bluuebunny/crossref_metadata_2025 huggingface dataset:
The Team Education and Adherence Monitoring (TEAM) Trial
Authors: Svarstad Bonnie L. , Kotchen Jane Morley , Shireman Theresa I. , Crawford Stephanie Y. , Palmer Pamela A. , Vivian Eva M. , Brown Roger L.
Published: May 2009

Recent studies suggest that involving pharmacists is an effective strategy for improving patient adherence and blood pressure (BP) control. To date, few controlled studies have tested the cost-effectiveness of specific models for improving patient adherence and BP control in community pharmacies, where most Americans obtain prescriptions. We hypothesized that a team model of adherence monitoring and intervention in corporately owned community pharmacies can improve patient adherence, prescribing, and BP control among hypertensive black patients. The Team Education and Adherence Monitoring (TEAM) Trial is a randomized controlled trial testing a multistep intervention for improving adherence monitoring and intervention in 28 corporately owned community pharmacies. Patients in the 14 control pharmacies received “usual care,” and patients in the 14 intervention pharmacies received TEAM Care by trained pharmacists and pharmacy technicians working with patients and physicians. Data collectors screened 1250 patients and enrolled 597 hypertensive black patients. The primary end points were the proportion of patients achieving BP control and reductions in systolic and diastolic BP measured after 6 and 12 months. Secondary end points were changes in adherence monitoring and intervention, patient adherence and barriers to adherence, prescribing, and cost-effectiveness. Researchers also will examine potential covariates and barriers to change. Involving pharmacists is a potentially powerful means of improving BP control in blacks. Pharmacists are in an excellent position to monitor patients between clinic visits and to provide useful information to patients and physicians.
Prolactin and Preclinical Atherosclerosis in Menopausal Women With Cardiovascular Risk Factors
Authors: Georgiopoulos George A. , Stamatelopoulos Kimon S. , Lambrinoudaki Irene , Lykka Maria , Kyrkou Katerina , Rizos Dimitrios , Creatsa Maria , Christodoulakos George , Alevizaki Maria , Sfikakis Petros P. , Papamichael Christos
Published: May 2009

Hyperprolactinemia has been associated with endothelial dysfunction and an adverse cardiovascular risk profile, possibly as a result of the vasoconstrictive properties of prolactin. In this cross-sectional study, we examined the hypothesis that prolactin contributes to the increased cardiovascular risk occurring in early menopause by studying apparently healthy women without hyperprolactinemia. Prolactin serum levels were measured by immunoassay in 76 women aged 54.4±4.9 years in menopause for 4.9±2.8 years, and possible correlations with traditional cardiovascular risk factors and surrogate markers of preclinical atherosclerosis, arterial stiffening, and endothelial and microcirculatory function were examined. Positive correlations between prolactin serum levels and arterial blood pressure, but no other traditional risk factors, were found. Prolactin also correlated with central aortic systolic (
r
=0.337;
P
=0.002) and diastolic (
r
=0.272;
P
=0.012) blood pressures and pulse wave velocity (
r
=0.264;
P
=0.02), a marker of aortic stiffness, but not with endothelial or microcirculatory function or carotid intima-media thickness. By multivariate regression analysis, prolactin levels determined, independent of traditional risk factors, both blood pressures and aortic stiffness. Notably, prolactin correlated with European Society of Cardiology HeartScore (
r
=0.364;
P
=0.002), a composite index that predicts 10-year cardiovascular mortality. Prolactin levels >8.0 ng/mL had 100% sensitivity to predict a high peripheral blood pressure. Prolactin may play a role in accelerated arteriosclerosis in early menopause by affecting central/peripheral blood pressure and arterial stiffness. In contrast, no correlation was observed with other risk factors or surrogate markers of atherosclerosis. Prospective studies to assess whether prolactin is an additional hormone increasing cardiovascular risk are warranted.
Atorvastatin Prevents Angiotensin II–Induced Vascular Remodeling and Oxidative Stress
Authors: Briones Ana M. , Rodríguez-Criado Natalia , Hernanz Raquel , García-Redondo Ana B. , Rodrigues-Díez Raul R. , Alonso María J. , Egido Jesús , Ruiz-Ortega Marta , Salaices Mercedes
Published: May 2009

Angiotensin II (Ang II) modulates vasomotor tone, cell growth, and extracellular matrix deposition. This study analyzed the effect of atorvastatin in the possible alterations induced by Ang II on structure and mechanics of mesenteric resistance arteries and the signaling mechanisms involved. Wistar rats were infused with Ang II (100 ng/kg per day, SC minipumps, 2 weeks) with or without atorvastatin (5 mg/kg per day). Ang II increased blood pressure and plasmatic malondialdehyde levels. Compared with controls, mesenteric resistance arteries from Ang II–treated rats showed the following: (1) decreased lumen diameter; (2) increased wall/lumen; (3) decreased number of adventitial, smooth muscle, and endothelial cells; (4) increased stiffness; (5) increased collagen deposition; and (6) diminished fenestrae area and number in the internal elastic lamina. Atorvastatin did not alter blood pressure but reversed all of the structural and mechanical alterations of mesenteric arteries, including collagen and elastin alterations. In mesenteric resistance arteries, Ang II increased vascular O
2
·−
production and diminished endothelial NO synthase and CuZn/superoxide dismutase but did not modify extracellular-superoxide dismutase expression. Atorvastatin improved plasmatic and vascular oxidative stress, normalized endothelial NO synthase and CuZn/superoxide dismutase expression, and increased extracellular-superoxide dismutase expression, showing antioxidant properties. Atorvastatin also diminished extracellular signal–regulated kinase 1/2 activation caused by Ang II in these vessels, indicating an interaction with Ang II–induced intracellular responses. In vascular smooth muscle cells, collagen type I release mediated by Ang II was reduced by different antioxidants and statins. Moreover, atorvastatin downregulated the Ang II–induced NADPH oxidase subunit, Nox1, expression. Our results suggest that statins might exert beneficial effects on hypertension-induced vascular remodeling by improving vascular structure, extracellular matrix alterations, and vascular stiffness. These effects might be mediated by their antioxidant properties.
Boundaries and Territoriality in South Asia
Authors: Mishra Atul
Published: May 2009

This article examines the theoretical salience of territoriality, particularly in South Asia, by comparing the histories of the region's three most contentious boundaries—Durand, McMahon and Radcliffe lines. It argues that four distinct avenues are central to theoretical considerations on territoriality in South Asia: the role of liberalism in colonial construction of state; international and domestic dimensions of geopolitics; disruptions in demographic and cultural contiguities produced by the boundaries; and the nature of sovereignty resulting from the experience of colonialism. Traditional lenses for studying boundaries and territoriality offer limited analytical purchase. The article posits that critical geopolitics and history-intensive approaches allow a better grasp of material and discursive dimensions of territoriality. Such an eclectic consideration is especially suitable for studying territoriality in South Asia given the region's cross-border complexities, both real and symbolic.
Multilevel, Two-Parameter, and Random-Weights Generalizations of a Model With Internal Restrictions on Item Difficulty
Authors: Wang Wen-Chung , Jin Kuan-Yu
Published: May 2009

In this study, all the advantages of slope parameters, random weights, and latent regression are acknowledged when dealing with component and composite items by adding slope parameters and random weights into the standard item response model with internal restrictions on item difficulty and formulating this new model within a multilevel framework in which Level 2 predictors are added to account for variation in the latent trait. The resulting model is a nonlinear mixed model (NLMM) so that existing parameter estimation procedures and computer packages for NLMMs can be directly adopted to estimate the parameters. Through simulations, it was found that the SAS NLMIXED procedure could recover the parameters in the new model fairly well and produce appropriate standard errors. To illustrate applications of the new model, a real data set pertaining to guilt was analyzed with gender as a Level 2 predictor. Further model generalization is discussed.
Aprotinin concentration varies significantly according to cardiopulmonary bypass conditions
Authors: Okamura T , Ishibashi N , Iwata Y , Zurakowski D , Jonas RA
Published: May 2009

Although aprotinin is partially excreted unchanged in the urine, its primary site of metabolism is in the renal lysosomes following proximal tubule resorption. This study tested the hypothesis that plasma aprotinin concentration varies with cardiopulmonary bypass conditions. Thirty-two piglets (weight 13.2 ± 1.9 kg) received an aprotinin initial dose of 30,000 KIU/kg, a maintenance infusion of 10,000 KIU/kg/h, with a cardiopulmonary bypass (CPB) prime of 30,000 KIU/kg. Aprotinin infusion was terminated at the end of CPB and stopped during hypothermic circulatory arrest (HCA). Piglets were randomized to four groups (n = 8 per group): HCA, 60-minute period at 15°C; low-flow (LF), 10 mL/kg/min low-flow CPB at 25°C; full flow (FF), full flow CPB at 37°C; control at 37°C without CPB. Blood samples were collected at 7 time points: after induction of anesthesia (baseline), after initial dose, 10, 50 and 115 min after start of CPB, just before end of CPB and 30 min after CPB. Plasma aprotinin levels were determined by modified functional assays. Aprotinin levels in the control group were significantly lower at each point after start of CPB than all groups with CPB ( p < .001). In particular, during the reperfusion period, aprotinin levels were higher in HCA and LF groups than FF group ( p < .05). Throughout CPB, aprotinin levels in the HCA group remained unchanged ( p > .40). Bypass conditions affect plasma aprotinin concentration. Recently reported renal and neurological complications with aprotinin use during CPB may reflect excessive dosing and point to the need for real-time monitoring.
Heidegger, Digital Technology, and Postmodern Education
Authors: Walters Patrick , Kop Rita
Published: May 2009

Digital technology is transforming life and is beginning to have a profound effect on individual psychic life and the wider social milieu. This article seeks to understand the nature of the new technology and its implications for personal life, culture, and education. The scene is set by comparing the introduction of printing to the revolution inaugurated by digital technology. This new age is often called “postmodern,” and some of the characteristics of the age suggested by Lyotard, Baudrillard, McLuhan, and others are identified. The cultural impact of technology, according to Heidegger, is outlined, together with the interpretation in terms of digital technology proposed by Dreyfus and Spinosa. This is illustrated with examples and compared with the position of other thinkers. Finally, the consequences for education, including universities, are presented, and some proposals for approaches to education in terms of meaning, embodiment, and teacher-student relationship are considered.
Science-Technology-Society (STS)
Authors: Mansour Nasser
Published: May 2009

Changes in the past two decades of goals for science education in schools have induced new orientations in science education worldwide. One of the emerging complementary approaches was the science-technology-society (STS) movement. STS has been called the current megatrend in science education. Others have called it a paradigm shift for the field of science education. The success of science education reform depends on teachers' ability to integrate the philosophy and practices of current programs of science education reform with their existing philosophy. Thus, when considering the STS approach to science education, teacher beliefs about STS implementation require attention. Without this attention, negative beliefs concerning STS implementation and inquiry learning could defeat the reform movements emphasizing STS. This article argues the role of STS in science education and the importance of considering science teachers' beliefs about STS in implementing significant reforms in science education.
American Exceptionalism, Human Resource Management, and the Contract State
Authors: Durant Robert F. , Girth Amanda M. , Johnston Jocelyn M.
Published: May 2009

With the nature, scope, and pace of public sector contracting accelerating significantly during the Bush administration, and with the Obama administration promising to curb the contracting excesses of its predecessors, it is useful to take stock and ponder the consequences of this movement to date for human resource management. This article puts public sector contracting and its effects in a larger historical, political, and democratic context by (a) reviewing the American propensity for market-based solutions (including contracting) to government problems, a disposition rooted in American exceptionalist values; (b) chronicling how that predisposition has manifested itself in four successive and now overlapping expansions of contracting (from products, to services, to core governmental functions, to human resource management functions); and (c) showing how these developments have had significant consequences not only for the future of the public service but also for the values associated with democratic constitutionalism in the United States.
Depressive Episode With Catatonic Features in a Case of Mitochondrial Myopathy, Encephalopathy, Lactic Acidosis, and Stroke-Like Episodes (MELAS)
Authors: Ju Seok Ryu  , Sook Joung Lee  , In Young Sung  , Tae Sung Ko  , Han Ik Yoo
Published: May 2009

Three months previously, a 17-year-old girl had complained of right-hand side hemiparesis, and her brain magnetic resonance imaging (MRI) showed a signal change in the left temporoparietooccipital area. The 3243A>G mutation was found in mitochondrial DNA. She was diagnosed with mitochondrial myopathy, encephalopathy, lactic acidosis, and stroke-like episodes (MELAS) and was prescribed dichloroacetic acid to treat lactic acidosis. Her health improved. Two months later, she developed drowsiness and generalized weakness. A New lesion was not found on brain MRI, and electrodiagnostic findings were compatible with acute motor sensory axonal neuropathy. Her negative symptoms, such as depressed mood, loss of interest in activities, psychomotor retardation, and hypersomnia, were aggravated. She was prescribed antidepressants and psychostimulants by a psychiatrist after diagnosis of severe depression episode with catatonic features. One month later, her catatonic condition had improved with medication. Our experience shows that psychiatric diagnostic evaluation of abruptly regressed neurologic and clinical features is important, even in a patient with devastating underlying disease.
In Vitro Evaluation of a 3D PLGA–TCP Composite Scaffold in an Experimental Bioreactor
Authors: Mäkitie Antti A. , Yan Yongnian , Wang Xiaohong , Xiong Zhuo , Paloheimo Kaija-Stiina , Tuomi Jukka , Paloheimo Markku , Salo Jari , Renkonen Risto
Published: May 2009

A 3D poly(lactic acid-co-glycolic acid)/tricalcium phosphate (PLGA-TCP) composite scaffold, generated with the low-temperature deposition modeling rapid prototyping technique, was tested for its viability in a 3D cell cultivation in vitro. The aim was to find optimal cell culture conditions for the selected scaffold material and to monitor cell division, differentiation, and migration of selected cell types in this environment. In addition, the behavior and cell-matrix interactions of selected cell types were monitored as well as the biodegradation rate of the tested scaffold material. Chinese hamster ovary cells as well as a human cell line 293 epithelial cells were cultured on the scaffolds. A variety of different preconditioning protocols were deployed to prepare the scaffolds before seeding with the cells. Cell cultivations were conducted for 1–4 weeks and the coverage of the luminal surfaces was analyzed with light microscopy. Long cultivation periods were required to achieve partial coverage of the luminal surfaces of the scaffolds. Tissue engineering with 3D cell cultures and biomaterials represents a promising approach for organ manufacturing research. It may have potential for eventual on-demand high-throughput production of artificial tissues but the process has many challenges. The culture system in a well controlled bioreactor environment is discussed.
Rapid Prototyping a Double-layer Polyurethane—collagen Conduit and its Schwann Cell Compatibility
Authors: Cui Tongkui , Wang Xlaohong , Tan Yongnian , Zhang Renji
Published: May 2009

A new double-layer conduit that combined an outer synthetic Polyurethane (PU) layer and inner natural collagen layer was fabricated via a double-nozzle low-temperature deposition manufacturing (DLDM) technology. The outer PU layer provided a mechanically stable tunnel against scar tissue invasion in vivo, while the inner collagen layer promoted Schwann cell adhesion, migration, and proliferation. Microporous structures were found in both the layers. A tight connection between the double layers was achieved by adjusting the distance between the two deposit nozzles and adjusting other processing parameters. Schwann cells from rat sciatic nerves were cultured in the layered PU-collagen conduits for one week; a significant enhancement in their retention and viability was seen compared to those made of pure PU. The poly(urethane-collagen) double layer conduit had better Schwann cell compatibility and so has a great potential use in clinical peripheral nerve repair.
In Vitro Cytotoxicity of Bacterial Cellulose Scaffolds Used for Tissue-engineered Bone
Authors: Chen Y.M. , Xi Tingfei , Zheng Yudong , Guo Tingting , Hou Jiaquan , Wan Yizao , Gao Chuan
Published: May 2009

The in vitro degradation and cytotoxicity of bacterial cellulose (BC) and its degradation products were studied for potential applications in bone tissue engineering. Emission scanning electron microscope was used to observe the morphology of original materials and their degradation products. The degradation was evaluated by measuring the concentration of reducing sugar by using ultraviolet spectrophotometer. Bone forming osteoblast (OB) cells and infinite culture cell line L929 fibroblasts were used to measure the cytotoxicity of materials using the MTT assay. Both types of cells proliferated normally with the BC and its degradation products with a cytotoxicity graded of 0–1. Nevertheless, the bone-forming target OB cells were more susceptible to cytotoxicity than the infinite culture fibroblast cells L929 fibroblasts. The results indicate that the BC is not very cytotoxic and that tissue functional cells are more suitable for evaluating the cytotoxicity of biomedical materials.
Controlled Adipose-derived Stromal Cells Differentiation into Adipose and Endothelial Cells in a 3D Structure Established by Cell-assembly Technique
Authors: Xu Mingen , Van Yongnian , Liu Haixia , Yag Rui , Wang Xiaohong
Published: May 2009

One of the major obstacles in engineering thick and complex tissues while vascularizing tissues in vitro is to maintain cell viability during tissue growth and structural organization. Adipose-derived stromal (ADS) cells were used to establish a multicellular system through a cell-assembly technique. Attempts were made to control ADS cells differentiation into different targeted cell types according to their positions within an orderly 3D structure. Oil red 0 staining confirmed that the ADS cells in the structure differentiated into adipocytes with a spherical shape while immunostaining tests confirmed that the endothelial growth factor induced ADS cells on the walls of channels differentiated into mature endothelial cells and then organized into tubular structures throughout the engineered 3D structure. The endothelin-1 and nitric oxide release rules of the endothelial cells were coincidental with those in vivo.

This study provides a new approach to engineer orderly endothelial vessel networks in vitro and has potential applications in adipose-tissue engineering.
Gradient Hydrogel Construct Based on an Improved Cell Assembling System
Authors: Li Shengjie , Yan Yongnian , Xiong Zhuo , Zhang Chenyang Weng Renji , Wang Xiaohong
Published: May 2009

In this study, a two-step crosslinking method derived from commercial rapid prototyping equipment was used to fabricate a gradient hydrogel scaffold in vitro. This system contained two types of nozzles; one was double-nozzle unit, used for relatively simple gradient hydrogel scaffold composed of two nonmiscible hydrogel materials. The other was single nozzle that was used for mixing a gradient hydrogel scaffold composed of two types of hydrogel materials. Different types of scaffolds were formed by modifying the gradient in one of the relevant nozzles. To improve the extrusion controlling effect, accessorial parameters were introduced. A 3D gradient construct containing neuron cells and Schwann cells was fabricated and cultured for 7 days. This construct was helpful in designing a gradient mode to observe the relationship between different cells in vitro. This work has improved tissue-engineering techniques for later manufacturing of very complicated organ analogs.
Is There a Threshold Level of Inflation for Bangladesh?
Authors: Hayat Zia Uddin Chowdhury , Kalirajan Kaliappa P.
Published: May 2009

Given the argument that an excessively low inflation threshold in developed countries may hurt economic growth, the objective of this study is to examine whether a developing country's perspective is different. The empirical analysis is done using the annual data from Bangladesh for the period 1976 to 2005. A specific question that is addressed in this paper is what the threshold inflation rate is for Bangladesh. The findings clearly suggest that the increase in inflation from any level has negative effects on economic growth, and substantial gains can be obtained by focusing monetary policy towards maintaining price stability.
Damage Evaluation of Piezoelectric Ceramics from the Variation of the Elastic Coefficient under Static Compressive Stress
Authors: Mizuno Mamoru , Okayasu Mitsuhiro , Odagiri Nozomi
Published: May 2009

In the present article, columnar specimens of lead zirconate titanate (PZT) were subjected to static compressive stress, and the characteristics of fracture under compression were clarified. The fracture tests were interrupted at certain intervals, and resonance and anti-resonance frequencies and electrostatic capacity were measured by means of an impedance analyzer with the compressive stress unloaded. The interruption and measurement were repeated with the maximum stress increased up to the fracture. The material properties of the specimens such as the electromechanical coupling coefficient, the dielectric constant, the elastic coefficient, and the piezoelectric constant were evaluated based on the resonant properties, and the variation of the material properties in the process of the fracture were clarified experimentally. An elastic coefficient was also evaluated from stress— strain relations during the compression fracture tests, and the difference in the elastic coefficient depending on the method of evaluation was discussed. Furthermore, internal damage developed in the specimens during the compression fracture tests was evaluated based on the variation of the elastic coefficients indirectly as a scalar damage variable on the basis of the continuum damage mechanics. Features of the damage development and the dependence of the quantitative value of the damage variables on the evaluation method of the elastic coefficient were discussed. SEM micrographs of the fracture surface were observed and the causes of the damage were investigated.
Attributes of competence — on GPs’ work performance in daily practice
Authors: Landström Björn , Mattsson Bengt , Rudebeck Carl Edvard
Published: May 2009

Aim: The core competencies of general practitioners (GP) are ordinarily formulated by professional bodies and international organisations, like the World Organization of Family Doctors (Wonca). Official documents are sometimes questioned as being too comprehensive and products of the drawing board. The aim was to explore clinically oriented GPs own description of the proficiency used in everyday practice. The study could be essential both for GPs and other professionals who work with consultations. Method: Group interviews with GPs selected by regional supervisors and with substantial clinical competence were carried out. The verbatim transcribed sessions were analyzed with a qualitative content analysis approach. Results: Two main categories emerged reflecting the competence: ‘‘Professional readiness’’ and ‘‘Working behaviour’’. Professional readiness comprises the inclination of understanding and acting based on the subcategories: medical knowledge modified by experience, knowing the patient, involvement and uncertainty. Working behaviour describes in a more concrete way the doctoring approach and is formed by the subcategories: preparation, the current problem, use of time, body attention, cooperation with other professionals, and record keeping as a work aid. Conclusions: The attributes of competence of GPs empirically have two components: professional readiness and working behaviour. Together they compose a comprehensive picture of the GP’s everyday clinical setting.
Snuff use associated with abdominal obesity in former smokers
Authors: Sundbeck Mats , Grahn Mathias , Lönngren Vincent , Månsson Nils Ove , Råstam Lennart , Lindblad Ulf
Published: May 2009

Aim: To describe the consumption of snuff in a rural male population and to explore associations between snuff use and obesity. Participants and Methods: Tobacco use was explored in 834 men aged 30—75 years old who participated in a cross-sectional population survey in the municipality of Vara (participation rate was 81%). Self-reported questionnaires assessed the habits of smoking and snuff use. Anthropometric measures were obtained during a health examination. Results: Of these men 21% (n = 179) were snuff users, 13% (n = 109) current smokers, and 65% (n = 546) were non-users. Of all snuff users 65% (n = 116) were former smokers, and 35% (n = 63) were exclusive snuff users (current users who never smoked). Among non-users 65% (n = 357) were never users and 35% (n = 189) had quit smoking without nicotine substitution. These men were characterized by abdominal obesity; OR 1.84 (1.08—3.12) (p = 0.002) (WHR 41.0) and OR 1.71 (1.08—2.72) (p = 0.022) (waist circumference 4102 cm). One can/week use of snuff among ex-smokers was associated with a 1.21 cm wider (0.05—2.36) (p = 0.041) waist circumference and 0.01 (0.00—0.02) units higher (p = 0.021) WHR. There were statistically significant associations between former smoking without current nicotine substitute and both general and abdominal obesity. No similar association with abdominal obesity was seen among exclusive snuff users. Conclusions: Abdominal obesity in current snuff users is limited to former smokers. The remaining effect of previous smoking has to be considered in future studies on obesity and related disorders in snuff users. Counselling among people who substitute snuff for smoking should include measures to prevent weight gain.
Psychiatric status among stepchildren and domestic and international adoptees in Denmark. A comparative nationwide register-based study
Authors: Laubjerg Merete , Christensen Anne Maj , Petersson Birgit
Published: May 2009

Aims: To investigate adoptees’ psychiatric contact compared with non-adoptees and to clarify the related diagnoses. Method: Observational, nationwide, register-based study, where correlations between psychiatric, demographic and socioeconomic variables were analyzed for adoptees compared with non-adoptees. The study period is 1992—2008. The setting is Denmark, encompassing seven different types of adoptees registered from 1988 to 2005 (n = 13,524). The non-adoptees (n = 839,989) are matched on sex, age and residence. Various comparison models are designed: one with delayed entries (17 years) shows a 5.0% psychiatric contact prevalence for non-adoptees and 9.2% for adoptees (adjusted odds ratio: 2.91). Another design without delayed entries (2 years) shows a 2% prevalence for non-adoptees and 3.9% for adoptees (adjusted odds ratio 2.65). p-values <0.0005. Results: Only one type of adoptee: ‘‘registered partner’s adoption of the other partner’s child’’ has a lower risk than non-adoptees (odds ratio: 0.26). Comparison within the same birth region shows a significant increased risk for most adoption types. More adoptees than non-adoptees have more than one contact. Age at adoption is an additional risk factor for4one year only. The most frequent diagnosis is ‘‘Inherent or acquired brain suffering’’ (ICD-10: F50 — F99). Conclusions: The results stress that ‘‘adoptee’’ is an independent risk factor for psychiatric contact for international as well as for Danish adoptees. Danish stepchildren have a higher risk than non-adopted Danish children, while ‘‘registered partner’s child adopted by the other partner’’ have a lower risk than non-adopted Danish children.
`Clearing' the cervical spine in conscious trauma patients
Authors: Blackham Julian , Benger Jonathan
Published: May 2009

This is a systematic review of published evidence regarding management of the cervical spine in conscious and co-operative trauma patients. We examine the literature in the following sections: clinical evaluation of the cervical spine; use of plain radiography; use of additional radiographic views; use of computed tomography; use of magnetic resonance imaging. Finally we consider the elderly and paediatric populations, particularly where there are significant differences compared to the general adult population. This paper also reviews the literature regarding non-medical assessment of the cervical spine. We conclude that there are well-validated decision rules available to guide the clinician, and that each imaging strategy has distinct advantages and disadvantages. Familiarity with these issues provides a sound basis for safe and effective decision-making.
Management of female genital trauma
Authors: Hall Susanna , Brown David JG
Published: May 2009

The management of female genital trauma is complex and should be performed by a well-trained team of health care professionals. It is important to remember that many female genital injuries will cause not just physical injury, but also significant psychological and emotional distress that may lead on to future physical dysfunction. The approach of any health care professional in the immediate diagnosis and management of females with a genital injury must be aimed at getting the best and most appropriate care to the patient as soon as possible. It is also important to remember that many of these injuries are the result of crimes and careful documentation is required so as not to remove or invalidate evidence that may later be required by the courts. This article is aimed at non-specialist healthcare providers who may find themselves faced with a female genital trauma patient. It will cover the range of injuries and conditions that should be expected and describes the treatment that should be given for the best possible physical and psychological outcomes. At all times it should be remembered that the patient should be assessed and resuscitated in accordance with recognised ATLS protocols.
Pioneering Healthier Communities, West Michigan
Authors: Cyzman Denise , Wierenga Janet , Sielawa Julie
Published: May 2009

In 2005, the Pioneering Healthier Communities initiative prompted the creation of the Activate West Michigan coalition. One of its earliest objectives was to increase fruit and vegetable consumption for people who lived in low-income, African American, and Latino communities in urban Grand Rapids. Because the existing food environment created barriers to this objective, the coalition created community and schoolyard gardens and farmers' markets. By 2008, the Activate West Michigan coalition had begun to improve the food environment by establishing nine community and schoolyard gardens and five farmers' markets.
REACH 2010: Kansas City, Missouri
Authors: Collie-Akers Vicki , Schultz Jerry A. , Carson Valorie , Fawcett Stephen B. , Ronan Marianne
Published: May 2009

Health disparities, differences in health status, and mortality among different groups have challenged the public health commitment to health for all. African Americans and Latinos have historically experienced greater prevalence and mortality from many chronic diseases than Whites. Community mobilization is a promising approach to addressing health disparities. The Kansas City—Chronic Disease Coalition (KC-CDC), a REACH 2010 initiative, aimed to engage neighborhoods and faith organization in changing conditions to reduce risk for cardiovascular disease and diabetes. Using a time series design replicated with each of these two sectors, we examined the effects of a microgrant strategy and a resource distribution strategy on the coalition's facilitation of community change. Results indicate that both strategies increased the implementation of community change by neighborhood and faith organizations, with higher rates of change for the microgrant strategy. This study holds important implications for public health practitioners working with neighborhood and faith-based organizations to address health disparities.
REACH 2010: New York City
Authors: Findley Sally E. , Sanchez Martha , Mejia Miriam , Ferreira Richard , Pena Oscar , Matos Sergio , Stockwell Melissa S. , Irigoyen Matilde
Published: May 2009

Most immunization coalitions have originated with health care providers, potentially excluding families without medical homes. This study focused on a community-based approach to providing timely vaccinations. A coalition of 23 organizations developed an immunization program in a low-income community in New York City. Nearly 1,000 community health workers incorporated immunization promotion into social service and educational programs. Outcomes were coverage rates for the 4:3:1:3:3 series at 19 to 35 months, which were compared with national data by ethnicity, as reported in the National Immunization Survey 2002-2006. Parents (n = 10,251) of children <5 years received immunization education and reminders. The 2003-2007 rates of 80% equaled or exceeded the national rates for 19- to 35-month-olds, and the 2007 rate of 96.8% far surpassed the national average. Coalitions can effectively integrate immunization promotion activities into community programs. Immunization rate improvements maintained for a 5-year period, suggesting this approach to be sustainable.
High-dose therapy and autologous peripheral blood stem cell transplantation as salvage treatment for AIDS-related lymphoma: long-term results of the Italian Cooperative Group on AIDS and Tumors (GICAT) study with analysis of prognostic factors
Authors: Re Alessandro , Michieli Mariagrazia , Casari Salvatore , Allione Bernardino , Cattaneo Chiara , Rupolo Maurizio , Spina Michele , Manuele Rosa , Vaccher Emanuela , Mazzucato Mario , Abbruzzese Luciano , Ferremi Pierino , Carosi Giampiero , Tirelli Umberto , Rossi Giuseppe
Published: May 2009

After the introduction of highly active antiretroviral therapy (HAART), intensive treatment, including high-dose therapy (HDT) and peripheral blood stem cell transplantation (PBSCT), has become feasible in HIV-positive patients with Hodgkin (HL) and non-Hodgkin (NHL) lymphoma. Herein, we report the long-term results, on an intention-to-treat basis, of a prospective study on HDT and PBSCT in 50 HIV-positive HAART-responding patients with refractory/relapsed lymphoma. After debulking therapy, 2 patients had early toxic deaths, 10 had chemoresistant disease, 6 failed stem cell mobilization, 1 refused collection, and 4 progressed soon after PBSC harvest. Twenty-seven actually received transplant. Twenty-one patients are alive and disease-free after a median follow-up of 44 months (OS, 74.6%; PFS, 75.9%). Only lymphoma response significantly affected OS after transplantation. In multivariate analyses both lymphoma stage and low CD4 count negatively influenced the possibility to receive transplant. Median OS of all 50 eligible patients was 33 months (OS, 49.8%; PFS, 48.9%). Low CD4 count, marrow involvement, and poor performance status independently affected survival. PBSCT is a highly effective salvage treatment for chemosensitive AIDS-related lymphoma. It seems rational to explore its use earlier during the course of lymphoma to increase the proportion of patients who can actually receive transplant.
Effect of a glucose impulse on the CcpA regulon in Staphylococcus aureus
Authors: Seidl Kati , Müller Susanne , François Patrice , Kriebitzsch Carsten , Schrenzel Jacques , Engelmann Susanne , Bischoff Markus , Berger-Bächi Brigitte
Published: May 2009

Background

The catabolite control protein A (CcpA) is a member of the LacI/GalR family of transcriptional regulators controlling carbon-metabolism pathways in low-GC Gram-positive bacteria. It functions as a catabolite repressor or activator, allowing the bacteria to utilize the preferred carbon source over secondary carbon sources. This study is the first CcpA-dependent transcriptome and proteome analysis inStaphylococcus aureus, focussing on short-time effects of glucose under stable pH conditions.

Results

The addition of glucose to exponentially growingS. aureusincreased the expression of genes and enzymes of the glycolytic pathway, while genes and proteins of the tricarboxylic acid (TCA) cycle, required for the complete oxidation of glucose, were repressed via CcpA. Phosphotransacetylase and acetate kinase, converting acetyl-CoA to acetate with a concomitant substrate-level phosphorylation, were neither regulated by glucose nor by CcpA. CcpA directly repressed genes involved in utilization of amino acids as secondary carbon sources. Interestingly, the expression of a larger number of genes was found to be affected byccpAinactivation in the absence of glucose than after glucose addition, suggesting that glucose-independent effects due to CcpA may have a particular impact inS. aureus. In the presence of glucose, CcpA was found to regulate the expression of genes involved in metabolism, but also that of genes coding for virulence determinants.

Conclusion

This study describes the CcpA regulon of exponentially growingS. aureuscells. As in other bacteria, CcpA ofS. aureusseems to control a large regulon that comprises metabolic genes as well as virulence determinants that are affected in their expression by CcpA in a glucose-dependent as well as -independent manner.
Bacterial diversity analysis of larvae and adult midgut microflora using culture-dependent and culture-independent methods in lab-reared and field-collected Anopheles stephensi-an Asian malarial vector
Authors: Rani Asha , Sharma Anil , Rajagopal Raman , Adak Tridibesh , Bhatnagar Raj K
Published: May 2009

Background

Mosquitoes are intermediate hosts for numerous disease causing organisms. Vector control is one of the most investigated strategy for the suppression of mosquito-borne diseases. Anopheles stephensi is one of the vectors of malaria parasite Plasmodium vivax. The parasite undergoes major developmental and maturation steps within the mosquito midgut and little is known about Anopheles-associated midgut microbiota. Identification and characterization of the mosquito midgut flora is likely to contribute towards better understanding of mosquito biology including longevity, reproduction and mosquito-pathogen interactions that are important to evolve strategies for vector control mechanisms.

Results

Lab-reared and field-collected A. stephensi male, female and larvae were screened by "culture-dependent and culture-independent" methods. Five 16S rRNA gene library were constructed form lab and field-caught A. stephensi mosquitoes and a total of 115 culturable isolates from both samples were analyzed further. Altogether, 68 genera were identified from midgut of adult and larval A. stephensi, 53 from field-caught and 15 from lab-reared mosquitoes. A total of 171 and 44 distinct phylotypes having 85 to 99% similarity with the closest database matches were detected among field and lab-reared A. stephensi midgut, respectively. These OTUs had a Shannon diversity index value of 1.74–2.14 for lab-reared and in the range of 2.75–3.49 for field-caught A. stephensi mosquitoes. The high species evenness values of 0.93 to 0.99 in field-collected adult and larvae midgut flora indicated the vastness of microbial diversity retrieved by these approaches. The dominant bacteria in field-caught adult male A. stephensi were uncultured Paenibacillaceae while in female and in larvae it was Serratia marcescens, on the other hand in lab-reared mosquitoes, Serratia marcescens and Cryseobacterium meninqosepticum bacteria were found to be abundant.

Conclusion

More than fifty percent of the phylotypes were related to uncultured class of bacteria. Interestingly, several of the bacteria identified are related to the known symbionts in other insects. Few of the isolates identified in our study are found to be novel species within the gammaproteobacteria which could not be phylogenetically placed within known classes. To the best of our knowledge, this is the first attempt to study the midgut microbiota of A. stephensi from lab-reared and field-collected adult and larvae using "culture-dependent and independent methods".
Molecular beacon-based real-time PCR detection of primary isolates of Salmonella Typhimurium and Salmonella Enteritidis in environmental and clinical samples
Authors: Hadjinicolaou Andreas V , Demetriou Victoria L , Emmanuel Maria A , Kakoyiannis Charalambos K , Kostrikis Leondios G
Published: May 2009

Background

A fast and simple two-step multiplex real-time PCR assay has been developed to replace the traditional, laborious Salmonella serotyping procedure. Molecular beacons were incorporated into the assay as probes for target DNA. Target sequences were regions of the invA, prot6E and fliC genes specific for Salmonella spp. Salmonella Enteritidis and Salmonella Typhimurium, respectively, the two most clinically relevant serotypes. An internal amplification positive control was included in the experiment to ensure the optimal functioning of the PCR and detect possible PCR inhibition. Three sets of primers were used for the amplification of the target sequences. The results were compared to those of the Kauffmann-White antigenic classification scheme.

Results

The assay was 100% sensitive and specific, correctly identifying all 44 Salmonella strains, all 21 samples of S. Enteritidis and all 17 samples of S. Typhimurium tested in this work. Therefore, the entire experiment had specificity and sensitivity of 100%. The detection limit was down to 10 copies of DNA target per 25 μl reaction.

Conclusion

The assay can amplify and analyse a large number of samples in approximately 8 hours, compared to the 4 to 5 days conventional identification takes, and is thus considered a very promising method for detecting the two major serotypes of Salmonella quickly and accurately from clinical and environmental samples.
Proteomics of Porphyromonas gingivalis within a model oral microbial community
Authors: Kuboniwa Masae , Hendrickson Erik L , Xia Qiangwei , Wang Tiansong , Xie Hua , Hackett Murray , Lamont Richard J
Published: May 2009

Background

Porphyromonas gingivalis is a periodontal pathogen that resides in a complex multispecies microbial biofilm community known as dental plaque. Confocal laser scanning microscopy showed that P. gingivalis can assemble into communities in vitro with Streptococcus gordonii and Fusobacterium nucleatum, common constituents of dental plaque. Whole cell quantitative proteomics, along with mutant construction and analysis, were conducted to investigate how P. gingivalis adapts to this three species community.

Results

1156 P. gingivalis proteins were detected qualitatively during comparison of the three species model community with P. gingivalis incubated alone under the same conditions. Integration of spectral counting and summed signal intensity analyses of the dataset showed that 403 proteins were down-regulated and 89 proteins up-regulated. The proteomics results were inspected manually and an ontology analysis conducted using DAVID. Significant decreases were seen in proteins involved in cell shape and the formation of the cell envelope, as well as thiamine, cobalamin, and pyrimidine synthesis and DNA repair. An overall increase was seen in proteins involved in protein synthesis. HmuR, a TonB dependent outer membrane receptor, was up-regulated in the community and an hmuR deficient mutant was deficient in three species community formation, but was unimpaired in its ability to form mono- or dual-species biofilms.

Conclusion

Collectively, these results indicate that P. gingivalis can assemble into a heterotypic community with F. nucleatum and S. gordonii, and that a community lifestyle provides physiologic support for P. gingivalis. Proteins such as HmuR, that are up-regulated, can be necessary for community structure.