bluuebunny/crossref_metadata_2025_split huggingface dataset:
Mid‐upper arm circumference and weight‐for‐height to identify high‐risk malnourished under‐five children
Authors: Briend André , Maire Bernard , Fontaine Olivier , Garenne Michel 
Published: September 2011

AbstractThe World Health Organization and UNICEF define non‐oedematous severe acute malnutrition (SAM) either by a mid‐upper arm circumference (MUAC) less than 115 mm or by a weight‐for‐height z‐score (WHZ) less than –3. The objective of this study was to assess whether there was any benefit to identify malnourished children with a high risk of death to combine these two diagnostic criteria. Data of a longitudinal study examining the relationship between anthropometry and mortality in rural Senegal and predating the development of community‐based management of SAM were used for this study. First, the receiver operating characteristic (ROC) curves of MUAC and of WHZ to predict mortality were drawn, and then the points corresponding to WHZ less than –3 and/or MUAC less than 115 mm were positioned in relation to these curves. MUAC had the highest ROC curve, which indicates that it identifies high‐risk children better than WHZ. Both points representing WHZ less than –3 and/or MUAC less than 115 mm were below the MUAC ROC curve. It is concluded that to identify high‐risk malnourished children, there is no benefit in using both WHZ less than –3 and/or MUAC less than 115 mm, and that using MUAC alone is preferable.
Diameter Growth of Juvenile Trees after Gap Formation in a Bolivian Rain Forest: Responses are Strongly Species‐specific and Size‐dependent
Authors: Soliz‐Gamboa Claudia C. , Sandbrink Anne , Zuidema Pieter A. 
Published: September 2011

ABSTRACTWe evaluated growth responses to gap formation for juvenile individuals of three canopy rain forest species: Peltogyne cf. heterophylla, Clarisia racemosa and Cedrelinga catenaeformis. Gaps were formed during selective logging operations 7 yr before sampling in a Bolivian rain forest. We collected wood samples for tree‐ring analyses at different distances to the stump (<10, 10–40 and >40 m) and from trees with different diameters (5–30 cm diameter at breast height [dbh]). Tree‐rings width was measured in at least two radii and converted to average diameter growth. Changes in 7‐yr median diameter growth before and after selective logging were analyzed. Diameter growth rates significantly increased by 0.7–0.8 mm/yr after gap formation for P. heterophylla and C. catenaeformis, but not for C. racemosa. We applied a multiple regression analysis to explain variation in growth responses of P. heterophylla and C. catenaeformis by distance to logging gap and tree size. For P. heterophylla we found that growth increase occurring close to logging gaps was strongest for large juvenile trees (20–25 cm dbh) and almost absent in small juveniles. For C. catenaeformis, variation in growth responses was not related to tree size or distance to gaps. Our results show that growth responses to gap formation strongly differ across species and tree sizes. This finding calls for caution in the interpretation of growth releases in tree‐ring series, as gap formation does not necessarily invoke growth responses and if such growth responses occur, their strength is species‐ and size specific.
Retrospective Review of 25 Cases of Thrombotic Thrombocytopenic Purpura in Pakistan
Authors: Sagheer Safoorah , Moiz Bushra , Usman Mohammad , Khurshid Mohammad 
Published: September 2011

AbstractThrombotic thrombocytopenic purpura (TTP) is a disorder characterized by thrombocytopenia, microangiopathic hemolytic anemia, fever, neurological abnormalities, and renal dysfunction. Because of the rarity of TTP, no comprehensive data is available in the Pakistani population. The present study aimed to review the therapeutic interventions, relapses and mortality rate in patients with TTP treated at a tertiary care hospital in Pakistan. This was a retrospective review of patients treated over a period of more than nine years (2001–2010). Medical charts were retrieved using the ICD coding system version 9 and each file was reviewed by the principal author for clinical and laboratory details, along with the therapy utilized and the outcome. Twenty‐five patients were diagnosed with TTP, including nine males (36%) and 16 females (64%) with a median age of 30 ± 18.4 years for all patients. Idiopathic TTP was seen in 17 patients (68%) and secondary causes were identified in eight (32%). Patients were treated with plasma exchange once the diagnosis of TTP was established. Only neurological and renal involvement at the time of presentation emerged as important indicators in determining the outcome and response to treatment. Most of our patients tolerated plasmapheresis very well; however, delay in starting plasmapheresis due to late presentation was a major hurdle in our set up.
Re‐imagining Infrastructure*
Authors: Gerencser Mark 
Published: September 2011

A senior executive of Booz Allen Hamilton and co‐author of a business bestseller called Megacommunities argues that the United States is locked into an obsolete pattern of dealing with infrastructure investment, even as the country's population growth and technology have raced ahead. Three of America's basic “lifeline” infrastructures—energy, transportation, and water—are nearing the end of their useful operating lives and in desperate need of modernization. U.S. capital spending on infrastructure has been inadequate, amounting to less than 2% of GDP, as compared to 9% in China and 5% in India.But if infrastructure renewal will be costly, money is not the biggest obstacle. History shows that modernizing existing infrastructures tends to be even more challenging than creating new ones because of the drag caused by legacy hardware and the associated human “software.” And so the real problems are conceptual, institutional, and political—problems whose solutions demand transformational vision and leadership that will encourage collaborative participation by both the public and private sectors.What is lacking, then, is an oversight and coordination mechanism that restores government's traditional integrating role without creating either new monopolies or a larger, more centralized government. To that end the author issues four imperatives:First is the need to rethink the form and function of our old infrastructures.Second is the need for design principles that make future infrastructures robust and adaptable as technology advances, funding changes, and the needs of our citizens evolve.Third is the need for leadership that succeeds by convening, integrating, and aligning the interests and actions of all important stakeholders.Fourth and last is the need for a national vision for America's infra‐structure that defines the function and performance of the entire system over its total lifecycle.A new kind of collaboration by different constituencies, which the author refers to as the creation of “megacommunities,” is held up as a way for stakeholders with conflicting interests to cooperate on compelling issues of national importance with a shared set of practices and protocols.
The Upside to Fiscal Challenges: Innovative Partnerships Between Public and Private Sector
Authors: Amram Martha , Crawford Tabitha 
Published: September 2011

The first U.S. public‐private partnerships, or P3s as they are now called, began over 200 years ago. These contractual arrangements between government entities and private companies for the delivery of services or facilities have long been used for water/wastewater, transportation, urban development, and the provision of social services. And the use of such partnerships is increasing because they provide an effective means for meeting public needs, maintaining a high level of public control, improving the quality of services, and increasing the cost‐effectiveness of traditional delivery methods.Although outsourcing of public services is sometimes used to accomplish many of the same goals, P3s are likely to be a solution when public funds are not available and when:
Capital is required to upgrade the infrastructure and so achieve a lower cost, or higher quality, of services.
The contract horizon in the P3 transaction is sufficiently long for the investor/operation to recoup investment dollars and a rate of return.
City residents make payments for the service provided, creating the revenue stream for private profits.
The private partner in the P3 has a low cost of capital, often attributable largely to a large and sophisticated balance sheet.
This article uses examples of several recent P3 contracts to illustrate their role in shifting risk and increasing collaboration between the public and private sectors.
Evidence for protein‐mediated fatty acid efflux by adipocytes
Authors: Henkin A. H. , Ortegon A. M. , Cho S. , Shen W.‐J. , Falcon A. , Kraemer F. B. , Lee S.‐J. , Stahl A. 
Published: September 2011

Abstract
Aim:  The hormonally controlled mobilization and release of fatty acids from adipocytes into the circulation is an important physiological process required for energy homeostasis. While uptake of fatty acids by adipocytes has been suggested to be predominantly protein‐mediated, it is unclear whether the efflux of fatty acids also requires membrane proteins.
Methods:  We used fluorescent fatty acid efflux assays and colorimetric assays for free fatty acids and glycerol to identify inhibitors with effects on fatty acid efflux, but not lipolysis, in 3T3‐L1 adipocytes. We assessed the effect of these inhibitors on a fibroblast‐based cell line expressing fatty acid transport protein 1, hormone‐sensitive lipase and perilipin, which presumably lacks adipocyte‐specific proteins for fatty acid efflux.
Results:  We identified 4,4′‐diisothiocyanatostilbene‐2,2′‐disulfonic acid (DIDS) as an inhibitor of fatty acid efflux that did not impair lipolysis or the cellular exit of glycerol but lead to an accumulation of intracellular fatty acids. In contrast, fatty acid efflux by the reconstituted cellular model for fatty acid efflux was responsive to lipolytic stimuli, but insensitive to DIDS inhibition.
Conclusion:  We propose that adipocytes specifically express an as yet unidentified DIDS‐sensitive protein that enhances the efflux of fatty acids and therefore may lead to novel treatment approaches for obesity‐related disorders characterized by abnormal lipid fluxes and ectopic triglyceride accumulation.
Management of Cardiovascular Risk Factors Is Leaving the Office: Potential Impact of Telemedicine*
Authors: Krakoff Lawrence R. 
Published: September 2011

J Clin Hypertens (Greenwich). 2011;13:791–794. ©2011 Wiley Periodicals, Inc.Effective control of hypertension and the other cardiovascular risk factors has been dependent on primary medical care as provided by family practitioners and internists. The progressive reduction in availability of primary care for adult populations in the United States threatens the likelihood of better control of the risk factors and potential loss of opportunity for prevention of cardiovascular disease. Recent progress has been made in the use of home blood pressure monitoring for improvement in classification of risk for hypertensive patients. Several studies establish the feasibility of home pressure monitoring combined with telemedicine for improving control of hypertension. Some studies have explored the role of self‐care for adjustment of medication, as well. The potential growth of this strategy for effective control of hypertension with reduced need for face‐to‐face encounter time in primary care is a promising solution to the reduction in primary care providers. Management of hyperlipidemia and diabetes by telemedicine is also being explored, particularly for rural areas, but may also be effective in urban settings. Development of technology for home monitoring together with electronic communication to providers and mechanisms for education, feedback, and warnings offers a promising solution to the possible crisis in prevention of cardiovascular disease due to the loss of traditional primary care.
Sex differences in lipid profiles in relation to the progression of glucose abnormalities
Authors: CARNEVALE SCHIANCA Gian P. , FRA Gian P. , COLLI Elena , BIGLIOCCA Marcello , MELLA Roberto , SCAGLIA Elena , BARTOLI Ettore 
Published: September 2011

AbstractBackground:  In the present study, we investigated the role of changes in blood lipids in the abolition of the lower cardiovascular risk associated with the female gender in individuals with type 2 diabetes mellitus (T2DM).Methods:  An oral glucose tolerance test (OGTT) was performed in 1091 consecutive patients (478 men and 613 women) and patients were divided into groups as follows: (i) those with normal glucose tolerance (NGT; n = 589); (ii) those with pre‐diabetes (pre‐T2DM), who were further divided into those with impaired fasting glucose (IFG; n = 212), impaired glucose tolerance (IGT; n = 84), and both IFG and IGT (IFG/IGT; n = 102); and (iii) those with T2DM (n = 104). Total cholesterol, triglycerides, high‐density lipoprotein–cholesterol (HDL‐C), low‐density lipoprotein–cholesterol (LDL‐C), apolipoprotein (apo) A‐I, apoB, and the apoB:apoA‐I ratio were determined in each patient. Differences in lipids between the different groups were assessed using Student’s t‐test.Results:  Significantly higher triglyceride levels and an apoB:apoA‐I ratio were found in NGT men (P < 0.0001), along with lower HDL‐C and apoA‐I (P < 0.0001). Men in the pre‐T2DM group maintained a higher apoB:apoA‐I ratio (P < 0.05) and lower HDL‐C (P < 0.0001) compared with women. In the T2DM group, only HDL‐C was lower in men compared with women (P < 0.05).Conclusions:  The progression of glucose intolerance from NGT to pre‐T2DM and T2DM exhibits striking sex differences regarding the lipid profile. The data demonstrate a worsening of plasma lipid composition in women who become diabetic. This could explain, at least in part, the loss of the more favorable cardiovascular risk normally associated with NGT women.
Conjunctival findings in hyperbaric and low‐tension glaucoma: an in vivo confocal microscopy study
Authors: Agnifili Luca , Carpineto Paolo , Fasanella Vincenzo , Mastropasqua Rodolfo , Zappacosta Antonio , Di Staso Silvio , Costagliola Ciro , Mastropasqua Leonardo 
Published: September 2011

Abstract.Purpose:  To analyse the epithelial features of the bulbar conjunctiva in hyperbaric and low‐tension glaucoma (LTG) using in vivo confocal microscopy (IVCM).Methods:  Thirty‐six eyes of 36 patients [18 affected by primary open‐angle glaucoma (POAG) and 18 with LTG] were studied; control group was constituted by 28 eyes of 28 healthy subjects. All eyes were examined using digital confocal laser‐scanning microscopy (HRT II Rostock Cornea Module). The main IVCM outcome measurements were mean density (MMD: cysts/mm2) and mean total area (MMA: μm2) of the epithelial microcysts.Results:  The mean intraocular pressure level (mmHg ± SD) was 15.1 ± 1.7, 16.3 ± 3.1 and 12.6 ± 1.8 in healthy, POAG and LTG eyes, respectively. Conjunctival microcysts were found in all patients and subjects: for healthy subjects, MMD = 10.9 ± 11.1 cysts/mm2 and MMA = 1501.9 ± 1191.1 μm2; for patients infected with POAG, MMD = 36.8 ± 28.6 cysts/mm2 and MMA = 7904.8 ± 7050.5 μm2; and for patients infected with LTG MMD = 45.6 ± 29.0 cysts/mm2 and MMA =7946.9± 5227.5 μm2. MMD and MMA were not significantly different between patients infected with POAG and those with LTG, whereas they were significantly greater in patients (fourfold and fivefold, respectively) than healthy subjects.Conclusions:  The present study demonstrated that conjunctival microcysts represent an in vivo feature in all eyes with medically controlled POAG and LTG. Therefore, conjunctiva deserves careful analysis, because its accurate microscopic definition could help clarify the pathophysiology of aqueous outflow in glaucoma.
A Preliminary Study ofSalmonella, VerocytotoxigenicEscherichia coli/Escherichia coliO157 andCampylobacteron Four Mixed Farms
Authors: Bolton D. J. , O’Neill C. J. , Fanning S. 
Published: September 2011

SummaryThe aims of this study were to investigate the incidence ofSalmonella, verocytotoxigenicEscherichia coli(VTEC)/Escherichia coliO157 andCampylobacteron four mixed farms and to characterize the isolates in terms of a range of virulence factors. Eighty‐nine composite (five different samples from the same animal species combined) faecal [cattle (24), pigs (14), sheep (4), poultry (4), horses (7), deer (4), dogs (9), rodents (2) and wild birds (20)] samples, 16 composite soil samples plus 35 individual water samples were screened using culture‐based, immunomagnetic separation and molecular methods.Salmonellawas detected in bovine faeces, cattle and poultry house water.Salmonellaserotypes/phage types included Dublin, Kiel and Typhimurium DT193, and most isolates werespvC,invAandrckpositive. ThepefAandrckgenes were found exclusively in the non‐Typhimurium strains, whileSalmonellaDublin andSalmonellaKiel strains carriedSalmonellagenomic island I marker(s). VTEC/E. coliO157 were found in deer and dog faeces only. TheE. coliO157 isolate was an enteroinvasiveE. coli, while the VTEC isolate was untypable but carried thevt1,eaeA,hlyA,tirandeptDgenes. This article reports the first confirmed carriage ofE. coliO157 in Irish deer.Campylobacterspecies were not detected over the course of this study. It was concluded that [1]Salmonella, VTEC andCampylobacterhave low (<5%) prevalence or are absent on the farms in this study; [2] water was an important source of bacterial pathogens; [3] both dogs and deer may act as a source of pathogenicE. coliand [4] key virulence and resistance determinants are widespread in farmSalmonellastrains. This study highlights the need to control water as a source of pathogens and suggests that the domestic pets and deer should be considered in any farm risk assessment.
Fourth branchial arch defects in full‐siblings treated with a partial arytenoidectomy
Authors: Menéndez I. M. , Mancha D. A. I. , Fitch G. 
Published: September 2011

SummaryFourth branchial arch defects (4‐BAD) is a syndrome that consists of aplasia, or varying degrees of hypoplasia, of one or more of the cartilaginous or muscular structures derived from the fourth branchial arch, unilaterally or bilaterally. This case report describes the cases of 2 directly related siblings admitted with a complaint of abnormal respiratory noise at rest and complete exercise intolerance. Laryngeal palpation, resting upper airway (UA) endoscopy, lateral radiography of the larynx and cervical trachea, and laryngeal ultrasonography revealed multiple laryngeal and pharyngeal abnormalities. The clinical findings were compatible with the diagnosis of fourth branchial arch defects. A left partial arytenoidectomy and a unilateral ventriculocordectomy were performed in both cases. The follow‐up endoscopies revealed a functional airway aperture. The surgery enabled the horses to be used for riding. Considering the direct family relationship between the horses, these cases would support a genetic component of 4‐BAD.
Anticoagulant, anti-aggregation and antithrombotic effects of a novel hexapeptide
Authors: Long Li-hui , Cao Yong-xiao , Ma Zhao , Liu Jing 
Published: September 2011

Abstract

Objectives
Hexapeptide is a novel synthetic oligopeptide with a structure similar to that of eptifibatide. This study was designed to investigate the anticoagulant, anti-aggregation, disaggregation and anti-thrombogenesis effects of hexapeptide.

Methods
The effects of antiplatelet aggregation induced by adenosine diphosphate (ADP), arachidonic acid (AA) and thrombin, and the effect of disaggregation of platelet aggregation induced by ADP were determined. The anticoagulation indexes were determined by different kits.

Key findings
Hexapeptide 1 × 10−5–1 × 10−4m could significantly prolong rabbit blood clotting time, thrombin time, prothrombin time and activated partial thromboplastin enzyme time, and reduce the length, wet weight, dry weight and the index of thrombus in a concentration-dependent manner. Hexapeptide 1 × 10−4m decreased platelet adhesion rate by 40.2%. The platelet aggregation inhibition of hexapeptide in dogs and humans was more obvious than in rabbits and rats. The aggregation inhibition rate of 1 × 10−5m hexapeptide in dogs, rabbits, rats and humans induced by ADP was 93.9 ± 1.3%, 66.2 ± 1.4%, 76.1 ± 3.2% and 99.8 ± 0.2%, respectively; the 50% inhibitory concentration (IC50) of hexapeptide was 7.24 × 10−8, 3.24 × 10−6, 6.61 × 10−6 and 8.91 × 10−8m, respectively. For the aggregation inhibition rate of hexapeptide in dogs, rabbits and humans induced by AA, the IC50 was 1.29 × 10−9, 1.32 × 10−6 and 9.33 × 10−8m, respectively; the IC50 of aggregation inhibition rates induced by thrombin was 2.88 × 10−6, &gt;1 × 10−5 and 4.17 × 10−6m, respectively. The disaggregation rate of 1 × 10−4m hexapeptide in dog induced by ADP was 68.8 ± 7.4%.

Conclusions
Hexapeptide has anticoagulant, antiplatelet aggregation, disaggregation and antithrombotic effects in vitro.
Bead layering as a process to stabilize nanosuspensions: influence of drug hydrophobicity on nanocrystal reagglomeration following in-vitro release from sugar beads
Authors: Kayaert Pieterjan , Anné Michaël , Van den Mooter Guy 
Published: September 2011

Abstract

Objectives
In this article the feasibility of fluidized bed bead coating of nanosuspensions of drugs with significantly different physicochemical properties was investigated as a process to transform nanosuspensions into a solid dosage form. The second aim was to see how those physicochemical properties affect the coating process and the subsequent in-vitro dissolution process.

Methods
Naproxen and cinnarizine were used as model drugs. A fluidized bed pellet coater with Würster insert was used to coat the nanosuspensions prepared by media milling on sugar beads.

Key findings
Bead layering of cinnarizine nanosuspensions resulted in a complete dissolution in 15 min, compared to only 11% in 1 h for the unmilled powder. Naproxen also dissolved three times faster when formulated on a bead. A difference could be observed between naproxen and cinnarizine. Cinnarizine nanocrystals reagglomerate when released from the coating, resulting in a slower release when compared to the original nanosuspension. No agglomeration and no delay could be observed for naproxen. These differences are most likely caused by the difference of surface hydrophobicity between naproxen and cinnarizine.

Conclusion
This study confirms that bead layering is a valuable drying technique that could complement spray drying and freeze drying, but more important is that we prove that drug physicochemical properties have a significant influence on in-vitro dissolution performance after bead layering and this is not readily predictable from the information obtained from the original nanosuspension itself.