bluuebunny/crossref_metadata_2025 huggingface dataset:
Is decreased bone mineral density associated with development of scoliosis? A bipedal osteopenic rat model
Authors: Dede Ozgur , Akel Ibrahim , Demirkiran Gokhan , Yalcin Nadir , Marcucio Ralph , Acaroglu Emre
Published: November 2011

Background

An association between adolescent idiopathic scoliosis and osteopenia has been proposed to exist. It is still not clear whether there is such an association and if so, whether osteopenia is a causative factor or a consequence. Our previous pilot studies have suggested the presence of osteopenia in scoliotic animals. The aim of this study was to investigate the development of scoliosis in an unpinealectomized bipedal osteopenic rat model, implementing osteoporosis as a causative factor.

Methods

Fifty Sprague-Dawley rats were rendered bipedal at the 3rd postnatal week and separated into control (25 rats) and heparin (25 rats receiving 1 IU/gr body weight/day) groups. DEXA scans after 4 weeks of heparin administration showed low bone mass in the heparin group. Anteroposterior and lateral x-rays of the surviving 42 animals (19 in heparin and 23 in control groups) were taken under anesthesia at the 40th week to evaluate for spinal deformity. Additional histomorphometric analysis was done on spine specimens to confirm the low bone mass in heparin receiving animals. Results of the DEXA scans, histomorphometric analysis and radiological data were compared between the groups.

Results

Bone mineral densities of rats in the heparin group were significantly lower than the control group as evidenced by both the DEXA scans and histomorphometric analyses. However, the incidence of scoliosis (82% in heparin and 65% in control; p > 0.05) as well as the curve magnitudes (12.1 ± 3.8 in heparin versus 10.1 ± 4.3 degrees in control; p > 0.05) were not significantly different. Osteopenic rats were significantly less kyphotic compared to control specimens (p = 0.001).

Conclusions

This study has revealed two important findings. One is that bipedality (in the absence of pinealectomy) by itself may be a cause of scoliosis in this animal model. Further studies on animal models need to consider bipedality as an independent factor. Secondly, relative hypokyphosis in osteopenic animals may have important implications. The absence of sagittal plane analyses in previous studies makes comparison impossible, but nonetheless these findings suggest that osteopenia may be important in the development of 3D deformity in adolescent idiopathic scoliosis.
Castleman's disease in childhood: report of three cases and review of the literature
Authors: Farruggia Piero , Trizzino Antonino , Scibetta Nunzia , Cecchetto Giovanni , Guerrieri Patrizia , D'Amore Emanuele SG , D'Angelo Paolo
Published: November 2011

Castleman's disease (CD) is a rare, localized or generalized, lymphoproliferative disorder with a frequent mediastinal location, but possible in any lymph node or extra nodal site. It usually appears in young adults whilst it rarely occurs in childhood. There are only about 100 pediatric cases published, five of them in Italy. We report 3 cases of localized Castleman's disease, investigated in our Department in a 3 years period and reviewed the literature.
Glucose deprivation in tuberous sclerosis complex-related tumors
Authors: Jiang Xiuyun , Kenerson Heidi L , Yeung Raymond S
Published: November 2011

Background

Cancer cells possess unique metabolic phenotypes that are determined by their underlying oncogenic pathways. Activation of the PI3K/Akt/mTOR signaling cascade promotes glycolysis and leads to glucose-dependence in tumors. In particular, cells with constitutive mTORC1 activity secondary to the loss of TSC1/TSC2 function are prone to undergo apoptosis upon glucose withdrawal in vitro, but this concept has not been tested in vivo. This study examines the effects of restricting glucose metabolism by pharmacologic and dietary means in a tuberous sclerosis complex (TSC) tumor xenograft model.

Results

Tumor-bearing mice were randomly assigned to receive unrestricted carbohydrate-free ("Carb-free") or Western-style diet in the absence or presence of 2-deoxyglucose (2-DG) in one of four treatment groups. After 14 weeks, tumor sizes were significantly different among the four treatment groups with those receiving 2-DG having the smallest tumors. Unexpectedly, the "Carb-free" diet was associated with the largest tumors but they remained responsive to 2-DG. PET imaging showed significant treatment-related changes in tumor 18fluorodeoxyglucose-uptake but the standard uptake values did not correlate with tumor size. Alternative energy substrates such as ketone bodies and monounsaturated oleic acid supported the growth of the Tsc2-/- cells in vitro, whereas saturated palmitic acid was toxic. Correspondingly, tumors in the high-fat, "Carb-free" group showed greater necrosis and liquefaction that contributed to their larger sizes. In contrast, 2-DG treatment significantly reduced tumor cell proliferation, increased metabolic stress (i.e., ketonemia) and AMPK activity, whereas rapamycin primarily reduced cell size.

Conclusions

Our data support the concept of glycolytic inhibition as a therapeutic approach in TSC whereas dietary withdrawal of carbohydrates was not effective.
Urinary Bisphenol A (BPA) Concentration Associates with Obesity and Insulin Resistance
Authors: Wang Tiange , Li Mian , Chen Bing , Xu Min , Xu Yu , Huang Yun , Lu Jieli , Chen Yuhong , Wang Weiqing , Li Xiaoying , Liu Yu , Bi Yufang , Lai Shenghan , Ning Guang
Published: November 2011

Context:

Bisphenol A (BPA) is one of the world's highest-volume chemicals in use today. Previous studies have suggested BPA disturbs body weight regulation and promotes obesity and insulin resistance. But epidemiological data in humans were limited.

Objective:

Our objective was to determine whether BPA associates with obesity and insulin resistance.

Design, Setting, and Participants:

This cross-sectional study included 3390 adults aged 40 yr or older, in Songnan Community, Baoshan District, Shanghai, China.

Main Outcome Measures:

Questionnaire, clinical and biochemical measurements, and urinary BPA concentration were determined. Generalized overweight was defined as body mass index (BMI) of 24 to less than 28 kg/m2 and obesity was defined as BMI of 28 kg/m2 or higher. Abdominal obesity was defined as waist circumference at least 90 cm for men and at least 85 cm for women. Insulin resistance was defined as the index of homeostasis model assessment of insulin resistance higher than 2.50.

Results:

The participants in the highest quartile of BPA had the highest prevalence of generalized obesity [odds ratio (OR) = 1.50; 95% confidence interval (CI) = 1.15–1.97], abdominal obesity (OR = 1.28; 95% CI = 1.03–1.60), and insulin resistance (OR = 1.37; 95% CI = 1.06–1.77). In participants with BMI under 24 kg/m2, compared with the lowest quartile, the highest quartile of BPA increased the prevalence of insulin resistance by 94% (OR = 1.94; 95% CI = 1.20–3.14), but this association was not observed in those with BMI of 24 kg/m2 or higher.

Conclusions:

BPA was positively associated with generalized obesity, abdominal obesity, and insulin resistance in middle-aged and elderly Chinese adults.
The Binocular Vision Project: An Introduction
Authors: Hanne Michael
Published: November 2011

Claims for the fundamental role of narrative and of metaphor as cognitive instruments have been taken up by scholars in a wide range of disciplines, but with little communication between the champions of the two perspectives. In the medical context, the narrative medicine movement has worked systematically and gained strong institutional support, while the exponents of metaphor in medicine, even though their research and writings are prolific, have not been so well organized and have achieved less recognition. The Binocular Vision project brings together medical practitioners and scholars from several disciplinary perspectives working on medical discourse who are willing to observe the fields of health, illness, and medicine through both the lens of narrative and the lens of metaphor, thereby gaining, it is hoped, a more three-dimensional view. This issue includes articles on the role of narrative and metaphor in patients' accounts of their experience, in doctor-patient communications and therapy, in creative work by doctors and patients, in professional medical concepts, and in public health policy, ethics, and education.
The Machine-Body as Contested Metaphor in Clinical Care
Authors: Mattingly Cheryl
Published: November 2011

There has been far more attention to narrative than to metaphor among scholars looking at clinical care. In this article, I consider the relationship between metaphor and narrative in a contested confrontation between family members and clinicians over a do-not-resuscitate decision. Drawing upon a key metaphor in biomedicine, the body as machine, I consider its canonical uses but also its limits and the way it is contested, refuted, and even “poached” by one family in its battle with clinicians. I also explore the relationship between metaphor and narrative as I consider the divergence of framing between clinicians and family as connected to the way the machine-body metaphor is embedded within different and perhaps even incommensurable narrative horizons.
Accessibility of Hydroxyl Groups of Brown-Rot Degraded Spruce Wood to Heavy Water
Authors: Fackler Karin , Schwanninger Manfred
Published: November 2011

The accessibility of alcoholic and phenolic hydroxyl (O–H) groups in non-degraded and brown-rot degraded spruce wood ( Piceas abies L. Karst.) was investigated with Fourier transform near infrared (FT-NIR) transmission spectroscopy in combination with deuterium exchange with heavy water (D2O). In the presence of excess D2O, accessible O–H groups were converted into O–D groups and characteristic O–H first overtone bands disappeared in the FT-NIR spectra. Hydroxyl groups of cellulose Iα were more accessible than those of cellulose Iβ. O–H groups of wood degraded by brown-rot fungi showed much lower overall accessibility, and free O–H groups from amorphous matrix polysaccharides, preferentially those located in primary and outer secondary cell walls and middle lamellae were least accessible, whereas H-bonded O–H groups associated with cellulose microfibrils showed residual accessibility in brown-rotted wood of incipient, early and pronounced degradation stages.
Determination of Lignin Content in Norway Spruce Wood by Fourier Transformed near Infrared Spectroscopy and Partial Least Squares Regression. Part 1: Wavenumber Selection and Evaluation of the Selected Range
Authors: Schwanninger Manfred , Rodrigues José Carlos , Gierlinger Notburga , Hinterstoisser Barbara
Published: November 2011

Although it might be thought that the determination of lignin content in wood by near infrared (NIR) spectroscopy is well known and has been used for several years, model statistics (mainly errors of prediction) found in the literature recommend further study. It is shown that partial least squares regression (PLS-R) models can be improved, namely the number of PLS vectors and the error of prediction can be substantially decreased by careful selection of the combination of wavenumber range(s) and pre-processing methods and validation of the models. To cover a wide range of the natural variability, the total lignin content of 200 Norway spruce wood samples was determined by wet-laboratory chemical methods. From the same milled samples Fourier transform near infrared (FT-NIR) spectra were recorded using a NIR fibre-optic probe. NIR bands, property weighting spectra and correlation coefficients were used to pre-select convenient wavenumber ranges. PLS regressions were carried out to establish a mathematical correlation between the data sets of wet-laboratory chemical methods and the FT-NIR spectra, leading to a number of “good” models with similar coefficients of determination ( r2)>0.90 and root mean square errors of cross-validation ( RMSECV) below 0.3%. External validation of the models also gave r2>0.90 and root mean square errors of prediction ( RMSEP) below 0.3%. As several models showed similar statistics, a further simple step, called evaluation, was introduced to assist in being able to make a decision about what model should be used. Therefore, in addition, FT-NIR spectra of another 366 wood samples were measured to evaluate the pre-selected combinations of wavenumber ranges and pre-processing methods. With this simple additional step (evaluation) the model with the highest predictability could be selected easily.
Determination of Lignin Content in Norway Spruce Wood by Fourier Transformed near Infrared Spectroscopy and Partial Least Squares Regression Analysis. Part 2: Development and Evaluation of the Final Model
Authors: Schwanninger Manfred , Rodrigues José Carlos , Gierlinger Notburga , Hinterstoisser Barbara
Published: November 2011

Partial least squares (PLS) regressions were carried out to establish a mathematical correlation between the wet-laboratory reference values and the Fourier transformed near infrared spectra. The wavenumber range resulting from the investigations in Part 1 of this series was examined in detail, evaluating several data pre-processing methods. The data set was spilt into a cross-validation set and a test set to validate each model. Then the data set first used for cross-validation was used as a test set and vice versa. The coefficients of determination and the errors were very similar, but the number of PLS vectors varied widely, depending on the pre-processing method used. Applying the evaluation step used in Part 1, namely the prediction of lignin content of 732 additional spectra (366 wood samples with unknown lignin content) revealed which pre-processing method gave the most consistent results. The most appropriate model was found with the underlying assumption that it will cover a wide range of the natural variability of spruce wood and thus be applicable to as many samples as possible. The results of the models of cross-validation and test-set validation were compared to the results of a model calculated with all spectra ( CV) and thus comprising a higher variability of the wood spectra. It is shown that the three models were equal and that the final model with the following parameters is highly qualified for prediction: wavenumber range 6102 cm−1-5762 cm−1, data pre-processing method 1st Der-MSC, number of PLS vectors (rank) = 2, r2 = 0.926, root mean square error of estimation ( RMSEE) = 0.24%, root mean square error of cross-validation ( RMSECV) = 0.25%, an estimated root mean square error of prediction ( RMSEP) = 0.25% with a corrected estimated RMSEP = 0.22%, bias = 0.00038 and a residual prediction deviation ( RPD) = 3.7. These results confirm the importance of careful validation.
Fourier Transform near Infrared Analysis of Waste Paper with the Addition of Cereal Bran Biodegraded by Ascomycetes Fungi
Authors: Sandak Anna , Modzelewska Izabela , Sandak Jakub
Published: November 2011

The goal of this work was to develop a Fourier transform near infrared (FT-NIR)-based methodology for estimating the biodegradation rate of recycled paper. Two types of fungi, Chaetomium globosum Kunze et Fr. and a mixture of Aspergillus niger van Tieghem, Trichoderma viride Persoon ex. S.F. Gray aggr. and Penicillium funiculosum Thom. were used as biotic cultures. Paper sheets made of recycled fibres with the addition of 0%, 3%, 5% and 10% of cereal bran, were used as test samples. Tests of breaking length (according to PN-EN ISO 1924–1:1998) and the degree of fungal infestation were performed on the 2nd, 4th, 7th, 10th, 14th and 21st days after infestation to quantify the resistance of the paper to biodegradation. The surface of each sheet of paper was scanned using a FT-NIR spectrometer. It was found that the addition of wheat bran increased susceptibility to fungal colonisation, compared to the samples without any bran. Degradation of paper colonised by Ch. globosum was more advanced. FT-NIR analysis revealed that spectra displayed the most significant difference in the wavenumber bands 4280 cm−1, 4404cm−1 and 4620–4890cm−1, which correspond to CH, CH2 and OH functional groups of cellulose. Differences in FT-NIR spectra were in good agreement with the reference methods and, therefore, this technique has the potential for monitoring the paper biodegradation process.
A Review of Band Assignments in near Infrared Spectra of Wood and Wood Components
Authors: Schwanninger Manfred , Rodrigues José Carlos , Fackler Karin
Published: November 2011

Near infrared (NIR) spectra of wood and wood products contain information regarding their chemical composition and molecular structure. Both influence physical properties and performance, however, at present, this information is under-utilised in research and industry. Presently NIR spectroscopy is mainly used following the explorative approach, by which the contents of chemical components and physico–chemical as well as mechanical properties of the samples of interest are determined by applying multivariate statistical methods on the spectral data. Concrete hypotheses or prior knowledge on the chemistry and structure of the sample—exceeding that of reference data—are not necessary to build such multivariate models. However, to understand the underlying chemistry, knowledge on the chemical/functional groups that absorb at distinct wavelengths is indispensable and the assignment of NIR bands is necessary. Band assignment is an interesting and important part of spectroscopy that allows conclusions to be drawn on the chemistry and physico–chemical properties of samples. To summarise current knowledge on this topic, 70 years of NIR band assignment literature for wood and wood components were reviewed. In addition, preliminary results of ongoing investigations that also led to new assignments were included for discussion. Furthermore, some basic considerations on the interactions of NIR radiation with the inhomogeneous, anisotropic and porous structure of wood, and what impact this structure has on information contained in the spectra, are presented. In addition, the influence of common data (pre)-processing methods on the position of NIR bands is discussed. For more conclusive band assignments, it is recommended that wood is separated into its components. However, this approach may lead to misinterpretations when evaluation methods other than direct comparison of spectra are used, because isolation and purification of wood components is difficult and may lead to chemical and structural alterations when compared to the native state. Furthermore, “pure” components have more distinct and symmetric bands that influence the shape of the spectra. This extended review provides the reader with a comprehensive summary of NIR bands, as well as some practical considerations important for the application of NIR to wood.
Retrospectives: X-Efficiency
Authors: Perelman Michael
Published: November 2011

In a 1966 article in the American Economic Review, Harvey Leibenstein introduced the concept of “X-efficiency”: the gap between ideal allocative efficiency and actually existing efficiency. Leibenstein insisted that absent strong competitive pressure, firms are unlikely to use their resources efficiently, and he suggested that X-efficiency is pervasive. Leibenstein, of course, was attacking a fundamental economic assumption: that firms minimize costs. The X-efficiency article created a firestorm of criticism. At the forefront of Leibenstein's powerful critics was George Stigler, who was very protective of classical price theory. In terms of rhetorical success, Stigler's combination of brilliance and bluster mostly carried the day. While Leibenstein's response to Stigler was well reasoned, it never resonated with many economists, and Leibenstein remains undeservedly underappreciated. Leibenstein's challenge is as relevant today as it ever was.
Acute hepatitis B: the limits of maintaining patient confidentiality
Authors: Quinn K J , Mccarty E J , Quah S P
Published: November 2011

Summary

Household contacts of hepatitis B (HBV) are at risk of infection, and guidelines advise vaccination of these contacts in addition to sexual partners (along with traditional high-risk groups). We present a case of intrafamilial transmission of acute hepatitis B virus (HBV) following failure to self-disclose status to family members. Complex confidentiality issues can arise following a diagnosis of HBV infection.
Factors associated with repeat visits among clients attending a clinic for sexually transmitted infections in Kisumu, Kenya
Authors: Pultorak E , Odoyo-June E , Hayombe J , Opiyo F , Odongo W , Ogollah J A , Moses S , Bailey R C , Mehta S D
Published: November 2011

Summary

To identify factors associated with repeat visits among patients attending a clinic for sexually transmitted infections (STIs) in Kisumu, Kenya, we examined records of clinic visits from March 2009 to May 2010. Multivariable logistic regression identified factors associated with repeat visits occurring >30 days after the initial visit. Among 1473 clients (1296 single-visit individuals versus 177 individuals with repeat visits), the median age was 24 years, 67% were men and 8.6% self-reported being HIV-positive. In adjusted analyses, men with repeat visits were more likely to report ≥2 recent sexual partners (adjusted odds ratio [aOR] = 1.60) and being HIV-positive (aOR = 2.35). They were less likely to have been referred from other health facilities (aOR = 0.14) and more likely to have urethral discharge at their initial visit (aOR = 2.46). Among women, repeat visits were associated with vaginal discharge (aOR = 2.22), but attending the clinic with a partner was protective (aOR = 0.38). The association between sexual risk, HIV positivity and repeat visits among male clients highlights the need to focus intervention efforts on this group. For women, attending with a partner may reflect a decreased risk of re-infection if both partners are treated and counselled together.
Factors associated with HIV-1 virological failure in an outpatient clinic for HIV-infected people in Haiphong, Vietnam
Authors: Huong D T M , Bannister W , Phong P T , Kirk O , Peters L
Published: November 2011

The objective of our study was to investigate factors associated with virological failure in 100 consecutive HIV-1 infected Vietnamese adults who initiated antiretroviral therapy (ART) from June 2007 to June 2008. Data were collected from medical records, and a structured questionnaire was used in individual interviews to investigate factors associated with adherence to ART. Plasma HIV viral load was measured at the time of the interview. The median age was 35 years, 35% were women and heterosexual intercourse was the most common mode of HIV transmission (61 %). After a median of 14 months since starting ART, 23% had detectable HIV-1 viral load (≥400 copies/mL). Patients who had developed a World Health Organization (WHO) clinical stage 4 condition at the time of initiation of ART were more likely to experience virological failure than those in stages 1-3, odds ratio (OR): 5.20 (95% confidence interval [CI] 1.34-20.11), P = 0.017. Patients who reported that their health status was evaluated by a physician at each visit were less likely to experience virological failure, OR: 0.02 (95% CI 0.00-0.24), P = 0.002.
Screening for alcohol use disorders in a genitourinary medicine setting
Authors: Mitchell L , Lewis L , Hussey J
Published: November 2011

The new National Institute for Health and Clinical Excellence (NICE) guidance cites genitourinary (GU) medicine clinics as one setting where screening for alcohol-use disorders should be part of routine clinical practice. Northumberland GU medicine service has routinely used the Fast Alcohol Screening Tool (FAST) since June 2009. An audit of all first attendees to the service in April 2010 (n = 256) was carried out. This audit found that the FAST questionnaire was acceptable to both patients and staff (uptake of 95.7%). Statistically significant associations between excessive alcohol and higher rates of unprotected sex (P < 0.01), an increased number of sexual partners (P < 0.01) and higher rates of sexually transmitted infection (STI) diagnosis (P < 0.05) were also demonstrated.
Weight versus volume in breast surgery: an observational study
Authors: Parmar Chetan , West Malcolm , Pathak Samir , Nelson J , Martin Lee
Published: November 2011

Objectives

The study hypothesis is to assess correlation of breast specimen weight versus volume.

Design

Consecutive patients undergoing breast surgery at a single tertiary referral centre during a 6-month period were included. Specimen weight was measured in grams. Direct volume measurements were performed using water displacement. Data including side of the breast, age and menstrual status of the patient were noted.

Setting

Knowledge of breast volume provides an objective guide in facilitating the achievements of balance in reconstructive operations. Surgeons use intraoperative weight measurements from individual breasts to calculate the breast volume assuming that weight is equal to the volume of the specimen. However, it is unclear whether weight accurately reveals the true volume of resection.

Participants

Forty-one patients were included in the study with 28 having bilateral surgeries, 13 having unilateral procedures giving a total of 69 breast specimens.

Main outcome measures

Breast specimen weight correlation to breast specimen volume.

Results

The mean age of the group was 42.4 years. Fifty-two specimens were from premenopausal patients and 17 were of postmenopausal. Thirty-five were left-sided. Twenty-six patients had bilateral breast reduction, two had bilateral mastectomy, nine had a unilateral mastectomy and four patients had a unilateral breast reduction. The difference between weight and volume of these breasts was 36.4 units (6.6% difference). The difference in measurement of weight and volume in premenopausal was 37.6 units compared to 32.6 units in postmenopausal women. The density was 1.07 and 1.06, respectively. This was statistically not significant.

Conclusions

No significant difference between volume and weight was seen in this series. Furthermore, we are unable to support the notion that premenopausal patients have a significant difference in the proportion of fatty and glandular tissue as there was little difference between the weight and the volume. An easy, clinically proper formula for the quantification of actual breast volume has yet to be derived.
A study of thromboprophylactic practices of Scottish orthopaedic surgeons in patients undergoing total hip replacements. Should practice change with new guidelines?
Authors: Cowie J G , Butler S , Macpherson G , Brenkel I J
Published: November 2011

Despite increasing scientific investigation, the best method for preventing postoperative thromboembolism in patients undergoing a total hip replacement (THR) remains unclear. National Institute for Health and Clinical Excellence (NICE) and Scottish Intercollegiate Guidelines Network (SIGN) guidelines on the prevention of thromboembolism have caused much controversy. We surveyed Scottish surgeons regarding their thromboprophylaxis prescribing after THR. Questionnaires were sent to all Scottish orthopaedic consultants. They were asked about routine pharmacological and mechanical prophylaxis in patients undergoing a THR. Comparison was made with a previous survey done in 2003. The response rate was 75%. The survey showed an increased use of pharmacological prophylaxis from 93% to 100%. This was due to the increased use of aspirin from 51% to 64%. The use of low molecular weight heparin has remained constant at 51%. No surgeons routinely use warfarin, un-fractionated heparin or fondaparinux. Use of graded compression stockings has increased from 59% to 70%. In conclusion, there is increasing evidence that patients undergoing THR should receive extended prophylaxis for up to 35 days. Oral agents such as dabigatran and rivaroxaban have offered a new option for oral extended prescribing. The results in change of practice must be closely audited.
A new approach to scoring systems to improve identification of acute medical admissions that will require critical care
Authors: Carmichael H A , Robertson E , Austin J , Mccruden D , Messow C M , Belcher P R
Published: November 2011

Removal of the intensive care unit (ICU) at the Vale of Leven Hospital mandated the identification and transfer out of those acute medical admissions with a high risk of requiring ICU. The aim of the study was to develop triaging tools that identified such patients and compare them with other scoring systems. The methodology included a retrospective analysis of physiological and arterial gas measurements from 1976 acute medical admissions produced PREEMPT-1 (PRE-critical Emergency Medical Patient Triage). A simpler one for ambulance use (PREAMBLE-1 [PRE-Admission Medical Blue-Light Emergency]) was produced by the addition of peripheral oxygen saturation to a modification of MEWS (Modified Early Warning Score). Prospective application of these tools produced a larger database of 4447 acute admissions from which logistic regression models produced PREEMPT-2 and PREAMBLE-2, which were then compared with the original systems and seven other early warning scoring systems. Results showed that in patients with arterial gases, the area under the receiver operator characteristic curve was significantly higher in PREEMPT-2 (89·1%) and PREAMBLE-2 (84.4%) than all other scoring systems. Similarly, in all patients, it was higher in PREAMBLE-2 (92.4%) than PREAMBLE-1 (88.1%) and the other scoring systems. In conclusion, risk of requiring ICU can be more accurately predicted using PREEMPT-2 and PREAMBLE-2, as described here, than by other early warning scoring systems developed over recent years.
Impact of national guidelines on family history breast cancer surveillance
Authors: Saldanha J D , Garrett R M , Snaddon L , Longmuir M , Bradshaw N , Watt C , George W D , Wilson C R , Doughty J C , Stallard S , Reid I , Murday V , Davidson R
Published: November 2011

The breast cancer risk of women already under family history surveillance was accurately assessed according to national guidelines in an attempt to rationalize the service. Women attending two breast units in Glasgow between November 2003 and February 2005 were included. One thousand and five women under annual surveillance were assessed and had their relatives diagnoses verified. Four hundred and ninety-seven women were at significantly increased risk and eligible for follow-up. Five hundred and eight (50%) women attending were not eligible for family history surveillance, and 498 (98%) of these women accepted discharge. In conclusion, national guidelines have helped to more clearly define women who should undergo surveillance. This avoids unnecessary and potentially harmful routine investigations, and the service has been improved.
Popliteal cystic adventitial disease: a case report and literature review
Authors: Parnaby C N , Kent A , Wolf B
Published: November 2011

Cystic adventitial disease (CAD) is rare. The popliteal artery is the most commonly affected artery. Patients with CAD are usually young and present with ischaemic lower limb symptoms. We report a case of a 39-year-old male patient with popliteal CAD. The affected segment was resected and repaired with an interposition vein graft. In conclusion, we highlight the importance of correct diagnosis and outline the different management strategies.
A case of arm swelling and muscle Wii-kness
Authors: Baxter R D , Madhok R M
Published: November 2011

The Nintendo Wii is now the world's most popular home games console owing to its simple interface and replication of sports activities. Although safety advice is provided by the manufacturer, a number of injuries have previously been described. We describe a case of arm swelling with associated rise in serum creatine kinase to over 8000 U/L in a man, following unaccustomed and sustained strenuous muscle exertion through the use of the Nintendo Wii. His condition spontaneously resolved with rest and conservative measures. His presentation represents significant muscle injury through the use of this games console and the replication of sporting activities; physicians should be aware of the variety of musculoskeletal presentations such use of these devices can produce.
Toxic levels of glycosides in herbal medication: a potential cause of hyperkalaemia
Authors: Haden M , Marshall D A S , Murphy B
Published: November 2011

We report a previously healthy man presenting with life-threatening hyperkalaemia and heart failure. The only possible cause was thought to be the long list of herbal medications he was taking, several of which contained significant amounts of cardiac glycosides. Hyperkalaemia is known to be associated with digoxin toxicity and we present this as the likely cause in this case, and emphasize the importance of a thorough drug history in forming a differential diagnosis.
Effect of socioeconomic deprivation and the appointment of Welfare Attorneys
Authors: Booth M G , O'neil E , Haddow C , Cook B , Kinsella J
Published: November 2011

Most patients in intensive care unit (ICU) lack decision-making ability. The Adults with Incapacity (Scotland) Act 2000 allows someone to appoint a Welfare Attorney (WA) to act on their behalf should they lose capacity. Scotland has areas of major socioeconomic deprivation associated with lower life-expectancy and with a lack of knowledge about and consequently difficulty accessing services. The effect of socioeconomic deprivation on WA registration was investigated. A complete list of registered WAs was categorized by deprivation. The Public Guardian, Scotland indicated whether patients admitted to ICU at Glasgow Royal (April 2006-May 2009) had a WA registered. All Scottish ICU admissions (2004-2008) were categorized by deprivation. Twelve of 1152 ICU patients at Glasgow Royal had a WA. Of 165,997 WAs registered, 5984 were in the most deprived and 27,970 in the most affluent areas. Overall, 3.9% of the Scottish population had a WA (1.4% in the most, 6.5% in the least deprived population decile). In conclusion, the uptake of WAs was low, especially in deprived areas. The reasons could include a lack of knowledge, not anticipating the need for a WA or not being confident in the process. Any educational package needs to target the most socioeconomically disadvantaged.
Lossless Compression of JPEG2000 Whole Slide Images Is Not Required for Diagnostic Virtual Microscopy
Authors: Kalinski Thomas , Zwönitzer Ralf , Grabellus Florian , Sheu Sien-Yi , Sel Saadettin , Hofmann Harald , Roessner Albert
Published: November 2011

The use of lossy compression in medical imaging is controversial, although it is inevitable to reduce large data amounts. In contrast with lossy compression, lossless compression does not impair image quality. In addition to our previous studies, we evaluated virtual 3-dimensional microscopy using JPEG2000 whole slide images of gastric biopsy specimens with or without Helicobacter pylori gastritis using lossless compression (1:1) or lossy compression with different compression levels: 5:1, 10:1, and 20:1. The virtual slides were diagnosed in a blinded manner by 3 pathologists using the updated Sydney classification. The results showed no significant differences in the diagnosis of H pylori between the different levels of compression in virtual microscopy. We assume that lossless compression is not required for diagnostic virtual microscopy. The limits of lossy compression in virtual microscopy without a loss of diagnostic quality still need to be determined. Analogous to the processes in radiology, recommendations for the use of lossy compression in diagnostic virtual microscopy have to be worked out by pathology societies.
Characteristics Related to Effective Contraceptive Use Among a Sample of Nonurban Latinos
Authors: Warren Jocelyn T. , Harvey S. Marie , Bovbjerg Marit L.
Published: November 2011

CONTEXT:

A better understanding of effective contraceptive use among Latinos is needed to reduce their high rate of unintended pregnancy. Most research has focused on urban Latinas and has overlooked the relationship context of effective contraceptive use.

METHODS:

Interviews were conducted among a sample of 450 Latino women and men aged 18–25 in sexual relationships, who were recruited from community sites in four rural Oregon counties in 2006. Bivariate and multinomial logistic regression analyses were used to examine the associations between effective contraceptive use and ‐individual, cultural and relationship characteristics.

RESULTS:

Half of participants reported effective contraceptive use in their primary relationships: Thirty‐six percent consistently used a female method, and 15% consistently used condoms. Acculturation and confidence in one’s ‐ability to practice contraception with a primary partner were associated with female method use rather than no effective use (risk ratios, 0.7 and 1.7, respectively). Participation in sexual decision making was positively associated with condom use rather than no effective method use (2.2) or female method use (1.9); partner involvement in birth control was positively associated with condom use rather than female method use (1.8).

CONCLUSIONS:

Variations in effective contraceptive use among nonurban Latinos appear related to relationship characteristics and dynamics. Contraceptive counseling and unintended pregnancy prevention programs that are tailored to reflect relationship contexts and to include male partners where appropriate could improve the quality and cultural relevance of services among nonurban Latinos.
Fabrication and assessment of polyacrylate/(guar gum modified bentonite) superabsorbent polymeric composite
Authors: Banerjee Subham , Verma Sushma , Pal Dilipkumar , Ghosh Ashoke Kumar , Bhattacharya Shiv Sankar , Chattopadhyay Pronobesh , Ghosh Animesh , Kaity Santanu
Published: November 2011

A superabsorbent composite was synthesized via polymerization in a complete aqueous environment. A polymeric composites was fabricated effectively by varying the concentration of natural gum and crosslinker. Reinforcing of the polymer chains with bentonite sheets was confirmed by Fourier transform infrared (FTIR) spectra. X-ray diffraction (XRD) revealed that bentonite was exfoliated and dispersed in the polymeric matrix. Scanning electron microscopy (SEM) and thermal analysis (TGA/DSC/DTA) were used to study the morphology and thermal stability of the composites, respectively. The effects of natural gum and crosslinker were investigated. Results showed that introducing organic-inorganic composites improved the swelling capability and water retention ability of the superabsorbent.
Behavioral State Modulates the Activity of Brainstem Sensorimotor Neurons
Authors: McArthur Kimberly L. , Dickman J. David
Published: November 2011

Sensorimotor processing must be modulated according to the animal's behavioral state. A previous study demonstrated that motion responses were strongly state dependent in birds. Vestibular eye and head responses were significantly larger and more compensatory during simulated flight, and a flight-specific vestibular tail response was also characterized. In the current study, we investigated the neural substrates for these state-dependent vestibular behaviors by recording extracellularly from neurons in the vestibular nuclear complex and comparing their spontaneous activity and sensory responses during default and simulated flight states. We show that motion-sensitive neurons in the lateral vestibular nucleus are state dependent. Some neurons increased their spontaneous firing rates during flight, though their increased excitability was not reflected in higher sensory gains. However, other neurons exhibited state-dependent gating of sensory inputs, responding to rotational stimuli only during flight. These results demonstrate that vestibular processing in the brainstem is state dependent and lay the foundation for future studies to investigate the synaptic mechanisms responsible for these modifications.
Disrupting Effect of Drug-Induced Reward on Spatial But Not Cue-Guided Learning: Implication of the Striatal Protein Kinase A/cAMP Response Element-Binding Protein Pathway
Authors: Baudonnat Mathieu , Guillou Jean-Louis , Husson Marianne , Vandesquille Matthias , Corio Marc , Decorte Laurence , Faugère Angélique , Porte Yves , Mons Nicole , David Vincent
Published: November 2011

The multiple memory systems hypothesis posits that different neural circuits function in parallel and may compete for information processing and storage. For example, instrumental conditioning would depend on the striatum, whereas spatial memory may be mediated by a circuit centered on the hippocampus. However, the nature of the task itself is not sufficient to select durably one system over the other. In this study, we investigated the effects of natural and pharmacological rewards on the selection of a particular memory system during learning. We compared the effects of food- or drug-induced activation of the reward system on cue-guided versus spatial learning using a Y-maze discrimination task. Drug-induced reward severely impaired the acquisition of a spatial discrimination task but spared the cued version of the task. Immunohistochemical analysis of the phosphorylated form of the cAMP response element binding (CREB) protein and c-Fos expression induced by behavioral testing revealed that the spatial deficit was associated with a decrease of both markers within the hippocampus and the prefrontal cortex. In contrast, drug reward potentiated the cued learning-induced CREB phosphorylation within the dorsal striatum. Administration of the protein kinase A inhibitor 8-Bromo-adenosine-3',5'-cyclic monophosphorothioate Rp isomer (Rp-cAMPS) into the dorsal striatum before training completely reversed the drug-induced spatial deficit and restored CREB phosphorylation levels within the hippocampus and the prefrontal cortex. Therefore, drug-induced striatal hyperactivity may underlie the declarative memory deficit reported here. This mechanism could represent an important early step toward the development of addictive behaviors by promoting conditioning to the detriment of more flexible forms of memory.
Sharp Ca2+Nanodomains beneath the Ribbon Promote Highly Synchronous Multivesicular Release at Hair Cell Synapses
Authors: Graydon Cole W. , Cho Soyoun , Li Geng-Lin , Kachar Bechara , von Gersdorff Henrique
Published: November 2011

Hair cell ribbon synapses exhibit several distinguishing features. Structurally, a dense body, or ribbon, is anchored to the presynaptic membrane and tethers synaptic vesicles; functionally, neurotransmitter release is dominated by large EPSC events produced by seemingly synchronous multivesicular release. However, the specific role of the synaptic ribbon in promoting this form of release remains elusive. Using complete ultrastructural reconstructions and capacitance measurements of bullfrog amphibian papilla hair cells dialyzed with high concentrations of a slow Ca2+buffer (10 mmEGTA), we found that the number of synaptic vesicles at the base of the ribbon correlated closely to those vesicles that released most rapidly and efficiently, while the rest of the ribbon-tethered vesicles correlated to a second, slower pool of vesicles. Combined with the persistence of multivesicular release in extreme Ca2+buffering conditions (10 mmBAPTA), our data argue against the Ca2+-dependent compound fusion of ribbon-tethered vesicles at hair cell synapses. Moreover, during hair cell depolarization, our results suggest that elevated Ca2+levels enhance vesicle pool replenishment rates. Finally, using Ca2+diffusion simulations, we propose that the ribbon and its vesicles define a small cytoplasmic volume where Ca2+buffer is saturated, despite 10 mmBAPTA conditions. This local buffer saturation permits fast and large Ca2+rises near release sites beneath the synaptic ribbon that can trigger multiquantal EPSCs. We conclude that, by restricting the available presynaptic volume, the ribbon may be creating conditions for the synchronous release of a small cohort of docked vesicles.
A Novel Functionally Distinct Subtype of Striatal Neuropeptide Y Interneuron
Authors: Ibáñez-Sandoval Osvaldo , Tecuapetla Fatuel , Unal Bengi , Shah Fulva , Koós Tibor , Tepper James M.
Published: November 2011

We investigated the properties of neostriatal neuropeptide Y (NPY)-expressing interneurons in transgenic GFP (green fluorescent protein)-NPY reporter mice.In vitrowhole-cell recordings and biocytin staining demonstrated the existence of a novel class of neostriatal NPY-expressing GABAergic interneurons that exhibit electrophysiological, neurochemical, and morphological properties strikingly different from those of previously described NPY-containing, plateau-depolarization low-threshold spike (NPY–PLTS) interneurons. The novel NPY interneuron type (NPY–neurogliaform) differed from previously described NPY–PLTS interneurons by exhibiting a significantly lower input resistance and hyperpolarized membrane potential, regular, nonaccommodating spiking in response to depolarizing current injections, and an absence of plateau depolarizations or low-threshold spikes. NPY–neurogliaform interneurons were also easily distinguished morphologically by their dense, compact, and highly branched dendritic and local axonal arborizations that contrasted sharply with the sparse and extended axonal and dendritic arborizations of NPY–PLTS interneurons. Furthermore, NPY–neurogliaform interneurons did not express immunofluorescence for somatostatin or nitric oxide synthase that was ubiquitous in NPY–PLTS interneurons. IPSP/Cs could only rarely be elicited in spiny projection neurons (SPNs) in paired recordings with NPY–PLTS interneurons. In contrast, the probability of SPN innervation by NPY–neurogliaform interneurons was extremely high, the synapse very reliable (no failures were observed), and the resulting postsynaptic response was a slow, GABAAreceptor-mediated IPSC that has not been previously described in striatum but that has been elicited from NPY–GABAergic neurogliaform interneurons in cortex and hippocampus. These properties suggest unique and distinctive roles for NPY–PLTS and NPY–neurogliaform interneurons in the integrative properties of the neostriatum.
A Seven-Transmembrane Receptor That Mediates Avoidance Response to Dihydrocaffeic Acid, a Water-Soluble Repellent inCaenorhabditis elegans
Authors: Aoki Reina , Yagami Tatsurou , Sasakura Hiroyuki , Ogura Ken-ichi , Kajihara Yasuhiro , Ibi Masakazu , Miyamae Takeaki , Nakamura Fumio , Asakura Taro , Kanai Yoshikatsu , Misu Yoshimi , Iino Yuichi , Ezcurra Marina , Schafer William R. , Mori Ikue , Goshima Yoshio
Published: November 2011

The ability to detect harmful chemicals rapidly is essential for the survival of all animals. InCaenorhabditis elegans(C. elegans), repellents trigger an avoidance response, causing animals to move away from repellents. Dihydrocaffeic acid (DHCA) is a water-soluble repellent and nonflavonoid catecholic compound that can be found in plant products. Using aXenopus laevis(X. laevis) oocyte expression system, we identified a candidate dihydrocaffeic acid receptor (DCAR), DCAR-1. DCAR-1 is a novel seven-transmembrane protein that is expressed in the ASH avoidance sensory neurons ofC. elegans. dcar-1mutant animals are defective in avoidance response to DHCA, and cell-specific expression ofdcar-1in the ASH neurons ofdcar-1mutant animals rescued the defect in avoidance response to DHCA. Our findings identify DCAR-1 as the first seven-transmembrane receptor required for avoidance of a water-soluble repellent, DHCA, inC. elegans.