bluuebunny/crossref_metadata_2025 huggingface dataset:
A New Perspective for Delinquency
Authors: Einat Tomer , Herzog Sergio
Published: October 2010

Numerous theories have attempted to analyze and understand the factors and etiology of juvenile delinquency. The present study is the first to suggest the use of Sellin’s “culture conflict” theory as a possible cultural explanation for the phenomenon of juvenile delinquency. According to Sellin, crime in many instances is a product of culture conflict between the values and norms of a certain subculture in a given society and those of the general culture. Following Sellin’s rationale, this study argues that youths constitute a social subculture with certain values, norms, and stances toward the criminal law that is not necessarily concordant with the moral values and formal norms of the general culture of adults, who determine the content of the criminal law. These assertions are analyzed via a crime seriousness study, in which adult and teenage respondents from a national (Israeli) sample were asked to evaluate the seriousness of various criminal offenses committed by adolescents. Generally, significant differences were found between the seriousness and punishment values given by the adult and juvenile respondents to violent offenses (high) and self-use of illegal drugs (low), with adult respondents providing significantly higher seriousness values and punishment options for them. Moreover, in a regression analysis, the variable of respondents’ age was found as decisive in understanding both dependent variables. The implications of these findings are discussed in this study.
The protective role of zinc and calcium in Vicia faba seedlings subjected to cadmium stress
Authors: Taspinar M. Sinan , Agar Guleray , Alpsoy Lokman , Yildirim Nalan , Bozari Sedat , Sevsay Sevgi
Published: October 2010

The aim of the present study was to evidence the possible antagonistic effect of Zinc (Zn2+) and Calcium (Ca2+) against cadmium (Cd2+)-induced DNA damage by using random amplification of polymorphic DNA (RAPD) and metabolic activities in Vicia faba. The results showed that all doses of Cd2+ (10 -3 M, 10-5 M) caused an increase in polymorphism value and a decrease in genomic template stability (GTS %). In addition, when 10 -4-10-6 M Ca2+, 10-6 M Zn2+ were added together with 10-3 M, 10-4 M, 10-5 M of Cd2+, polymorphism value decreased besides GTS, total protein and chlorophyll content increased. Results suggested that Zn2+ and Ca2+ have an antagonistic effect against Cd2+. The order of the antagonisms of Ca2+, Zn2+ against Cd2+ toxicity was Ca2+ > Zn2+. Especially, the degree of antagonistic effect of Zn2+ against Cd2+ is probably related to its concentration ratio.
Blood Ammonia Levels in Epileptic Children on 2 Dose Ranges of Valproic Acid Monotherapy: A Cross-Sectional Study
Authors: Sharma Suvasini , Gulati Sheffali , Kabra Madhulika , Kalra Veena , Vasisht Suman , Gupta Yogender Kumar
Published: October 2010

This cross-sectional study was planned to study the blood ammonia levels in epileptic children on 2 dose ranges of valproic acid monotherapy. A total of 60 epileptic children aged 3 months to 12 years, that were on valproic acid monotherapy for at least 3 months, were enrolled and divided into 2 groups, a low-dose group (dose, 20-39 mg/kg/d [n = 32]) and a high-dose group (dose, 40-60 mg/kg/d [n=31]). Measurements of blood ammonia, serum valproic acid levels, and liver and renal function tests were performed. Blood ammonia levels were significantly higher in the high-dose group (median, 79.2 µg/dL; range, 55.23-114.29 µg/dL) as compared with the low-dose group (median, 47.2 µg/dL; range, 20.62-73.25 µg/dL). Blood ammonia levels significantly correlated with both the dose (r = .77, P < .001) and serum levels (r = .88, P < .001) of valproic acid. All the children with hyperammonemia were asymptomatic. There were no significant differences in the other biochemical parameters between the 2 groups.
Chronic ethanol ingestion induces aortic inflammation/oxidative endothelial injury and hypertension in rats
Authors: Husain Kazim , Ferder Leon , Ansari Rais A , Lalla Jainarine
Published: October 2010

The study aim was to investigate the relationship of chronic ethanol-induced inflammation leading to vascular endothelial injury and elevation of blood pressure (BP) in a rat model. Male Fisher rats were divided into two groups of six animals each and treated as follows: (1) Control (5% sucrose, orally) daily for 12 weeks and (2) 20% ethanol (4 g kg-1, orally) daily for 12 weeks. The mean arterial blood pressure was recorded every week. The animals were anesthetized with pentobarbital after 12 weeks; thoracic aorta were isolated and analyzed for aortic reactivity response, inflammatory mediators, oxidant/antioxidant enzyme protein expression and endothelial nitric oxide-generating system. The results show that the mean BP was significantly elevated 12 weeks after ethanol ingestion. The increased BP was related to increased aortic inflammation (tumor necrosis factor [TNF]-α; nitric oxide synthase [iNOS], COX-2 and MCP-1 protein expression) and elevated angiotensin II levels in alcohol-treated group compared to control. Aortic Nicotinamide adenine dinucleotide phosphate reduced (NADPH) oxidase activity, membrane and cytosolic subunits p22 phox and p47 phox expression and Mn-SOD activity and protein expression significantly increased, whereas nitric oxide (NO), endothelial NO synthase (eNOS), vascular endothelial growth factor (VEGF)-A and CuZn-SOD activity and protein expression significantly decreased in alcohol-treated group compared to control. The acetylcholine-mediated vasorelaxation response was depressed in the aorta of ethanol-treated rats compared to control. In conclusion, chronic ethanol-induced elevation in BP is related to increased aortic inflammation, elevated angiotensin II levels, induction of NADPH oxidase causing endothelial injury, depletion of CuZn-SOD, down-regulation of endothelial NO generating system and impaired vascular relaxation in rats.
Reflections on Pedagogy: A Journey of Collaboration
Authors: Woods Christine
Published: October 2010

One of the goals of autoethnography is to “offer lessons for further conversation”. In this article, the author reflects on several lessons that were learnt along a journey in management education in the area of indigenous entrepreneurship. In particular, the author outlines her pedagogical practice as an academic engaged in teaching entrepreneurship to Māori students in a university setting. In developing the pedagogical approach for the course, the author has drawn on the metaphor of spiral; this approach involves the teacher and students forming a collaborative double spiral of learning through a process of acknowledgment, adaptation, and advancement. It is hoped that this discussion stimulates conversation and reflection for the reader in much the same manner that writing this article has enabled the author to examine, question, and develop her own pedagogical practice.
Expanding the Ecological Validity of WAIS-IV and WMS-IV With the Texas Functional Living Scale
Authors: Whipple Drozdick Lisa , Munro Cullum C.
Published: October 2010

Assessment of functional status is an important aspect of clinical evaluation. As part of the standardization of the Wechsler Adult Intelligence Scale —Fourth Edition (WAIS-IV) and Wechsler Memory Scale—Fourth Edition (WMS-IV), participants completed the Texas Functional Living Scale (TFLS), a measure of Instrumental Activities of Daily Living. The relationships between TFLS and WAIS-IV and WMS-IV were examined in both normally developing and clinical samples. In general, the highest correlations were between TFLS and measures of general cognitive ability (WAIS-IV FSIQ [Full Scale IQ] and GAI [General Ability Index]) and working memory (WAIS-IV WMI [Working Memory Index] and WMS-IV VWMI [Visual Working Memory Index]). Across the clinical populations, working memory subtests were generally strongly related to TFLS performance, although this relationship was more consistent with WAIS-IV than WMS-IV. Contrast scaled scores are presented for the TFLS based on WAIS-IV or WMS-IV performance. These scores allow the evaluation of functional abilities within the context of cognitive and memory ability, enhancing and expanding the utility of the WAIS-IV and WMS-IV.
Osteopontin concentrations are increased in cerebrospinal fluid during attacks of multiple sclerosis
Authors: Börnsen Lars , Khademi Mohsen , Olsson Tomas , Sørensen Per Soelberg , Sellebjerg Finn
Published: October 2010

Background:The cytokine osteopontin (OPN) is a potential key player in the immunopathogenesis of multiple sclerosis (MS) and a candidate biomarker for disease activity.

Objective:The objective of this study was to examine concentrations of OPN in the cerebrospinal fluid (CSF) across the clinical spectrum of MS.

Methods:Our research consisted of a cross-sectional study of patients from two randomized, placebo-controlled trials. Concentrations of OPN and other blood and CSF markers were determined using an enzyme-linked immunosorbent assay (ELISA). Samples were obtained from untreated patients with exacerbation of clinically isolated syndrome (CIS) ( n = 25) and relapsing–remitting MS (RRMS) ( n = 41) of whom 48 participated in clinical trials, randomly allocated to treatment with placebo or methylprednisolone (MP) and undergoing repeated sampling after 3 weeks. Furthermore, we obtained CSF and blood samples from patients with primary progressive MS (PPMS, n = 9), secondary progressive MS (SPMS, n = 28) and other neurological disorders (OND, n = 44), and blood samples from 24 healthy subjects.

Results:OPN concentrations were significantly increased in the CSF of patients with CIS ( p = 0.02) and RRMS ( p < 0.001) in exacerbation compared to patients with OND, and increased levels of OPN were associated with high values of other biomarkers of inflammation. At 3-week follow-up CSF OPN concentrations had decreased significantly from baseline regardless treatment with placebo or MP. Patients with PPMS had increased OPN levels in the CSF ( p = 0.004) and high CSF levels of OPN were associated with high degrees of disability.

Conclusions:OPN concentration in the CSF is a dynamic indicator of disease activity in RRMS, presumably reflecting ongoing inflammation. Increased CSF OPN concentrations in PPMS may indicate ongoing inflammation even in these patients.
Autologous hematopoietic cell transplantation for multiple sclerosis: a systematic review
Authors: Reston James T , Uhl Stacey , Treadwell Jonathan R , Nash Richard A , Schoelles Karen
Published: October 2010

Background and objectives: The purpose of this systematic review was to evaluate the safety and efficacy of autologous hematopoietic cell transplantation in patients with progressive multiple sclerosis (MS) refractory to conventional medical treatment.

Methods: Eight case series met our a priori inclusion criteria for the primary outcome of progression-free survival. Individual study quality was rated using an 11-item scale for case series. The strength of the overall body of evidence for each outcome was rated using a system developed by the ECRI Institute. Data from different studies were statistically combined using meta-analysis. An additional six studies were included for a summary of mortality and morbidity.

Results: For secondary progressive MS, immunoablative therapy with autologous bone marrow/peripheral blood stem cell transplantation was associated with higher progression-free survival (up to 3 years following treatment) when using intermediate-intensity conditioning regimens compared with high-intensity conditioning regimens. The evidence was insufficient to determine whether the treatment was effective in patients with other types of MS. Treatment-related mortality was about 2.7%.

Conclusions: Patients with secondary progressive MS refractory to conventional medical treatment have longer progression-free survival following autologous stem cell transplantation with intermediate-intensity conditioning regimens than with high-intensity conditioning regimens.
Rapidly progressive course of very late onset multiple sclerosis presenting with Parkinsonism: case report
Authors: Schultheiss T , Reichmann H , Ziemssen T
Published: October 2010

Multiple sclerosis mainly affects young adolescents, making late-onset multiple sclerosis a rarity and diagnostic challenge, particularly for cases after age 80 years. We present an 82-year-old patient with multiple sclerosis with very late onset. As well as spastic paraplegia, additional Parkinsonism secondary to demyelination in the basal ganglia was observed in this case. In most publications, spinal cord lesions were more common in late-onset multiple sclerosis which, in contrast, could not be found in our case. Despite different treatment strategies, rapid clinical deterioration and death after about 2 years of disease course occurred. Further discrimination in late-onset multiple sclerosis (50–70 years) and multiple sclerosis with very late onset (above 70 years) might be considered. Future trials to elucidate potential benefit of immunosuppressive (and neuroprotective) therapies in these age groups are mandatory.
Rebuilding relationships: A pilot study of the effectiveness of the Mellow Parenting Programme for children with Reactive Attachment Disorder
Authors: Puckering Christine , Connolly Brenda , Werner Claudia , Toms-Whittle Louise , Thompson Lucy , Lennox Jeannette , Minnis Helen
Published: October 2010

Mellow Parenting is an intensive parenting programme which has been shown to be effective in improving the psychosocial functioning of very vulnerable babies and preschool children. We used a complex interventions model to evaluate its use with school-age children with Reactive Attachment Disorder (RAD), a serious disorder of social functioning associated with maltreatment. The programme had a positive effect on mothers’ mental health, but had no measurable effects on symptoms of RAD or on parent—child interaction, although the variation between families after the group suggested that some had responded more than others. Mellow Parenting is an effective programme for vulnerable families with younger children and may be a useful adjunct in the treatment of school-age children with RAD, but it cannot be considered a definite treatment for RAD in this age group. The search continues for safe and effective treatments for RAD in school-age children.
Assessment of children coming into care: Processes, pitfalls and partnerships
Authors: Chambers Megan F. , Saunders Alison M. , New Brendan D. , Williams Catherine L. , Stachurska Anna
Published: October 2010

Children in out-of-home care (OOHC) present with high levels of physical, developmental and emotional and behavioural difficulties, yet often fail to receive appropriate services. This article describes a joint health and welfare service specifically developed to provide comprehensive physical, developmental and mental health assessments to a cohort of children entering long-term care in one region of Sydney, New South Wales (NSW), Australia. Paediatric, allied health, dental and psychosocial assessments were co-ordinated from a single referral from the child’s welfare case manager. Follow-up appointments were held 6—12 months later to assess the outcomes of recommendations. Physical, mental health and developmental difficulties in the children are reported, the implications for service requirements are presented and process blocks described. There is a need for a specific co-ordinating service to overcome the inherent fragmentation of this group (related both to transience and change in the welfare sector, and levels of comorbidity and chronicity in health presentations). Health and Welfare services must operate together, with an awareness of the processes and resource constraints in each sector, if they are to deliver sustainable and reliable health care to this vulnerable group.
Concordance of mental health impairment and service utilization among children in care
Authors: Tarren-Sweeney Michael
Published: October 2010

This paper describes caregiver-reported patterns of mental health service use for 347 pre-adolescent children in foster and kinship care in New South Wales (NSW), Australia. Children’s mean time in care and mean time with their present caregivers were 4.3 and 3.3 years respectively. Forty-four percent of children received individual therapy or counselling, 45% received interventions in the form of clinical guidance for their caregivers, and 31% received both forms of service. Among children scoring in the clinical range on any CBCL sub-scale ( N = 191), equivalent rates of mental health service use were 60%, 55% and 41% respectively. Although not directly comparable, these findings describe a higher rate of service use than that reported for children in care elsewhere. While children with more complex and severe difficulties had higher rates of service use, there was no evidence of variable access for treatment of different types of disorder. Predictors of service use are reported and contrasted with previous findings. The paper considers several features of the NSW child welfare, health and education systems that may account for the relatively high rate of service use.
Review: Cancer and schizophrenia: is there a paradox?
Authors: Hodgson Richard , Wildgust Hiram J , Bushe Chris J
Published: October 2010

People with schizophrenia are more likely to die prematurely than the general population from both suicide and physical ill health. Published studies examining the incidence of cancer in schizophrenia patients report increased, reduced or similar incidence compared with the general population. Older studies tended to report lower incidence rates which fuelled speculation as to the biological and other mechanisms for this protective effect. Furthermore, mortality rates in patients with schizophrenia appear higher than expected. We undertook a non-systematic review of published data to give an overview for these variable findings and illustrate methodological confounders by highlighting a systematic review of breast cancer studies.
Factors influencing the willingness to contribute information to online communities
Authors: Xigen Li
Published: October 2010

This study examines the factors that influence the willingness to contribute information to online communities from the perspectives of the discretionary database and expectancy theory. The study identified four groups of variables and tested their predictive value on the willingness to contribute information to online communities. The findings confirmed the effect of the perceived value of contributing and the likelihood of getting a reward for the willingness to contribute. Cost of contribution was not a significant predictor of the willingness to contribute information. Benefit from, and interest in, the community were significant predictors, but community affinity was not. Among the four groups of variables, social approval was the strongest predictor of the willingness to contribute.
Review article: Platelet abnormalities in diabetes mellitus
Authors: Ferreiro José Luis , Gómez-Hospital Joan Antoni , Angiolillo Dominick J
Published: October 2010

Patients with diabetes mellitus (DM) have accelerated atherosclerosis, which is the main underlying factor contributing to the high risk of atherothrombotic events in these patients. Atherothrombotic complications are the leading cause of morbidity and mortality in patients with DM. Among factors contributing to the prothrombotic condition which characterise patients with DM, platelet hyperreactivity plays a pivotal role. Platelets of DM patients are characterised by dysregulation of several signalling pathways leading to intensified adhesion, activation and aggregation. Multiple mechanisms are involved in platelet dysfunction of patients with DM, which can be categorised as follows: a) hyperglycaemia, b) insulin deficiency and resistance, c) associated metabolic conditions, and d) other cellular abnormalities.The present manuscript aims to provide an overview on the current status of knowledge on platelet abnormalities that characterise patients with DM.
Use of Total Lymphocyte Count to Predict Absolute CD4 Count in HIV-Seropositive Cases
Authors: Gautam Hitender , Saini Sanjeev , Bhalla Preena , Singh Tejinder
Published: October 2010

We conducted an observational study to assess the use of total lymphocyte counts (TLC) alone and along with hemoglobin (Hb) as a predictor of CD4 count. A total of 103 antiretroviral therapy (ART)-naive HIV-1-infected patients were enrolled and divided in 2 groups (with CD4 count <200 cells/mm3 and CD4 count ≥200 cells/mm3). The TLC and Hb were performed by automatic full digital cell counter. CD4 count was determined by flow cytometry. Among the World Health Organization (WHO) clinical stages 2 and 3, in the cases with CD4 count <200 cells/mm3, 70.4% cases had TLC ≤1200 cells/mm 3, whereas 63% cases had TLC ≤1200 cells/mm3 + Hb ≤12 g/dL. In the cases with CD4 count >200 cells/mm3, 2% cases had TLC ≤1200 cells/mm3, whereas adding Hb ≤12 g/dL with TLC ≤1200 cells/mm3, none of the cases would require initiation of ART. TLC + Hb can be used to treat all HIV-infected patients with WHO stages 2 and 3 who have a TLC <1200 cells/mm3 + Hb ≤12 g/dL and to limit CD4 counts to patients who are symptomatic but have TLC + Hb values other than TLC <1200 cells/mm3 + Hb ≤12 g/dL.
Influence of Task-Oriented Training Content on Skilled Arm-Hand Performance in Stroke: A Systematic Review
Authors: Timmermans Annick A. A. , Spooren Annemie I. F. , Kingma Herman , Seelen Henk A. M.
Published: October 2010

Objective. This review evaluates the underlying training components currently used in task-oriented training and assesses the effects of these components on skilled arm—hand performance in patients after a stroke. Methods. A computerized systematic literature search in 5 databases (PubMed, CINAHL, EMBASE, PEDro, and Cochrane) identified randomized clinical trials, published through March 2009, evaluating the effects of task-oriented training. Relevant article references listed in publications included were also screened. The methodological quality of the selected studies was assessed with the Van Tulder Checklist. For each functional outcome measure used, the effect size (bias corrected Hedges’s g) was calculated. Results. The intervention results in 528 patients (16 studies) were studied. From these, 15 components were identified to characterize task-oriented training. An average of 7.8 (standard deviation = 2.1) components were used in the included trials. There was no correlation between the number of task-oriented training components used in a study and the treatment effect size. “Distributed practice” and “feedback” were associated with the largest postintervention effect sizes. “Random practice” and “use of clear functional goals” were associated with the largest follow-up effect sizes. Conclusion. The task-oriented training was operationalized with 15 components. The number of components used in an intervention aimed at improving arm—hand performance after stroke was not associated with the posttreatment effect size. Certain components, which optimize storage of learned motor performance in the long-term memory, occurred more in studies with larger treatment effects.
Ego Depletion Is Not Just Fatigue
Authors: Vohs Kathleen D. , Glass Brian D. , Maddox W. Todd , Markman Arthur B.
Published: October 2010

Is the self-regulation failure that comes from prior exertions of self-regulation—the ego-depletion effect—the result of fatigue? A reading of the literature suggests that self-regulatory resource depletion and fatigue might be overlapping constructs, but direct empirical evidence is lacking. The authors put this question to the test by subjecting half of their participants to total sleep deprivation for 24 hours whereas others were rested; they crossed this factor with a self-regulation manipulation in which participants did or did not suppress their emotional reactions to a film. The authors' measure of self-regulation was aggressive responses in a game involving blasting noise at an opponent. Contrary to expectations, there was no effect of sleep deprivation on aggression. In confirmation of the limited-resource model, the authors found that depleted participants were more aggressive than nondepleted participants (irrespective of fatigue condition). Lax self-regulation seems to be from a lack of self-regulatory capacity, not fatigue.
Missed Opportunities to Provide Self-management Education to Patients With Uncontrolled Asthma in a Rural State
Authors: Frazier Jessie , Loveland Katie , Harwell Todd S. , Helgerson Steven D.
Published: October 2010

Evidence-based clinical guidelines emphasize providing asthma self-management education (ASME) to patients at multiple points of care. However, clinical and population-based studies indicate that the provision of ASME is inconsistent. Between 2006 and 2008, the Montana Department of Public Health and Human Services (DPHHS) conducted the Asthma Call Back Survey (ACS), a telephone survey of a representative sample of adults with asthma in the state (N = 767). Based on a control scale algorithm, 54% of respondents with asthma were well controlled and 46% were either not well controlled or were very poorly controlled. Adults with uncontrolled asthma were more likely than adults with well-controlled asthma to report seeing a health care provider in the past year either through a routine checkup for asthma (adjusted odds ratio [AOR], 7.4; 95% confidence interval [CI], 4.8-11.5), to have an urgent care or emergency department visit for asthma (AOR, 18.3; 95% CI, 6.5-51.5), or to have ever taken a class to self-manage asthma (AOR, 3.0; 95% CI, 1.4-6.6). Respondents with uncontrolled asthma were somewhat more likely to use a peak flow meter (AOR, 1.8; 95% CI, 1.2-2.8) and to have been advised to change aspects of their home, work, or school to improve their asthma (AOR, 1.7; 95% CI, 1.1-2.6) compared with those with well-controlled asthma. Adults with uncontrolled asthma were no more likely than adults with well-controlled asthma to report ever being given an asthma management plan (AOR, 1.7; 95% CI, 1.0-2.7) or instructed on how to recognize the early signs of an asthma attack (AOR, 1.3; 95% CI, 0.8-2.1). Our findings suggest that Montana providers may be missing key clinical opportunities to provide and reinforce ASME, particularly among those with uncontrolled asthma. Strategies are needed to increase asthma control and use of ASME.
Gynecological Surgery and Low Back Pain in Older Women
Authors: Ericksen Jeffery , Pidcoe Peter E. , Ketchum-McKinney Jessica M. , Burnet Evie N. , Huang Emily , Wilson James C. , Hoogstad Vincent
Published: October 2010

Objective: To determine sacroiliac joint compliance characteristics and pelvic floor movements in older women relative to gynecological surgery history and back pain complaints. Design: Single-visit laboratory measurement. Setting: University clinical research center. Participants: Twenty-five women aged 65 years or older. Outcome Measures: Sacroiliac joint compliance measured by Doppler imaging of vibrations and ultrasound measures of pelvic floor motion during the active straight leg raise test. Results: Doppler imaging of vibrations demonstrated test reliability ranging from 0.701 to 0.898 for detecting vibration on the ilium and sacrum sides of the sacroiliac joint. The presence of low-back pain or prior gynecological surgery was not significantly associated with a difference in the compliance or laxity symmetry of the sacroiliac joints. No significant difference in pelvic floor movement was found during the active straight leg raise test between subject groups. All P values were ≥.4159. Conclusions: Prior gynecological surgery and low-back pain were not significantly associated with side-to-side differences in the compliance of the sacroiliac joints or in significant changes in pelvic floor movement during a loading maneuver in a group of older women.
Comparison of an Organized Geriatric Fracture Program to United States Government Data
Authors: Kates Stephen L. , Blake Deidre , Bingham Karilee W. , Kates Olivia S. , Mendelson Daniel A. , Friedman Susan M.
Published: October 2010

Objective: This study describes the financial impact of an organized hip fracture program for elderly patients age 65 years and older. Methods: This is a retrospective study of 797 fractures in 776 consecutive patients over a 50-month period (May 2005 to July 2009) treated in an organized hip fracture program for the elderly identified from a quality management database. Financial, demographic, and quality-of-care data were collected. The length of hospital stay, in-hospital complications, and Charlson comorbidity scores were collected from patient records, and all data were evaluated using standard statistical methods. Setting: 261-bed community-based, university-affiliated teaching hospital in an urban setting with a catchment area of approximately 1 million persons. This is a level 3 trauma center. Results: The average total net revenue per hip fracture was $12 159, with an average total cost to hospital of $8264. Physicians' fees consisted of fees collected by surgeons, anesthesiologists, medical specialty consultants, and consulting geriatricians and averaged $2024 per case. Thus, the average hospital charge to payers was $15 188. Compared to Agency for Healthcare Research and Quality average inpatient hospital costs in 2005 of $33 693, a savings of more than $18 000 was realized per patient. The average length of stay was 4.6 days, markedly less than the national average of 6.2 days. Conclusions: This organized geriatric fracture care model with geriatrics comanagement resulted in significant cost savings over a 50-month period, with associated increased quality. With an estimated 330 000 hip fractures annually in the United States, a large cost savings could potentially be realized if this model were more widely applied.
Glycogen Synthase Kinase-3 regulates multiple myeloma cell growth and bortezomib-induced cell death
Authors: Piazza Francesco , Manni Sabrina , Tubi Laura Quotti , Montini Barbara , Pavan Laura , Colpo Anna , Gnoato Marianna , Cabrelle Anna , Adami Fausto , Zambello Renato , Trentin Livio , Gurrieri Carmela , Semenzato Gianpietro
Published: October 2010

Background

Glycogen Synthase Kinase-3 (GSK-3) α and β are two serine-threonine kinases controlling insulin, Wnt/β-catenin, NF-κB signaling and other cancer-associated transduction pathways. Recent evidence suggests that GSK-3 could function as growth-promoting kinases, especially in malignant cells. In this study, we have investigated GSK-3α and GSK-3β function in multiple myeloma (MM).

Methods

GSK-3 α and β expression and cellular localization were investigated by Western blot (WB) and immunofluorescence analysis in a panel of MM cell lines and in freshly isolated plasma cells from patients. MM cell growth, viability and sensitivity to bortezomib was assessed upon treatment with GSK-3 specific inhibitors or transfection with siRNAs against GSK-3 α and β isoforms. Survival signaling pathways were studied with WB analysis.

Results

GSK-3α and GSK-3β were differently expressed and phosphorylated in MM cells. Inhibition of GSK-3 with the ATP-competitive, small chemical compounds SB216763 and SB415286 caused MM cell growth arrest and apoptosis through the activation of the intrinsic pathway. Importantly, the two inhibitors augmented the bortezomib-induced MM cell cytotoxicity. RNA interference experiments showed that the two GSK-3 isoforms have distinct roles: GSK-3β knock down decreased MM cell viability, while GSK-3α knock down was associated with a higher rate of bortezomib-induced cytotoxicity. GSK-3 inhibition caused accumulation of β-catenin and nuclear phospho-ERK1, 2. Moreover, GSK-3 inhibition and GSK-3α knockdown enhanced bortezomib-induced AKT and MCL-1 protein degradation. Interestingly, bortezomib caused a reduction of GSK-3 serine phosphorylation and its nuclear accumulation with a mechanism that resulted partly dependent on GSK-3 itself.

Conclusions

These data suggest that in MM cells GSK-3α and β i) play distinct roles in cell survival and ii) modulate the sensitivity to proteasome inhibitors.
Favorable response to doxorubicin combination chemotherapy does not yield good clinical outcome in patients with metastatic breast cancer with triple-negative phenotype
Authors: Yi Seong Yoon , Ahn Jin Seok , Uhm Ji Eun , Lim Do Hyoung , Ji Sang Hoon , Jun Hyun Jung , Kim Kyoung Ha , Chang Myung Hee , Park Min Jae , Cho Eun Yoon , La Choi Yoon , Park Yeon Hee , Im Young-Hyuck
Published: October 2010

Background

We analyzed the responses to first line treatment and clinical outcomes of metastatic breast cancer patients treated with palliative doxorubicin/cyclophosphamide (AC) according to molecular cancer subtype.

Methods

A retrospective analysis was performed for 110 metastatic breast cancer patients selected on the basis of palliative AC treatment and the availability of immunohistochemical data for estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor-2 (HER-2/neu) status.

Results

Of the 110 patients analyzed, 71 (64.5%) were hormone receptor positive (HR+), 14 (12.7%) were HER2+, and 25 (22.7%) were triple negative (TN). There were no differences in age, stage at diagnosis, total number of cycles of palliative chemotherapy, incidence of visceral metastasis, and metastatic sites with the exception of liver among breast cancer subtypes. The overall response rates to AC were 55.9% for the HR+ subgroup, 42.9% for the HER2+ subgroup, and 56.5% for the TN subgroup. The progression-free survival (PFS) in patients with HER2+ and TN were significantly shorter than in the HR+ (median PFS, 9.1 vs 8.1 vs 11.5 months, respectively; p = 0.0002). The overall survival (OS) was 25.4 months in the TN subgroup and 27.3 months in HER2+ subgroup. The median OS for these two groups was significantly shorter than for patients in the HR+ subgroup (median, 38.5 months; 95% CI, 30.1-46.9 months; p < 0.0001).

Conclusions

The response to palliative AC chemotherapy did not differ among breast cancer subtypes. Despite chemosensitivity for palliative AC, the TN subtype has a shorter overall survival than non-TN subtypes. Innovative treatment strategies should be developed to slow the course of disease.
Relating the shape of protein binding sites to binding affinity profiles: is there an association?
Authors: Simon Zoltán , Vigh-Smeller Margit , Peragovics Ágnes , Csukly Gábor , Zahoránszky-Kőhalmi Gergely , Rauscher Anna Á , Jelinek Balázs , Hári Péter , Bitter István , Málnási-Csizmadia András , Czobor Pál
Published: October 2010

Background

Various pattern-based methods exist that use in vitro or in silico affinity profiles for classification and functional examination of proteins. Nevertheless, the connection between the protein affinity profiles and the structural characteristics of the binding sites is still unclear. Our aim was to investigate the association between virtual drug screening results (calculated binding free energy values) and the geometry of protein binding sites. Molecular Affinity Fingerprints (MAFs) were determined for 154 proteins based on their molecular docking energy results for 1,255 FDA-approved drugs. Protein binding site geometries were characterized by 420 PocketPicker descriptors. The basic underlying component structure of MAFs and binding site geometries, respectively, were examined by principal component analysis; association between principal components extracted from these two sets of variables was then investigated by canonical correlation and redundancy analyses.

Results

PCA analysis of the MAF variables provided 30 factors which explained 71.4% of the total variance of the energy values while 13 factors were obtained from the PocketPicker descriptors which cumulatively explained 94.1% of the total variance. Canonical correlation analysis resulted in 3 statistically significant canonical factor pairs with correlation values of 0.87, 0.84 and 0.77, respectively. Redundancy analysis indicated that PocketPicker descriptor factors explain 6.9% of the variance of the MAF factor set while MAF factors explain 15.9% of the total variance of PocketPicker descriptor factors. Based on the salient structures of the factor pairs, we identified a clear-cut association between the shape and bulkiness of the drug molecules and the protein binding site descriptors.

Conclusions

This is the first study to investigate complex multivariate associations between affinity profiles and the geometric properties of protein binding sites. We found that, except for few specific cases, the shapes of the binding pockets have relatively low weights in the determination of the affinity profiles of proteins. Since the MAF profile is closely related to the target specificity of ligand binding sites we can conclude that the shape of the binding site is not a pivotal factor in selecting drug targets. Nonetheless, based on strong specific associations between certain MAF profiles and specific geometric descriptors we identified, the shapes of the binding sites do have a crucial role in virtual drug design for certain drug categories, including morphine derivatives, benzodiazepines, barbiturates and antihistamines.
The frequency of CD25+CD4+ and FOXP3+ regulatory T cells in ectopic endometrium and ectopic decidua
Authors: Basta Pawel , Majka Marcin , Jozwicki Wojciech , Lukaszewska Ewelina , Knafel Anna , Grabiec Marek , Stasienko Elzbieta , Wicherek Lukasz
Published: October 2010

Background

The presence of regulatory T (Treg) cells in human endometrium is crucial for maintaining immunological homeostasis within the uterus. For this study we decided to evaluate the subpopulations of Treg cells in conditions where a disturbance in the immunological equilibrium in ectopic endometrium and decidua has been observed, such as in cases of ovarian endometriosis (involving local immune cell suppression) and ectopic pregnancy (involving an increase in local immune system activity). We then compared these findings to what we observed in the normal eutopic endometrium of women during the secretory phase of the menstrual cycle (with immune cells under individual control).

Methods

The endometrium tissue samples evaluated in our study were obtained from 47 women during one of two kinds of laparoscopic procedures. 16 of the women underwent laparoscopies due to Fallopian tube pregnancies (EP), and 16 due to ovarian endometrioma, while 15 women made up a control group. The presence of regulatory T cells in these tissue samples was evaluated by FACS.

Results

In our study, the percentages of FOXP3+ cells within the subpopulation of CD4+ T lymphocytes found in the decidua of the patients treated for Fallopian tube pregnancies were statistically significantly lower than both those observed in the ovarian endometriosis tissue samples and those found in the secretory eutopic endometrium samples of the control group.

Conclusion

The disturbance in the immunological equilibrium observed in ectopic endometrium and decidua would seem to be related to the alteration in the Treg cell population that occurs in these ectopic tissues.
Increased matrix metalloproteinase activation in esophageal squamous cell carcinoma
Authors: Mukherjee Sumana , Roth Mark J , Dawsey Sanford M , Yan Wusheng , Rodriguez-Canales Jaime , Erickson Heidi S , Hu Nan , Goldstein Alisa M , Taylor Philip R , Richardson Annely M , Tangrea Michael A , Chuaqui Rodrigo F , Emmert-Buck Michael R
Published: October 2010

Background

Esophageal squamous cell carcinomas (ESCC) are usually asymptomatic and go undetected until they are incurable. Cytological screening is one strategy to detect ESCC at an early stage and has shown promise in previous studies, although improvement in sensitivity and specificity are needed. Proteases modulate cancer progression by facilitating tumor invasion and metastasis. In the current study, matrix metalloproteinases (MMPs) were studied in a search for new early detection markers for ESCC.

Methods

Protein expression levels of MMPs were measured using zymography in 24 cases of paired normal esophagus and ESCC, and in the tumor-associated stroma and tumor epithelium in one sample after laser capture microdissection (LCM). MMP-3 and MMP-10 transcripts in both the epithelium and stroma in five cases were further analyzed by quantitative reverse transcriptase polymerase chain reaction (qRT-PCR).

Results

Gelatin zymography showed bands corresponding in size to MMP-2, MMP-3, MMP-9, and MMP-10 enzymes in each of the 24 cancer cases. MMP levels tended to be higher in tumors than paired normal tissue; however, only the 45 kDa band that corresponds to the activated form of MMP-3 and MMP-10 was strongly expressed in all 24 tumors with little or no expression in the paired normal foci. LCM-based analysis showed the 45 kDA band to be present in both the stromal and epithelial components of the tumor microenvironment, and that MMP-3 and MMP-10 mRNA levels were higher in tumors than paired normal tissues for each compartment.

Conclusions

Increased levels of MMPs occur in ESCC suggesting their up-regulation is important in esophageal tumorigenesis. The up-regulated gene products have the potential to serve as early detection markers in the clinic.
Folk medicine used to heal malaria in Calabria (southern Italy)
Authors: Tagarelli Giuseppe , Tagarelli Antonio , Piro Anna
Published: October 2010

In Italy, malaria was an endemic disease that was eradicated by the mid-20th century. This paper evaluates the prophylactic and therapeutic remedies used by folk medicine to cure malaria in Calabria (southern Italy).

The data has been collected by analysing works of physicians, ethnographers, folklorists and specialists of the study of Calabrian history between the end of the 19th century and the 20th century. The data collected have allowed us to describe the most common cures used by the Calabrian people to treat malaria and the most evident symptoms of this disease, such as intermittent fever, hepato-spleenomegaly, asthenia and dropsy. This approach uncovered a heterogeneous corpus of empirical, magical and religious remedies, which the authors have investigated as evidences of past "expert medicine" and to verify their real effectiveness in the treatment of malaria.
A novel mutation of the ACADM gene (c.145C>G) associated with the common c.985A>G mutation on the other ACADM allele causes mild MCAD deficiency: a case report
Authors: Dessein Anne-Frédérique , Fontaine Monique , Andresen Brage S , Gregersen Niels , Brivet Michèle , Rabier Daniel , Napuri-Gouel Silvia , Dobbelaere Dries , Mention-Mulliez Karine , Martin-Ponthieu Annie , Briand Gilbert , Millington David S , Vianey-Saban Christine , Wanders Ronald JA , Vamecq Joseph
Published: October 2010

A female patient, with normal familial history, developed at the age of 30 months an episode of diarrhoea, vomiting and lethargy which resolved spontaneously. At the age of 3 years, the patient re-iterated vomiting, was sub-febrile and hypoglycemic, fell into coma, developed seizures and sequels involving right hemi-body. Urinary excretion of hexanoylglycine and suberylglycine was low during this metabolic decompensation. A study of pre- and post-prandial blood glucose and ketones over a period of 24 hours showed a normal glycaemic cycle but a failure to form ketones after 12 hours fasting, suggesting a mitochondrial β-oxidation defect. Total blood carnitine was lowered with unesterified carnitine being half of the lowest control value. A diagnosis of mild MCAD deficiency (MCADD) was based on rates of 1-14C-octanoate and 9, 10-3H-myristate oxidation and of octanoyl-CoA dehydrogenase being reduced to 25% of control values. Other mitochondrial fatty acid oxidation proteins were functionally normal. De novo acylcarnitine synthesis in whole blood samples incubated with deuterated palmitate was also typical of MCADD. Genetic studies showed that the patient was compound heterozygous with a sequence variation in both of the two ACADM alleles; one had the common c.985A>G mutation and the other had a novel c.145C>G mutation. This is the first report for the ACADM gene c.145C>G mutation: it is located in exon 3 and causes a replacement of glutamine to glutamate at position 24 of the mature protein (Q24E). Associated with heterozygosity for c.985A>G mutation, this mutation is responsible for a mild MCADD phenotype along with a clinical story corroborating the emerging literature view that patients with genotypes representing mild MCADD (high residual enzyme activity and low urinary levels of glycine conjugates), similar to some of the mild MCADDs detected by MS/MS newborn screening, may be at risk for disease presentation.
Variations in the length of stay of intensive care unit nonsurvivors in three scandinavian countries
Authors: Strand Kristian , Walther Sten M , Reinikainen Matti , Ala-Kokko Tero , Nolin Thomas , Martner Jan , Mussalo Petteri , Søreide Eldar , Flaatten Hans K
Published: October 2010

Introduction

The length of stay (LOS) in intensive care unit (ICU) nonsurvivors is not often reported, but represents an important indicator of the use of resources. LOS in ICU nonsurvivors may also be a marker of cultural and organizational differences between units. In this study based on the national intensive care registries in Finland, Sweden, and Norway, we aimed to report intensive care mortality and to document resource use as measured by LOS in ICU nonsurvivors.

Methods

Registry data from 53,305 ICU patients in 2006 were merged into a single database. ICU nonsurvivors were analyzed with regard to LOS within subgroups by univariate and multivariate analysis (Cox proportional hazards regression).

Results

Vital status at ICU discharge was available for 52,255 patients. Overall ICU mortality was 9.1%. Median LOS of the nonsurvivors was 1.3 days in Finland and Sweden, and 1.9 days in Norway. The shortest LOS of the nonsurvivors was found in patients older than 80 years, emergency medical admissions, and the patients with the highest severity of illness. Multivariate analysis confirmed the longer LOS in Norway when corrected for age group, admission category, sex, and type of hospital. LOS in nonsurvivors was found to be inversely related to the severity of illness, as measured by APACHE II and SAPS II.

Conclusions

Despite cultural, religious, and educational similarities, significant variations occur in the LOS of ICU nonsurvivors among Finland, Norway, and Sweden. Overall, ICU mortality is low in the Scandinavian countries.
Rotational motions in homogeneous anisotropic elastic media
Authors: Pham Nguyen Dinh , Igel Heiner , de la Puente Josep , Käser Martin , Schoenberg Michael A.
Published: October 2010

Rotational motions in homogeneous anisotropic elastic media are studied under the assumption of plane wave propagation. The main goal is to investigate the influences of anisotropy in the behavior of the rotational wavefield. The focus is on P-waves that theoretically do not generate rotational motion in isotropic media. By using the Kelvin–Christoffel equation, expressions are obtained of the rotational motions of body waves as a function of the propagation direction and the coefficients of the elastic modulus matrix. As a result, the amplitudes of the rotation rates and their radiation patterns are quantified and it is concluded that (1) for strong local earthquakes and typical reservoir situations quasi P-rotation rates induced by anisotropy are significant, recordable, and can be used for inverse problems; and (2) for teleseismic wavefields, anisotropic effects are unlikely to be responsible for the observed rotational energy in the P coda.