cat that has been shaved, anesthetized, marked with a grid, and shot. The individual squares are frames, the caption says, “(2880 per second) from a high speed motion picture of a cat’s abdomen, showing the volume changes and movements caused by a 6/32nd inch steel sphere.” We can recognize in this image the conventions of scientific inscription. The technologies are sophisticated, quantitative, impressive. The image speaks for itself. Or does it? What exactly is happening when an anesthetized cat with a shaved abdomen painted with a grid gets shot, in a laboratory, and when that event is hyper-documented in high speed photographs, and deployed in a range of texts as evidence? And what do these human creations — these highly quantified experimental wounds — tell us about the culture and practice of twentieth-century science?
Reasonable Suspicion of Child abuse: Finding a Common Language
Authors: Levi Benjamin H. , Portwood Sharon G.
Published: February 2011

A father brings his six-year-old daughter and her older sister to their pediatrician to be evaluated for a history of cough, runny nose, and low-grade fever. In addition to signs of a cold, the girl's nasal bridge is quite swollen and bruised. When asked how her nose was injured, she shrugs, and her father's only conjecture is that she sleepwalks and might have bumped into something. The father sits impatiently and as questioning progresses becomes increasingly defensive, at one point angrily declaring, “We don't beat our kids, if that's what you’re asking.” Further complicating the situation is information from nurses that this family is “on the brink” socially and financially, and that additional stress is likely “to blow this family apart.” A careful physical exam identifies no other injuries, and a thorough review reveals no evidence of prior suspicious injuries, frequent visits to the emergency room, or bleeding abnormalities. The evidence does not point to abuse as the most likely explanation for the injury, but it clearly is not ruled out. Should one report this family for suspected abuse? Is one required to report?
Harmonization of Ethics Policies in Pediatric Research
Authors: Blake Valarie , Joffe Steve , Kodish Eric
Published: February 2011

The Food and Drug Administration (FDA) and the European Medicines Agency (EMA) have launched a recent initiative to enhance collaboration in research, with the intent to “ensure that clinical trials submitted in drug marketing applications in the United States and European Union are conducted uniformly, appropriately, and ethically.” This initiative recalls efforts from two decades ago when the United States, the European Union and Japan formed the International Conference on Harmonization of Technical Requirements for Registration of Pharmaceuticals for Human Use (ICH) as a mechanism for harmonizing clinical research regulations. The intent of harmonization was to improve patients’ “access to new drugs, to prevent unnecessary global development delays and to avoid animal and human study duplications” through policy reconciliation.

FDA/EMA efforts at collaboration call for a reassessment of past harmonization efforts: to what extent are ICH member policies already synchronized and to what extent can they be harmonized in the future? This paper will focus on these questions through the lens of pediatric investigation.