bluuebunny/crossref_metadata_2025 huggingface dataset:
Novel Application of Proton Pump Inhibitor for the Prevention of Colitis-Induced Colorectal Carcinogenesis beyond Acid Suppression
Authors: Kim Yoon Jae , Lee Jeong Sang , Hong Kyung Sook , Chung Jun Won , Kim Ju Hyun , Hahm Ki Baik
Published: July 2010

Colitis-associated cancers arise in the setting of chronic inflammation wherein an “inflammation-dysplasia-carcinoma” sequence prevails. Based on our previous findings in which the proton pump inhibitor could impose significant levels of anti-inflammatory, antiangiogenic, and selective apoptosis induction beyond gastric acid suppression, we investigated whether omeprazole could prevent the development of colitis-associated cancer in a mouse model induced by repeated bouts of colitis. Omeprazole, 10 mg/kg, was given i.p. all through the experimental periods for colitis-associated carcinogenesis. Molecular changes regarding inflammation and carcinogenesis were compared between control groups and colitis-associated cancer groups treated with omeprazole in addition to chemopreventive outcome. Nine of 12 (75.0%) mice in the control group developed multiple colorectal tumors, whereas tumors were noted in only 3 of 12 (25.0%) mice treated with daily injections of omeprazole. The cancer-preventive results of omeprazole treatment was based on significant decreases in the levels of nitric oxide, thiobarbituric acid–reactive substance, and interleukin-6 accompanied with attenuated expressions of tumor necrosis factor-α, inducible nitric oxide synthase, and cyclooxygenase-2. The expressions of matrix metalloproteinase (MMP)-9, MMP-11, and MT1-MMMP were significantly decreased in mice treated with omeprazole in accordance with significant decreases in the number of β-catenin–accumulated crypts. A significant induction of apoptosis was observed in tumor tissue treated with omeprazole. Omeprazole could block the trophic effect of gastrin in colon epithelial cells. The significant anti-inflammatory, antioxidative, and antimutagenic activities of omeprazole played a cancer-preventive role against colitis-induced carcinogenesis, and our novel in vivo evidence is suggestive of chemopreventive action independent of gastric acid suppression. Cancer Prev Res; 3(8); 963–74. ©2010 AACR.
Circulating Levels of the Adipokine Chemerin in Gestational Diabetes Mellitus
Authors: Pfau Dörte , Stepan Holger , Kratzsch Jürgen , Verlohren Michael , Verlohren Hans-Joachim , Drynda Kathrin , Lössner Ulrike , Blüher Matthias , Stumvoll Michael , Fasshauer Mathias
Published: July 2010

Background: Chemerin was recently introduced as a novel adipokine playing a crucial role in adipocyte differentiation and insulin signaling. In the current study, we investigated circulating chemerin levels in patients with gestational diabetes mellitus (GDM) as compared to healthy pregnant controls matched for gestational age and fasting insulin. Methods: Chemerin was quantified by ELISA in control (n = 80) and GDM (n = 40) patients and correlated to clinical and biochemical measures of renal function, glucose and lipid metabolism, as well as inflammation, in both groups. Results: Median maternal serum chemerin concentrations were not significantly different in subjects with GDM (230.3 µg/l) as compared to healthy pregnant controls (217.6 µg/l). Chemerin significantly and positively correlated with homeostasis model assessment of insulin resistance (HOMA-IR) and serum creatinine in uni- and multivariate analyses. Furthermore, chemerin serum levels were highest in patients in the third tertile of HOMA-IR. Conclusions: Chemerin is independently associated with markers of insulin resistance and renal dysfunction but is not dysregulated in GDM if patients are matched with controls for fasting insulin.
Surgical Management of Craniopharyngiomas in the Pediatric Population
Authors: Zada Gabriel , Laws Edward R.
Published: July 2010

Background: Craniopharyngiomas (CPs) are benign, locally aggressive neoplasms that comprise approximately 10% of pediatric brain tumors. The role of surgical management for CPs is discussed in this review. Methods: A review of the goals and techniques associated with selected surgical approaches for the treatment of CPs in the pediatric population is provided. Results: CPs may be a cause of significant morbidity in children, requiring long-term, multimodal management by a team of specialists in order to optimize patient outcomes. Surgical intervention for CPs remains an important component of treatment, and depends upon establishing realistic and well-defined goals prior to any operation. Many transcranial and transsphenoidal approaches are available for approaching and resecting CPs. A summary of the rationale behind the timing and appropriateness of various surgical approaches, as well as associated benefits, pitfalls, and outcomes, is provided in this review. Conclusion: Consistent longitudinal management by an interdisciplinary team can alter the treatment course in patients with CPs from a debilitating, morbid or lethal condition to a chronic, survivable disease with functional adult livelihood. Excellent outcomes in children with CPs are obtained only by close, frequent monitoring and by developing a keen sense of judgment regarding the appropriateness, timing and aggressiveness of any particular intervention.
Alterations in Lipid and Carbohydrate Metabolism in Patients with Classic Congenital Adrenal Hyperplasia due to 21-Hydroxylase Deficiency
Authors: Zimmermann Anca , Grigorescu-Sido Paula , AlKhzouz Camelia , Patberg Karen , Bucerzan Simona , Schulze Egbert , Zimmermann Tim , Rossmann Heidi , Geiss Hans-Christian , Lackner Karl J. , Weber Matthias M.
Published: July 2010

Background: Classic 21-hydroxylase deficiency (21HD) presents some traits of the metabolic syndrome. Aim: To characterize discrete alterations of lipid and carbohydrate metabolism in children and young adults with classic 21HD, which could predict early atherogenesis. Patients and Methods: Twenty-seven Caucasian patients with classic 21HD (4–31 years); 27 sex-, age- and BMI-matched controls. Clinical parameters, hormonal status and genotype were assessed in all patients. Lipid parameters, including relative (%) and absolute (mg/dl) small-dense low-density lipoproteins subfractions (sd-LDL) were measured in patients and controls. Oral glucose tolerance tests were performed in both groups. Results: sd-LDL (%) was significantly higher in patients than controls (39.7 ± 5.9 vs. 35.5 ± 5.7%; p = 0.008). The same applies for absolute sd-LDL (mg/dl) (42.6 ± 11.9 vs. 36.4 ± 7.5; p = 0.029). HDL-cholesterol was lower in patients (p = 0.032). Fasting glucose and insulin were significantly higher in patients. Similar differences were noticed for HOMA-IR (p = 0.001), IRI (p = 0.001) and HOMA-B (p = 0.002). IRI correlated directly and significantly with the total hydrocortisone dose and the duration of treatment. Fasting glucose correlated with absolute sd-LDL. No obvious differences were seen between clinical forms or genotype groups. Conclusions: Substitution therapy should be adapted particularly at young ages to prevent early atherogenesis and cardiovascular risk in later life.
Apoptosis and Reduced Cell Proliferation of HL-60 Cell Line Caused by Human Telomerase Reverse Transcriptase Inhibition by siRNA
Authors: Miri-Moghaddam Ebrahim , Deezagi Abdolkhaleg , Soheili Zahra Sohaila , Shariati Parvin
Published: July 2010

Background: The close correlation between telomerase activity and human telomerase reverse transcriptase (hTERT) expression has made hTERT to be considered as a selective molecular target for human cancer therapy. In this study, the ability of short-interfering RNA (siRNA) to downregulate hTERT expression and its correlation with cell growth and apoptosis in the promyelocytic cell line HL-60 was evaluated. Materials and Methods: hTERT siRNA was designed and transfected to HL-60. hTERT mRNA expression, cell proliferation and apoptotic cells were measured. Results and Conclusion: The results indicated that hTERT siRNA resulted in 97.2 ± 0.6% downregulation of the hTERT mRNA content; inhibition of the cell proliferation rate was about 52.8 ± 2.3% and the apoptotic index of cells was 30.5 ± 1.5%. hTERT plays an essential role in cell proliferation and control of the viability of leukemic cells, thus promising the development of drugs for leukemia.
Lumbar Puncture: It Is Time to Change the Needle
Authors: Lavi Ronit , Rowe J.M. , Avivi Irit
Published: July 2010

Lumbar puncture is a frequent procedure performed by physicians from several disciplines to help establish a diagnosis and treatment for several diseases. Post-lumbar puncture headache (PLPH) is a frequent complication that typically lasts for a couple of days and can be severe enough to immobilize the patient and to require therapy. There are several risk factors identified, pain characteristics, and characteristic findings on spinal and head magnetic resonance imaging. There are several procedural factors that have been identified to be of consequence in attenuating the PLPH incidence, specifically the needle type and size used for this procedure. Once PLPH occurs, the clinician should treat it conservatively with bed rest, analgesics and increased fluids intake, especially caffeine-containing beverages, as it can dramatically affect the patient’s wellness. If the pain is severe and disabling and does not respond to conservative treatment, a blood patch should be considered at least 24–48 h following the LP. Epidural blood patch is a safe and rapidly effective treatment in experienced hands. Furthermore, patients who developed PLPH should be advised to contact the medical staff in case of changes in the characteristics of headaches. When a patient who was diagnosed with PLPH has a change in the pain character, or additional neurological manifestations appear, an urgent brain CT/head MRI should be performed to exclude rarer life-threatening intracranial complications.
Vitamin D and Ageing: Neurological Issues
Authors: Annweiler Cédric , Schott Anne-Marie , Berrut Gilles , Chauviré Valérie , Le Gall Didier , Inzitari Marco , Beauchet Olivier
Published: July 2010

Objective: Vitamin D has been shown to have multiple biological targets mediated by the vitamin D receptor present in many cells. Specific actions on the central nervous system (CNS) have been described. The objective of this review was to describe the relationship between vitamin D and the nervous system throughout the different stages of life. Methods: A bibliographical search was performed in the MedLine and Cochrane library databases. The keywords used were: ‘vitamin D’ and ‘nervous system’ and/or ‘central nervous system’ and/or ‘nervous system diseases’ and/or ‘psychological tests’ and/or ‘neuropsychological tests’ and/or ‘mental disorders’. The search period ranged from 01/01/1988 to 31/10/2009. Two hundred and ninety-five abstracts were first identified after screening. A final selection of 127 articles was used for the purpose of this review. Results: The studies published over the past 20 years provide an increasing number of arguments in favor of a life-long role of vitamin D on the nervous system as a whole, and in particular on the CNS. During cerebral development, vitamin D may act like a neurosteroid hormone in the areas of neurotransmission, neuroprotection, and neuroimmunomodulation. Moreover, vitamin D deficiency has been associated with neurological and psychiatric disorders. In older adults, hypovitaminosis D has been associated with neuromuscular disorders, dementia, and Parkinson’s disease. Thus, vitamin D supplementation might have a protective effect against these neurological disorders. Conclusions: Vitamin D has been associated with many neurological functions and its deficiency with dysfunction. Low serum 25-hydroxyvitamin D concentrations can potentially be reversed. This simple and low-cost correction might contribute to the primo-secondary prevention of various neuropsychiatric disorders.
Tissue Factor Is Induced by Resistin in Human Coronary Artery Endothelial Cells by the NF-ĸB-Dependent Pathway
Authors: Calabrò Paolo , Cirillo Plinio , Limongelli Giuseppe , Maddaloni Valeria , Riegler Lucia , Palmieri Rosalinda , Pacileo Giuseppe , De Rosa Salvatore , Pacileo Mario , De Palma Raffaele , Golino Paolo , Calabrò Raffaele
Published: July 2010

Objective: Atherosclerosis is characterized by endothelial inflammation and dysfunction. Adipose tissue has increasingly been recognized as an active endocrine organ secreting so-called adipokines. Among these, resistin – recently described, but not yet extensively studied – has been defined as a novel inflammatory marker in atherosclerosis. The pathophysiology underlying this interplay, however, remains to be fully characterized. The aim of the study is to determine whether resistin might affect prothrombotic characteristics of human coronary artery endothelial cells (HCAECs). Methods and Results: Incubation of HCAECs with resistin caused upregulation of tissue factor (TF) expression as demonstrated by FACS analysis. Moreover, TF activity was induced in a dose-dependent manner, as shown by real-time PCR and colorimetric assay. Resistin-induced TF expression was mediated by oxygen free radicals through the activation of the transcription factor nuclear factor-ĸB (NF-ĸB), as demonstrated by electrophoretic mobility shift assay and by suppression of TF expression by superoxide dismutase, catalase, and the NF-ĸB inhibitors PDTC and BAY 11-7082. Conclusions: These data confirm the hypothesis that resistin may contribute to atherothrombosis, exerting direct effects on HCAECs by promoting TF expression; thus, it represents an effector molecule able to induce a prothrombotic phenotype in cells present in the vessel wall.
Angiotensin II Upregulates CaV1.2 Protein Expression in Cultured Arteries via Endothelial H2O2 Production
Authors: Wang Wenze , Pang Li , Palade Philip
Published: July 2010

Background: We previously reported that angiotensin II caused an endothelial-dependent increase in L-type voltage-dependent Ca2+ channel (CaV1.2) in cultured arteries, but the signaling pathways are not clear. Methods: Endothelial damage was generated by brief intra-arterial perfusion with 0.3% CHAPS. CaV1.2 expression, function and H2O2 were measured by Western blot, tension recording and Amplex Red H2O2 assay kit, respectively. Results: Angiotensin II dose-dependently upregulated CaV1.2 expression in endothelium-intact arteries. The angiotensin II upregulation of CaV1.2 expression in endothelium-intact arteries was blocked by NAD(P)H oxidase inhibitor diphenyleneiodonium (DPI), apocynin, a more specific NAD(P)H oxidase inhibitor gp91ds-tat and also by catalase. H2O2 similarly upregulated CaV1.2 expression in endothelium-intact and endothelium-damaged arteries, and the latter effect was also blocked by DPI and apocynin. Angiotensin II increased H2O2 production by endothelium-intact but not by endothelium-damaged arteries, and this effect was blocked by apocynin, catalase and gp91ds-tat. The upregulation of CaV1.2 by angiotensin II and H2O2 is accompanied by an increased tension response to KCl and the Ca2+ channel activator FPL 64176, and this effect was also attenuated by gp91ds-tat. Conclusion: These results suggest that angiotensin II stimulates endothelial NAD(P)H oxidase-produced H2O2, which may additionally act through vascular smooth muscle NAD(P)H oxidase, to upregulate vascular CaV1.2 protein.
Oxygen-Dependent Vasomotor Responses Are Conducted Upstream in the Mouse Cremaster Microcirculation
Authors: Riemann Mads , Rai Amrit , Ngo Anh Thuc , Dziegiel Morten Hanefeld , Holstein-Rathlou Niels-Henrik , Torp-Pedersen Christian
Published: July 2010

Background: A new method was evaluated where local changes in oxygen tension were induced in a tissue while being studied under a microscope in vivo. We tested whether hypoxic vasodilation and hyperoxic vasoconstriction in arterioles in striated muscle are being propagated upstream, and whether the endothelium and smooth muscle cell layers are necessary components in the signaling pathway. Methods: The study was performed in mouse cremaster muscle superfused with Krebs buffer. A section of the capillary bed was then superfused with human red blood cell suspension equilibrated with either 95% nitrogen or 95% oxygen, and 5% carbon dioxide. Results: The superfusions caused a 12.9 ± 2.4% (p < 0.01) dilation and a 12.3 ± 2.7% (p < 0.01) constriction of the supplying non-exposed arteriole. Vasomotor responses could be detected 1 mm upstream of the stimulation site. The responses to hypoxia and hyperoxia were not affected by inhibition of nitric oxide (NO) synthases by L-NAME. Damage to the wall of an intervening segment of the arteriole abolished upstream changes. Conclusions: The method is capable of changing the oxygen tension locally in a membranous tissue and elicits NO-independent local and upstream vasomotor responses. Upstream responses were transmitted by a conducted vascular response.
NR4A Orphan Nuclear Receptors
Authors: Zhao Yue , Bruemmer Dennis
Published: July 2010

Members of the nuclear hormone receptor superfamily, including the peroxisome proliferator–activated receptor and the liver X receptor subfamilies, orchestrate transcriptional networks involved in the control of metabolism and the development of vascular disease. In addition to these well-characterized ligand-activated transcription factors, the nuclear receptor (NR) superfamily comprises many orphan receptors, whose ligands and physiological functions remain unknown. Among this group of orphan receptors is the NR4A subfamily, including Nur77 (NR4A1), Nurr1 (NR4A2), and NOR1 (NR4A3). These orphan NRs constitute an evolutionary ancient and highly conserved group of transcription factors. In contrast to other members of the superfamily, NR4A receptors function as ligand-independent transcription factors and immediate- or early-response genes, which are rapidly induced by a pleiotropy of environmental cues. Early functional studies have pointed to a critical role of NR4A receptors in regulating differentiation, proliferation, and apoptosis. More recent research has characterized NR4A receptors as key transcriptional regulators of glucose and lipid homeostasis, adipogenesis, inflammation, and vascular remodeling. In this review, we will summarize recent advances in understanding the molecular biology and physiological functions of NR4A receptors and discuss their role in the transcriptional control of metabolism and vascular remodeling.
Nuclear Receptors and Inflammation Control: Molecular Mechanisms and Pathophysiological Relevance
Authors: Huang Wendy , Glass Christopher K.
Published: July 2010

Tissue inflammation is a tightly regulated process that normally serves to recruit the immune system to sites of infection and injury and to facilitate tissue repair processes. When an inflammatory state is excessive or prolonged, local and systemic damage to host tissues can result in loss of normal physiological functions. Here, we briefly review recent studies that advance our understanding of signaling pathways involved in initiation of inflammatory responses at the level of transcription and counterregulation of these pathways by selected members of the nuclear receptor superfamily. Studies of the intersection of nuclear receptors and inflammation have revealed mechanisms of positive and negative transcriptional control that may provide new targets for pharmacological intervention in chronic diseases, such as atherosclerosis.
Liver X Receptor Signaling Pathways and Atherosclerosis
Authors: Calkin Anna C. , Tontonoz Peter
Published: July 2010

First discovered as orphan receptors, liver X receptors (LXRs) were subsequently identified as the nuclear receptor target of the cholesterol metabolites, oxysterols. There are 2 LXR receptors encoded by distinct genes: LXRα is most highly expressed in the liver, adipose, kidney, adrenal tissues, and macrophages and LXRβ is ubiquitously expressed. Despite differential tissue distribution, these isoforms have 78% homology in their ligand-binding domain and appear to respond to the same endogenous ligands. Work over the past 10 years has shown that the LXR pathway regulates lipid metabolism and inflammation via both the induction and repression of target genes. Given the importance of cholesterol regulation and inflammation in the development of cardiovascular disease, it is not surprising that activation of the LXR pathway attenuates various mechanisms underlying atherosclerotic plaque development. In this brief review, we will discuss the impact of the LXR pathway on both cholesterol metabolism and atherosclerosis.
Incorporating Spirituality and Religion Into the Treatment of African American Clients
Authors: Boyd-Franklin Nancy
Published: July 2010

This article discusses the process of incorporating spirituality and religion into the treatment of African American clients. It addresses religious diversity within the African American community. The roles of spirituality and religion as survival and coping mechanisms for overcoming racism, adversity, and loss are emphasized. The cases presented in this article discuss religious and spiritual issues of African American clients at different life cycle stages and are illustrative of the presenting problems encountered by counseling psychologists in a variety of mental health settings including counseling centers, clinics, hospitals, community agencies, and private practices. Although extensive research on the role of religion and spirituality in the lives of African Americans is now available, this article makes an important contribution to the literature and to practicing counseling psychologists by providing detailed case examples, particularly those that illustrate the application of these issues in cross-cultural treatment.
Online railway delay management: Hardness, simulation and computation
Authors: Berger André , Hoffmann Ralf , Lorenz Ulf , Stiller Sebastian
Published: July 2010

Delays in a railway network are a common problem that railway companies face in their daily operations. When a train is delayed, it may either be beneficial to let a connecting train wait so that passengers in the delayed train do not miss their connection, or it may be beneficial to let the connecting train depart on time to avoid further delays. These decisions naturally depend on the global structure of the network, on the schedule, on the passenger routes and on the imposed delays. The railway delay management (RDM) problem (in a broad sense) is to decide which trains have to wait for connecting trains and which trains have to depart on time. The offline version (i.e. when all delays are known in advance) is already NP-hard for very special networks. In this paper we show that the online railway delay management (ORDM) problem is PSPACE-hard. This result justifies the need for a simulation approach to evaluate wait policies for ORDM. For this purpose we present TOPSU—RDM, a simulation platform for evaluating and comparing different heuristics for the ORDM problem with stochastic delays. Our novel approach is to separate the actual simulation and the program that implements the decision-making policy, thus enabling implementations of different heuristics to ‘‘compete’’ on the same instances and delay distributions. We also report on computational results indicating the worthiness of developing intelligent wait policies. For RDM and other logistic planning processes, it is our goal to bridge the gap between theoretical models, which are accessible to theoretical analysis, but are often too far away from practice, and the methods which are used in practice today, whose performance is almost impossible to measure.
A Model of Rigid Bodies for Plain-Weave Fabrics Based on the Dynamics of Multibody Systems
Authors: Mingxing Xiao  , Zhaofeng Geng
Published: July 2010

Woven structures form the fundamental difference between woven fabrics and general continuum medium materials. This paper proposes a fabric modeling technique giving a realistic cloth simulation based on the description of woven structures. The ‘three-element unit cell’ of woven structure is put forward to describe the inherent connectivity between yarns. Applying the dynamics of multibody systems theory, a model of rigid bodies for plain-weave fabrics (MRBF) is presented. For uniaxial tensile, qualitative and quantitative dynamic analyzes are carried out. Our qualitative analysis reveals the strong coupling interaction between yarns and the mechanism of crimp interchange. The model is validated by comparison of our simulation results with qualitative analysis and with those obtained from Kawabata Evaluation System for Fabrics (KES) uniaxial tensile experiment.
Decision Fusion for Visual Inspection of Textiles
Authors: Tolba A.S. , Khan H.A. , Mutawa A.M. , Alsaleem S.M.
Published: July 2010

Defect detection of textiles is a necessary requirement for quality control and customer satisfaction. This paper presents a system for decision fusion in order to enhance the accuracy of defect detection in textiles. A multi-classifier decision fusion technique based on majority voting is presented to solve the problems of sensitivity to parameter variation and to make use of the advantages of the individual feature sets for accurate texture characterization. Features based on Gray Level Co-occurrence Matrix (GLCM), Laws Energy (LE) Filter, Local Binary Patterns (LBP), HU Moment invariants, Moment of Inertia (MOI) and Standard Deviation of Gray levels are used to train a set of Learning Vector Quantization (LVQ) classifiers. Detection accuracies of classifiers trained on single-feature sets are compared with those of the majority voting among the individual classifiers. The results obtained from majority voting indicate that the decision fusion technique improves the accuracy and reliability of the detection process. Empirical results indicate the high accuracy of the presented approach. The correct defect detection rate of the proposed approach is 98.64% with an average false acceptance rate of 0.0012.
The Poisson Ratio and Modulus of Elastic Knitted Fabrics
Authors: Zhou Jinyun  , Li Yi  , Lam Jimmy , Cao Xuyong
Published: July 2010

There is a significant Poisson effect for knitted fabric under tensile deformation. It is an important parameter for practical pattern design, numerical simulation of garment pressure distribution and garment dressing system. However, it is still difficult to measure the fabric Poisson ratio quickly and accurately. In this paper, a method for testing the elastic knitted fabric Poisson ratio and modulus was proposed based on orthotropic theory and strip biaxial tensile test. The fabric’s Poisson ratio and Young’s modulus are identified by linear regression, while the obtained values are validated by uniaxial tensile tests.
Auto-generating Uniform Stochastic Web Images for Ink-jet Printing Textiles
Authors: Yang Xu-Hong , Sui Jian-Hua , Bin Meng  , Zhang Xiao-Wei
Published: July 2010

Based on a kind of nonlinear scientific technology—weak chaos, we developed a parameterized program to generate various Uniform Stochastic Web (USW) images, and proposed the methods of transforming mapping function to obtain abundant colorful digital images for ink-jet printing. The ways to edit the images to be textile patterns were also explored, and the patterns were successfully transferred to the textiles by an ink-jet printing machine. This study not only explored a new design resource for textile patterns, but also combined the digital design with the digital textile manufacturing, so it is in favor of perfecting digital textile technology.
Tract Disruption and External Displacement Following Gastrostomy Tube Exchange in Adults
Authors: DiBaise John K. , Rentz Lauri , Crowell Michael D. , Decker G. Anton , Lunsford Tisha
Published: July 2010

Background: Anecdotal reports, mostly in children, indicate that disruption of the gastrostomy tract may occur during gastrostomy tube exchange and cause serious complications. The aim of our study was to determine the rate of tract disruption occurring in adults requiring long‐term enteral nutrition who had an original gastrostomy tube replaced and to evaluate factors contributing to this complication. Methods: We retrospectively reviewed the medical records of all patients who underwent replacement of their gastrostomy tube over a 3‐year period. Information was collected relating to patient demographics, underlying diagnosis, method of insertion and tube type used for initial gastrostomy tube and subsequent tube replacement, staff involved in tube replacement, patient nutritional status at the time of tube change, and the number of days from initial tube placement to replacement. For comparative purposes, the patients were divided into 2 groups: those with tract disruption and those without tract disruption. Results: A total of 182 tube changes in 108 adults were performed; 55 were initial tube changes. Four (7.3%) tract disruptions occurred, all with skin‐level replacement devices and only with the initial replacement of the original gastrostomy tube. There were no significant differences in patient demographics, principal diagnosis, method of insertion and tube type used for initial gastrostomy tube, staff involved in tube replacement, patient nutritional status at the time of tube change, or the number of days from initial tube placement to replacement. Conclusion: Tract disruption occurs infrequently during replacement of gastrostomy tubes and appears to be an issue primarily during the initial tube exchange when using a skin‐level device.
Effect of Free Fatty Acids on Bilirubin–Albumin Binding Affinity and Unbound Bilirubin in Premature Infants
Authors: Amin Sanjiv B.
Published: July 2010

Background: The author has previously shown that intravenous lipid intake may be associated with an increase in unbound bilirubin in infants ≤28 weeks gestational age. The objective of this study was to evaluate whether this increase in unbound bilirubin is mediated by free fatty acids and to examine the secondary effect of free fatty acids on bilirubin–albumin binding affinity. Methods: A prospective study was conducted to include 26 infants ≤32 weeks gestational age with indirect hyperbilirubinemia and receiving intravenous lipids during the first 10 postnatal days. Blood samples were collected for unbound bilirubin, binding affinity, and free fatty acid measurement at varying intravenous lipid intakes (1–3 g/kg/d). Regression analyses were performed to evaluate the roles of free fatty acids and binding affinity as mediators. Results: Intravenous lipid intake was significantly associated with an increase in free fatty acids and unbound bilirubin in infants ≤28 weeks but not >28 weeks gestational age. In infants ≤28 weeks gestational age, each unit increase in free fatty acids was significantly associated with a decrease in binding affinity, which was significantly associated with an increase in unbound bilirubin. Conclusions: In infants ≤28 weeks gestational age, intravenous lipid intake may be associated with an increase in unbound bilirubin, and this is mediated by an increase in free fatty acids and a secondary decrease in binding affinity. In infants >28 weeks gestational age, higher intravenous lipid intake may be used because it is unassociated with increases in free fatty acids and unbound bilirubin.
Safety and Efficacy of Fish Oil–Enriched Parenteral Nutrition Regimen on Postoperative Patients Undergoing Major Abdominal Surgery
Authors: Chen Bo , Zhou Yong , Yang Ping , Wan Hong‐wei , Wu Xiao‐ting
Published: July 2010

Background: To evaluate the safety and efficacy of a fish oil–enriched parenteral nutrition regimen in patients undergoing major abdominal surgery, a meta‐analysis of randomized controlled trials was conducted. Methods: An electronic search of PubMed, MEDLINE, EMBASE, Academic Search Premier, and China National Knowledge Infrastructure databases was performed in March 2009. RevMan 5.0 was used for statistical analysis. Results: The combined analysis showed that a fish oil–enriched parenteral nutrition regimen had a positive treatment effect on length of hospital stay (weighed mean difference = −2.98, P < .001), length of intensive care unit stay, postoperative infection rate (odds ratio = 0.56, P = .04), and serum levels of aspartate aminotransferase, alanine aminotransferase, and α‐tocopherol on postoperative day 6 in these patients. The regimen increased the plasma levels of eicosapentaenoic acid (standardized mean difference = 3.11, P < .001) and docosahexaenoic acid and upregulated the leukotriene B5 production in leukocytes on postoperative day 6. No significant differences were found between the 2 groups in postoperative mortality; incidence of postoperative cardiac complications; serum levels of bilirubin, triglyceride, or arachidonic acid; or the liberation of leukotriene B4. No serious adverse events related to fish oil treatment were reported. Conclusions: Based on the meta‐analysis, fish oil–supplemented parenteral nutrition was safe, improved clinical outcomes, and altered the fatty acid pattern as well as leukotriene synthesis. More laboratory parameters should be considered in future meta‐analyses.
An Exploration of Quality of Life and the Experience of Living With Home Parenteral Nutrition
Authors: Winkler Marion F. , Hagan Elizabeth , Wetle Terri , Smith Carol , Maillet Julie O'Sullivan , Touger‐Decker Riva
Published: July 2010

Introduction: The aim of this research was to achieve a deeper understanding of the experience of adults living with home parenteral nutrition (PN) and to define their quality of life (QOL). Methods: The research design was qualitative, using content and interpretative phenomenological analysis. The sample included adults with intestinal failure, stratified by length of home PN dependency. Sampling continued until data saturation was achieved. A second reviewer independently coded a subset of narratives (κ = 0.684). Results: Participants included 24 adults receiving home PN because of short bowel syndrome (95.8%) and pseudo‐obstruction (4.2%). Twenty‐five percent received PN for < 2 years, 20.8% for 2‐5 years, 25% for 5‐10 years, and 29.2% for > 10 years. Respondents viewed home PN as a “lifeline” and “nutritional safety net.” QOL was defined as “enjoying life”; “being happy, satisfied, or content with life”; and “being able to do what you want to do, when you want to do it.” Participants described their QOL as “good” to “wonderful.” Lifestyle was affected by health, stamina, diarrhea, having an ostomy, and the amount of flexibility there was with the infusion schedule. There was a strong desire to achieve normalcy in life among all participants. Conclusions: Qualitative methodology provides new insights and richness of data regarding adults receiving home PN. The positive description of QOL in this study contrasts with the published nutrition literature. It is important for healthcare practitioners to understand and discuss the realities of home PN and lifestyle adaptation.
Immunonutrition in High‐Risk Surgical Patients
Authors: Marik Paul E. , Zaloga Gary P.
Published: July 2010

Background: Immunomodulating diets (IMDs) have been demonstrated to improve immune function and modulate inflammation. However, the clinical benefit of these diets in patients undergoing elective surgery is controversial. The goal of this meta‐analysis was to determine the impact of IMDs on the clinical outcomes of high‐risk patients undergoing elective surgery. Methods: The review included prospective, controlled, clinical trials that compared the clinical outcome of elective surgical patients who were randomized to receive an IMD or a control enteral diet. Studies were stratified according to the type of IMD and the timing of the initiation of the IMD. Data were abstracted on study design, study size, patient population, and IMD used. The outcomes of interest were the acquisition of new infections, wound complications, length of hospital stay (LOS), and mortality. Meta‐analytic techniques were used to analyze the data. Results: Twenty‐one relevant studies were identified, which included a total of 1918 patients. Immunonutrition significantly reduced the risk of acquired infections, wound complications, and LOS. The mortality rate was 1% in both groups. The treatment effect was similar regardless of the timing of the commencement of the IMD. The benefits of immunonutrition required both arginine and fish oil. Conclusions: An immunomodulating enteral diet containing increased amounts of both arginine and fish oil should be considered in all high‐risk patients undergoing major surgery. Although the optimal timing cannot be determined from this study, it is suggested that immunonutrition be initiated preoperatively when feasible.
Parenteral Nutrition Rapidly Reduces Hepatic Mononuclear Cell Numbers and Lipopolysaccharide Receptor Expression on Kupffer Cells in Mice
Authors: Omata Jiro , Fukatsu Kazuhiko , Murakoshi Satoshi , Noguchi Midori , Moriya Tomoyuki , Okamoto Koichi , Saitoh Daizoh , Yamamoto Junji , Hase Kazuo
Published: July 2010

Background: Parenteral nutrition (PN) reduces the number of hepatic mononuclear cell (MNCs) and impairs their function, resulting in poor survival after intraportal bacterial challenge in mice. Our recent animal study demonstrated resumption of enteral nutrition after PN to rapidly restore hepatic MNC numbers (in 12 hours) and lipopolysaccharide (LPS) receptor expression on Kupffer cells (in 48 hours). The present study examined the time courses of hepatic MNC number reductions and LPS receptor expression changes in mice receiving PN. Methods: Male mice (n = 49) from the Institute of Cancer Research were divided into chow (n = 8), PN0.5 (n = 8), PN1 (n = 8), PN2 (n = 9), PN3 (n = 9), and PN5 (n = 7) groups. The chow group was given chow with an intravenous saline infusion. The PN groups were fed parenterally for 0.5, 1, 2, 3, or 5 days following the chow‐feeding courses. After 7 days of nutrition support, hepatic MNCs were isolated and counted. The expression of LPS receptors on Kupffer cells was analyzed by flow cytometry. Results: Hepatic MNC numbers rapidly reached their lowest level in the PN0.5 and PN1 groups but were somewhat restored thereafter and remained stable after the third day, without significant differences between any 2 of the PN groups. CD14 and Toll‐like receptor 4/MD‐2 expressions both showed significant reductions in the PN1 group compared with the chow group and gradually decreased to their lowest levels in the PN5 group. Conclusions: PN administration rapidly reduces hepatic MNC numbers and LPS receptor expression on Kupffer cells.
Comparison of two infusion rates of antithrombin concentrate in cardiopulmonary bypass surgery
Authors: Lund Philip E. , Wassbäck Göran , Thomas Owain , Carlsson Tony , Schött Ulf
Published: July 2010

Background: Antithrombin concentrate (AT) is used to treat heparin resistance (HR) in cardiac surgery. It is usually given slowly due to the fear of anaphylaxis. This may delay cardiac catheterisation and the start of cardiopulmonary bypass (CPB). HR is often defined as the failure to reach or maintain a target activated clotting time (ACT) despite a standard dose of heparin. It is not generally possible to predict which patients will display HR, although there are known risk factors. Routine early administration of AT before heparinisation is probably not cost-effective. Infusing AT relatively quickly after demonstrating HR may be more cost-effective, while not delaying surgery. The aim of this study is to investigate the safety and side effects of a faster infusion of AT.

Methods: Forty patients undergoing elective heart surgery were included and randomised to two groups in a double-blind fashion. Each group received 1000 IU of AT intravenously (IV). One group received a slow infusion (100 IU/min) before full-dose heparinisation. The other group received a fast infusion (250 IU/min). Haemodynamic and respiratory data were recorded. Any adverse effects were noted. Thrombin-antithrombin, anti-Xa and antithrombin levels in plasma were measured.

Results: No anaphylaxis occurred in either group. No differences were found regarding haemodynamics, respiration or laboratory results. Two patients experienced major haemorrhage and recovered; there were two deaths, thought to be unrelated to the study drugs.

Conclusion: AT can be infused at a rate of 250 IU/min. This is faster than the current recommendation of 100 IU/min. This rate of infusion allows restricting AT infusion to those patients who display HR, without delaying surgery. Optimal anticoagulant therapy for CPB probably includes point-of-care measurement of ACT and plasma AT and small, but rapid, infusions of AT in heparin-resistant patients.
The use of in-situ normothermic extracorporeal perfusion and leukocyte depletion for resuscitation of human donor kidneys
Authors: Reznik Oleg , Bagnenko Sergey , Scvortsov Andrei , Loginov Igor , Ananyev Alexei , Senchik Konstantin , Moysyuk Yan
Published: July 2010

The unexploited potential of donors after cardiac death is an actual issue for all countries where organ transplantation is performed. The crucial point in uncontrolled donation after cardiac death is the warm ischemic time. The primary purpose of our work was to define the limits of warm ischemic time. Another purpose was the development of an in situ kidney preservation protocol. In 8 uncontrolled donors with warm ischemic time from 45 to 91 minutes, a normothermic extracorporeal perfusion device was applied, providing preservation and restoration of the kidney after ischemic damage. Main attention was paid to the elimination of leukocytes as the key damaging factor from modified donor blood circulating in the device. In 6 out of 16 kidney recipients, graft function was recovered immediately and, by the end of the third month, the average creatinine was 117.9±21.9 mmol/L. Treatment of ischemically damaged kidneys by normothermic extracorporeal perfusion, with leukocyte depletion before procurement, seems to be a challenging protocol and demands further study. Implementation of perfusion systems in organ procurement practice could lead to a partial solution in the organ deficit problem.
Stripping in hot mix asphalt produced by aggregates from construction and demolition waste
Authors: Pérez I , Pasandín A R , Gallego J
Published: July 2010

This paper analyses the effect of water on the durability of hot asphalt mixtures made with recycled aggregates from construction and demolition debris. Indirect tensile stress tests were carried out to evaluate stripping behaviour. The mixtures tested were fabricated with 0, 20, 40 and 60% recycled aggregates. Two types of natural aggregates were used: schist and calcite dolomite. An increase in the percentage of recycled aggregates was found to produce a decrease in the tensile stress ratio of the hot asphalt mixtures. To study this phenomenon, two and three factor analyses of variance (ANOVA) were performed with indirect tensile stress being used as the dependent variable. The factors studied were the percentage of recycled aggregates (0, 20, 40 and 60%), the moisture state (dry, wet) and the type of natural aggregate (schist, calcite). On the basis of the ANOVA results, it was found that the most important factor affecting resistance was the moisture state (dry, wet) of the specimens. The percentage of recycled aggregate also affected indirect tensile stress, especially in the dry state. The type of natural aggregate did not have a significant effect on indirect tensile stress. The hot asphalt mixture specimens made with different percentages of recycled aggregates from construction and demolition debris and of natural quarry aggregates showed poor stripping behaviour. This stripping behaviour can be related to both the poor adhesion of the recycled aggregates and the high absorption of the mortar of cement adhered to them.
Ag09
Authors: Popping Roel
Published: July 2010

This text describes a computer program that allows computing the interrater agreement index Scott’s π for at least two ratings per object. The program allows using weights; therefore, the user is not restricted to data on a nominal level of measurement. If wanted, it is possible to compute the agreement per category.
Twentieth-century summer temperature variability in the southern Altai Mountains: A carbon and oxygen isotope study of tree-rings
Authors: Loader N.J. , Helle G. , Los S.O. , Lehmkuhl F. , Schleser G.H.
Published: July 2010

The Altai mountains, southern Siberia, represent an area of significant scientific interest and exceptional palaeoecological potential. To assess the influence of climate on the stable isotopic composition of tree-ring cellulose and the potential of this record as a palaeoclimate proxy, replicated stable oxygen and carbon isotope time-series were developed for the twentieth century from four Siberian Pine ( Pinus sibirica Du Tour) trees growing near the settlement of Aktash, Russian Altai mountains, southern Siberia. Bootstrapped calibrations for the local instrumental period (AD 1954—2000) reveal strong correlations between summer (July—August) growing season temperatures and tree-ring oxygen ( r2=0.55) and carbon ( r2=0.30) isotopes. Covariance observed between both carbon and oxygen isotope data suggest a common (stomatal) control. The resulting empirical model was used to reconstruct regional summer temperatures for the twentieth century. No divergence is observed between the non-detrended tree-ring isotope series and instrumental data nor is there any twentieth-century summer warming trend. The strong isotopic signal preserved in the tree-ring series supports the wider application of this approach to explore climatic variability and environmental trends during past millennia through analysis of new and existing long tree-ring chronologies from this region.
Ideology, environment and forced relocation: Kiruna - a town on the move
Authors: Nilsson Bo
Published: July 2010

Kiruna, a small town in the north of Sweden, is facing a major change because an expanding mining industry is threatening the town. The iron ore body runs under the central parts of the town and continued mining will cause that area to collapse. Therefore, the municipality of Kiruna (Kiruna kommun) has, under the influence of the mining company LKAB (Luossavaara-Kiirunavaara Aktiebolag), decided to relocate parts of the town a few miles to the north-west. The relocation plans have attracted a great deal of attention in both national and international media. This article examines the ideological bias that characterizes various opinions in relation to the relocation plans, and especially the views of those in favour of the move, the mining company and the majority of the municipality of Kiruna. ‘Ideology’, both as a concept and as a perspective, is used in an analysis of how some specific ‘truths’ regarding the relocation are produced. Furthermore, I argue that the relocation plans are part of an ideological fantasy rooted in the social structure, of which the mining company has historically been a creator. On a more general level, the article deals with democratic processes in the context of an urban transformation.
Advantaged group members’ reactions to tokenism
Authors: Richard Norann T. , Wright Stephen C.
Published: July 2010

Existing research on tokenism has focused exclusively on the disadvantaged group, despite the important role advantaged groups could play in challenging tokenism. This study examines American students’ responses to a university admission policy for African students that produced an open, closed or tokenism context, when attention was focused on their own or the disadvantaged group. An open context always received higher approval ratings than a completely closed context. However, when attention was focused on the ingroup, tokenism received higher approval ratings than the closed context, whereas, when attention was focused on the outgroup, tokenism was viewed as negatively as the closed context. These findings are discussed in terms of tokenism’s inherent ambiguity and its influence on advantaged group members’ support for change.