bluuebunny/crossref_metadata_2025 huggingface dataset:
Effect of the herbicide glyphosate on glyphosate‐tolerant maize rhizobacterial communities: a comparison with pre‐emergency applied herbicide consisting of a combination of acetochlor and terbuthylazine
Authors: Barriuso Jorge , Marín Silvia , Mellado Rafael P.
Published: January 2010

A comparison was made of the effect of glyphosate (Roundup®Plus), a post‐emergency applied herbicide, and of Harness®GTZ, a pre‐emergency applied herbicide, on the rhizobacterial communities of genetically modified NK603 glyphosate‐tolerant maize. The potential effect was monitored by direct amplification, cloning and sequencing of soil DNA encoding 16S rRNA, rhizobacterial DNA hybridization to commercially available genome‐wide microarrays from the soil bacterium Streptomyces coelicolor, and high‐throughput DNA pyrosequencing of the bacterial DNA coding for 16S rRNA hypervariable V6 region. The results obtained strongly suggest that both herbicides do in fact affect the maize rhizobacterial communities, glyphosate being, to a great extent, the environmentally less aggressive herbicide.
Human enteric viruses in groundwater indicate offshore transport of human sewage to coral reefs of the Upper Florida Keys
Authors: Futch J. Carrie , Griffin Dale W. , Lipp Erin K.
Published: January 2010

To address the issue of human sewage reaching corals along the main reef of the Florida Keys, samples were collected from surface water, groundwater and coral [surface mucopolysaccharide layers (SML)] along a 10 km transect near Key Largo, FL. Samples were collected semi‐annually between July 2003 and September 2005 and processed for faecal indicator bacteria (faecal coliform bacteria, enterococci and Clostridium perfringens) and human‐specific enteric viruses (enterovirus RNA and adenovirus DNA) by (RT)‐nested polymerase chain reaction. Faecal indicator bacteria concentrations were generally higher nearshore and in the coral SML. Enteric viruses were evenly distributed across the transect stations. Adenoviruses were detected in 37 of 75 samples collected (49.3%) whereas enteroviruses were only found in 8 of 75 samples (10.7%). Both viruses were detected twice as frequently in coral compared with surface water or groundwater. Offshore, viruses were most likely to be found in groundwater, especially during the wet summer season. These data suggest that polluted groundwater may be moving to the outer reef environment in the Florida Keys.
A new group of cosmopolitan bacteriophages induce a carrier state in the pandemic strain of Vibrio parahaemolyticus
Authors: Bastías Roberto , Higuera Gastón , Sierralta Walter , Espejo Romilio T.
Published: January 2010

A clonal population of pathogenic Vibrio parahaemolyticus O3 : K6 serovar has spread in coastal waters, causing outbreaks worldwide since 1996. Bacteriophage infection is one of the main factors affecting bacterial strain concentration in the ocean. We studied the occurrence and properties of phages infecting this V. parahaemolyticus pandemic strain in coastal waters. Analysing 143 samples, phages were found in 13. All isolates clustered in a closely related group of podophages with at least 90% nucleotide sequence identity in three essential genes, despite distant geographical origins. These bacteriophages were able to multiply on the V. parahaemolyticus pandemic strain, but the impact on host concentration and subsequent growth was negligible. Infected bacteria continued producing the phage but were not lysogenized. The phage genome of prototype strain VP93 is 43 931 nucleotides and contains 337 bp direct terminal repeats at both ends. VP93 is the first non‐Pseudomonas phage related to the ΦKMV‐like subgroup of the T7 supergroup. The lack of a major effect on host growth suggests that these phages exert little control on the propagation of the pandemic strain in the environment. This form of phage growth can be modelled if phage‐sensitive and ‐resistant cells that convert to each other with a high frequency are present in clonal cultures of pandemic V. parahaemolyticus.
Colorectal carcinoma in young adults: a retrospective study on Indian patients: 2000–2008
Authors: Gupta S. , Bhattacharya D. , Acharya A. N. , Majumdar S. , Ranjan P. , Das S.
Published: January 2010

Aim  To highlight an increased incidence of colorectal cancer (CRC) amongst young Indian adults.

Method  A retrospective study of 305 cases of CRC admitted to SSKM Hospital, Kolkata, India during 2000–2008 was carried out.

Results  The ratio (0.64) of under‐40 to above‐40 CRC patients reported in this study is comparable to those from premier Oncology Centers in India (∼0.52) and is higher than those in the Indian National Cancer Registry (∼0.20) and international average (0.07). Distinctive tumour characteristics in younger patients including left‐sided lesion (69.7%), presentation at an advanced (III/IV) stage (60%), poor histological differentiation (50%) and predominance of mucin‐secreting adenocarcinoma (80%) are similar to those reported in the international literature. Some features are suggestive of hereditary non polyposis colorectal cancer syndrome, which may be a possible reason for the high proportion of young CRC patients.

Conclusion  A high index of suspicion for CRC among young Indian adults is necessary.
THE EFFECTS OF EMPLOYMENT PROTECTION ON LABOR TURNOVER: EMPIRICAL EVIDENCE FROM TAIWAN
Authors: KAN KAMHON , LIN YEN‐LING
Published: January 2010

This paper investigates the effects of employment protection legislation on the rates of hiring, separation, worker flows, job reallocation, and churning flows for the case of Taiwan. Our empirical identification takes advantage of a reform created by Taiwan's enactment of Labor Standards Law, which has substantially increased the costs of firing, and the implementation of the law's enforcement measures. Moreover, our identification also exploits the fact that the stringency of the law's provisions and the intensity of the law's enforcement vary with establishment size. On the basis of the monthly data at the establishment level for the period 1983–1995, we find that Taiwan's Labor Standards Law and its enforcement measures have dampened labor turnover for medium‐sized and large establishments, while that of small establishments was not affected. (JEL J65, J63, J88)
AUTOMATIC COMPLEXITY REDUCTION IN REINFORCEMENT LEARNING
Authors: Chiu Chung‐Cheng , Soo Von‐Wun
Published: January 2010

High dimensionality of state representation is a major limitation for scale‐up in reinforcement learning (RL). This work derives the knowledge of complexity reduction from partial solutions and provides algorithms for automated dimension reduction in RL. We propose the cascading decomposition algorithm based on the spectral analysis on a normalized graph Laplacian to decompose a problem into several subproblems and then conduct parameter relevance analysis on each subproblem to perform dynamic state abstraction. The elimination of irrelevant parameters projects the original state space into the one with lower dimension in which some subtasks are projected onto the same shared subtasks. The framework could identify irrelevant parameters based on performed action sequences and thus relieve the problem of high dimensionality in learning process. We evaluate the framework with experiments and show that the dimension reduction approach could indeed make some infeasible problem to become learnable.
DIPKIP: A CONNECTIONIST KNOWLEDGE MANAGEMENT SYSTEM TO IDENTIFY KNOWLEDGE DEFICITS IN PRACTICAL CASES
Authors: Herrero Álvaro , Corchado Emilio , Sáiz Lourdes , Abraham Ajith
Published: January 2010

This study presents a novel, multidisciplinary research project entitled DIPKIP (data acquisition, intelligent processing, knowledge identification and proposal), which is a Knowledge Management (KM) system that profiles the KM status of a company. Qualitative data is fed into the system that allows it not only to assess the KM situation in the company in a straightforward and intuitive manner, but also to propose corrective actions to improve that situation. DIPKIP is based on four separate steps. An initial “Data Acquisition” step, in which key data is captured, is followed by an “Intelligent Processing” step, using neural projection architectures. Subsequently, the “Knowledge Identification” step catalogues the company into three categories, which define a set of possible theoretical strategic knowledge situations: knowledge deficit, partial knowledge deficit, and no knowledge deficit. Finally, a “Proposal” step is performed, in which the “knowledge processes”—creation/acquisition, transference/distribution, and putting into practice/updating—are appraised to arrive at a coherent recommendation. The knowledge updating process (increasing the knowledge held and removing obsolete knowledge) is in itself a novel contribution. DIPKIP may be applied as a decision support system, which, under the supervision of a KM expert, can provide useful and practical proposals to senior management for the improvement of KM, leading to flexibility, cost savings, and greater competitiveness. The research also analyses the future for powerful neural projection models in the emerging field of KM by reviewing a variety of robust unsupervised projection architectures, all of which are used to visualize the intrinsic structure of high‐dimensional data sets. The main projection architecture in this research, known as Cooperative Maximum‐Likelihood Hebbian Learning (CMLHL), manages to capture a degree of KM topological ordering based on the application of cooperative lateral connections. The results of two real‐life case studies in very different industrial sectors corroborated the relevance and viability of the DIPKIP system and the concepts upon which it is founded.
CAN A PERPETRATOR WRITE ATESTIMONIO? Moral Lessons from the Dark Side
Authors: Twiss Sumner B.
Published: January 2010

By posing a heuristically provocative question, this essay compares and explores in some detail the testimonies of three infamous perpetrators from the Nazi period—Albert Speer, Rudolph Hoess, and Adolf Eichmann—for what they reveal about their motives, ideological thinking, and strategies of denial and self‐deception, as well as influences from their social, political, and cultural context. The conclusion drawn is that many of the external and internal factors at work in them are recognizable to us as features of our own moral experience and, further, that this recognition is particularly important for motivating self‐scrutiny in our own lives for any hints of impending complicity with moral evil.
EXPERIENTIAL NARRATIVES OF RAPE AND TORTURE
Authors: Cates Diana Fritz
Published: January 2010

Many Guatemalan women suffered extreme sexual violence during the latter half of the twentieth century. Learning of this violence can evoke hatred in persons who love and respect women—hatred for the men who perpetrated the violence and also for other men around the world who victimize women in this way. Hatred is a common response to a perceived evil, and it might in some cases be a fitting response, but it is important to subject one's emotions to critical moral reflection. A key task of ethics is to encourage persons to cultivate good habits of being moved. This essay analyzes the way in which two different texts manage, through the skillful presentation of experiential narratives, to help readers acknowledge the hatred they might feel, but also to think twice about the hatred to which they consent.
Resolving Disputes Over Frozen Embryos: A New Proposal
Authors: WILLIAMS JEREMY
Published: January 2010

abstract

This paper proposes a principle for adjudicating conflicts between estranged couples over whether the frozen embryos they earlier created together ought to be gestated or destroyed. I argue that the fate of the embryos ought to be determined by the party who would be most harmed by having his or her preferences overruled. But I also claim that, when embryos are destroyed against the opposition of one of their co‐creators, the individual at whose behest this was done owes compensation to his disappointed opposite number, in an amount that reflects the harm accruing to the latter as a result of the termination of the procreative project.
Muscle blood flow response to mental stress and adrenaline infusion in man: microdialysis ethanol technique compared to 133Xe clearance and venous occlusion plethysmography
Authors: Widegren U. , Hickner R. C. , Jorfeldt L. , Henriksson J.
Published: January 2010

Background and aim:  Adrenaline, administered locally by microdialysis in skeletal muscle, causes vasoconstriction around the microdialysis catheter. This is contrary to the vasodilation that normally occurs when adrenaline is infused intravenously or intra‐arterially. The hypothesis was tested that vasoconstriction, measured by microdialysis, would not occur with two interventions causing increased plasma levels of adrenaline, mental stress and intravenous adrenaline infusion (0·1 nmol kg−1 min−1).

Methods:  Twenty‐four men (27 ± 1·6 years) underwent these interventions. Blood flow was determined by the microdialysis ethanol technique and 133Xe clearance (gastrocnemius muscle, medial head) and by venous occlusion plethysmography (calf).

Results:  The ethanol outflow/inflow ratio, which is inversely related to blood flow, decreased to 92·0 ± 3·4% of basal, P = 0·014 (mean ± SEM, n = 16) during the mental stress test, but increased to 108·3 ± 2·2% of basal, P = 0·001 (n = 16) during the adrenaline infusion. The latter increase was abolished when adrenaline was infused during α‐receptor blockade by phentolamine. On the contrary, by 133Xe clearance and venous occlusion plethysmography, blood flow increased during both interventions; 2·0–1·7‐fold (mental stress) and 1·3–1·4‐fold (adrenaline infusion), respectively, P<0·05.

Conclusion:  Adrenaline causes vasoconstriction in skeletal muscle when blood flow is measured with the microdialysis ethanol technique, irrespective of the mode of administration. The discrepant blood flow result obtained with the microdialysis ethanol technique might, at least partly, be explained by differential diffusion properties of ethanol and 133Xe. An additional or alternative explanation might be that an inserted microdialysis catheter shifts the balance of vasoconstrictor and vasodilator effects of adrenaline in skeletal muscle.
‘Why do they hate us?’ Reframing immigration through participatory action research
Authors: Cahill Caitlin
Published: January 2010

Why do ‘they’ hate ‘us’? is a painful starting point for trying to make sense of the tangled web of global restructuring, politics and racism. My discussion draws upon ‘Dreaming of No Judgment’, a participatory action research project developed with young people in Salt Lake City, Utah that explores the emotional and economic impacts of stereotypes upon immigrant communities. My analysis focuses upon the disjunctures between the dominant immigration discourse and the everyday experiences of young Latino immigrants. Drawing upon borderlands scholarship, starting with embodied everyday lived experiences and concerns, here I consider how the questions, concerns and feelings of young people offer new openings for reframing immigration. In conclusion, I reflect upon how PAR might be a transformative ‘construction site’ for reworking and responding to social injustices through the arts.
Improving governance through local Coastal Partnerships in the UK
Authors: STOJANOVIC TIM , BARKER NATASHA
Published: January 2010

The effectiveness of institutional arrangements and policies for governance has become a key question within the sustainability paradigm. The term ‘Coastal Partnerships’ describes a variety of arrangements in the UK that bring together interested stakeholders to advocate sustainable management of the coast, based on the principles of integrated coastal management (ICM). This paper considers the unique role, achievements and challenges facing local Coastal Partnerships in the UK. The paper examines empirical evidence of how Coastal Partnerships are contributing to sustainable coastal management. The first section considers their shortfalls, the second section their achievements, and the final section discusses their potential role in the context of the evolving policy framework. The policy drivers include European Directives, the reform of the Terrestrial Planning System, and proposals for Marine Spatial Planning through a UK Marine Bill. The authors present a blueprint for the future of Coastal Partnerships, based on this policy analysis. The findings contribute to the ongoing debate in geographical literature on how the scale and structure of governance can be best organised to deliver local sustainability.
Governance and planning policy in the marine environment: regulating aquaculture in Scotland
Authors: PEEL D , LLOYD M G
Published: January 2010

This paper provides a new discussion of the emerging governance regime for marine and coastal environments. It examines the evolution from a non‐statutory to a statutory planning regulatory regime for marine aquaculture in Scotland. Specifically, the definition of development, which underpins the statutory operation of the terrestrial planning system, has been extended to include aquaculture developments within 12 nautical miles of the coast. This effectively expands the geographical territory over which land use planning controls operate in Scotland, and coincides with an emerging interest in the governance, planning and management of the marine environment. Taking into account the various controls put in place over time, the paper identifies the changing state–market–civil relations involved in this shift. Notably, over time, the state has progressively intervened in different ways to correct the perceived market failures associated with aquaculture and its environment. The analysis presented here illustrates the deliberate transition to a statutory planning context through a review of the steps taken by the stakeholders involved to devise a regulatory regime that better serves a contemporary social construction of the public interest. It provides evidence of an explicit attempt within the wider modernisation project to design an appropriate form of governance that is open, participative, accountable, coherent and effective. The paper suggests that the elaboration of such contemporary forms of active mediation remain iterative, partial and dysfunctional and points to an important research agenda to inform the emerging marine environmental planning and governance debates.
The pedagogy of integrated coastal management
Authors: FLETCHER STEPHEN , POTTS JONATHAN , BALLINGER RHODA
Published: January 2010

Capacity building is commonly considered to be a fundamental prerequisite to successful integrated coastal management (ICM). Capacity building for ICM is an educational process, in which skills and knowledge are taught, learned and then applied, within a coastal management process. Previous research into ICM capacity building has tended to focus upon identifying the skills and knowledge required for effective ICM rather than the pedagogic elements of capacity building; that is, how the effectiveness of learning can be improved. This paper reports on a study that focuses on establishing the favoured learning style of students studying ICM in UK universities in order to consider more generally the role of pedagogy in ICM. Kolb's Learning Styles Inventory, a widely used generic learning styles test, was used to establish preferred learning styles. The results showed that ICM learners exhibited a complete range of learning styles, but that 47% were classified as ‘convergers’, who prefer to learn through practice and consider the teacher to be a facilitator and role model rather than knowledge giver. It is concluded that ICM capacity building leaders should consider pedagogic issues more fully in the design and delivery of capacity‐building activities and that a specific pedagogy of ICM is required.
Beach erosion and marine aggregate dredging: a question of evidence?
Authors: PHILLIPS M R
Published: January 2010

Coastal erosion is a global problem and a major concern for European Union Member States. In the UK, marine aggregate dredging is considered by many to be responsible for coastal loss, and campaigns based on the ‘precautionary principle’ have been mounted to halt extraction. Two South Wales, UK coastal areas, where critical beach loss has been associated with dredging activities, were monitored to assess morphological change. In five years of beach monitoring along the Penarth coastline (September 1997 to September 2002) and six years of monitoring Port Eynon and Horton beaches (January 2001 to October 2007), no qualitative or quantitative causal link was found between marine aggregate dredging and beach erosion. Conversely, many qualitative and quantitative relationships were established between beach erosion and forcing agents such as water level, wind and waves. Results from Port Eynon and Horton showed significant temporal variations in beach level, and onshore/offshore sediment movement was seen as significant in beach formation processes. At Penarth, changing wind direction and increased easterly storms were most significant. Furthermore, there were indications of recognised causes of coastal erosion, such as increased water levels, storms and anthropogenic construction. Therefore, morphological changes on a relatively short timescale can be clearly attributed to influences other than marine aggregate dredging. Potential future work includes regular monitoring and analysis of shoreline changes in areas adjacent to dredging sites together with concurrent bathymetric surveys. As well as being a strategic approach, it would address stakeholder concern and reduce conflict.
Patient Navigation: Development of a Protocol for Describing What Navigators Do
Authors: Parker Victoria A. , Clark Jack A. , Leyson Jenniffer , Calhoun Elizabeth , Carroll Jennifer K. , Freund Karen M. , Battaglia Tracy A.
Published: January 2010

Objective. To develop a structured protocol for observing patient navigators at work, describing and characterizing specific activities related to their goals.

Data Sources/Setting. Fourteen extended observations of navigators at three programs within a national trial of patient navigation.

Study Design. Preliminary observations were guided by a conceptual model derived from the literature and expert consensus, then coded to develop and refine observation categories. These findings were then used to develop the protocol.

Methods. Observation fieldnotes were coded, using both a priori codes and new codes based on emergent themes. Using these codes, the team refined the model and constructed an observation tool that enables consistent categorization of the observed range of navigator actions.

Findings. Navigator actions across a wide variety of settings can be categorized in a matrix with two dimensions. One dimension categorizes the individuals and organizational entities with whom the navigator interacts; the other characterizes the types of tasks carried out by the navigators in support of their patients.

Conclusions. Use of this protocol will enable researchers to systematically characterize and compare navigator activities within and across programs.
Using Information on Clinical Conditions to Predict High‐Cost Patients
Authors: Fleishman John A. , Cohen Joel W.
Published: January 2010

Objective. To compare the ability of different models to predict prospectively whether someone will incur high medical expenditures.

Data Source. Using nationally representative data from the Medical Expenditure Panel Survey (MEPS), prediction models were developed using cohorts initiated in 1996–1999 (N=52,918), and validated using cohorts initiated in 2000–2003 (N=61,155).

Study Design. We estimated logistic regression models to predict being in the upper expenditure decile in Year 2 of a cohort, based on data from Year 1. We compared a summary risk score based on diagnostic cost group (DCG) prospective risk scores to a count of chronic conditions and indicators for 10 specific high‐prevalence chronic conditions. We examined whether self‐rated health and functional limitations enhanced prediction, controlling for clinical conditions. Models were evaluated using the Bayesian information criterion and the c‐statistic.

Principal Findings. Medical condition information substantially improved prediction of high expenditures beyond gender and age, with the DCG risk score providing the greatest improvement in prediction. The count of chronic conditions, self‐reported health status, and functional limitations were significantly associated with future high expenditures, controlling for DCG score. A model including these variables had good discrimination (c=0.836).

Conclusions. The number of chronic conditions merits consideration in future efforts to develop expenditure prediction models. While significant, self‐rated health and indicators of functioning improved prediction only slightly.
Aggregate Market Reaction to Earnings Announcements
Authors: CREADY WILLIAM M. , GURUN UMIT G.
Published: January 2010

This analysis identifies a distinct immediate announcement period negative relation between earnings announcement surprises and aggregate market returns. Such a relation implies that market participants use earnings information in forming expectations about expected aggregate discount rates and, specifically, that good earnings news is associated with a positive shock to required returns. Consistent with this interpretation we find that Treasury bond rates and implied future inflation expectations respond directly to earnings news. We also find some evidence that the negative relation between earnings news and market return persists beyond the immediate announcement period, suggesting that market participants do not immediately fully impound these future market return implications of aggregate earnings news.
Expected Mispricing: The Joint Influence of Accounting Transparency and Investor Base
Authors: ELLIOTT W. BROOKE , KRISCHE SUSAN D. , PEECHER MARK E.
Published: January 2010

We examine how accounting transparency and investor base jointly affect financial analysts' expectations of mispricing (i.e., expectations of stock price deviations from fundamental value). Within a range of transparency, these two factors interactively amplify analysts' expectations of mispricing—analysts expect a larger positive deviation when a firm's disclosures more transparently reveal income‐increasing earnings management and the firm's most important investors are described as transient institutional investors with a shorter‐term horizon (low concentration in holdings, high portfolio turnover, and frequent momentum trading) rather than dedicated institutional investors with a longer‐term horizon (high concentration in holdings, low portfolio turnover, and little momentum trading). Results are consistent with analysts anticipating that transient institutional investors are more likely than dedicated institutional investors to adjust their trading strategies for near‐term factors affecting stock mispricings. Our theory and findings extend the accounting disclosure literature by identifying a boundary condition to the common supposition that disclosure transparency necessarily mitigates expected mispricing, and by providing evidence that analysts' pricing judgments are influenced by their anticipation of different investors' reactions to firm disclosures.
Icariin protects against bone loss induced by oestrogen deficiency and activates oestrogen receptor‐dependent osteoblastic functions in UMR 106 cells
Authors: Mok Sao‐Keng , Chen Wen‐Fang , Lai Wan‐Ping , Leung Ping‐Chung , Wang Xin‐Luan , Yao Xin‐Sheng , Wong Man‐Sau
Published: January 2010

Background and purpose:  Icariin may be the active ingredient in Herba Epimedii, a Chinese herb commonly used for treatment of osteoporosis. The present study aims to delineate the mechanism(s) by which icariin prevents bone loss after ovariectomy (OVX) in vivo and stimulates osteoblastic functions in vitro.

Experimental approach:  Ovariectomized or sham‐operated C57BL/6 mice were treated with vehicle, 17β‐oestradiol or icariin for 6 weeks. Total and trabecular bome mineral density (BMD) as well as polar stress‐strain index of distal femur were measured by peripheral computed tomography. The mRNA expressions of OPG and RANKL in tibia were studied by RT‐PCR. Interactions between the oestrogen receptor (ER) antagonist ICI182,780 and icariin were studied in UMR 106 cells. The functional transactivation of ERα and ERβ as well as ERα phosphorylation by icariin were also assessed.

Key results:  Icariin suppressed the loss of bone mass and strength in distal femur and increased the mRNA expression ratio of OPG/RANKL in tibia, following OVX. Icariin increased ER‐dependent cell proliferation, alkaline phosphatase (ALP) activity, gene expression of OPG and the OPG/RANKL ratio in UMR 106 cells. Icariin did not activate ERE‐luciferase activity in UMR 106 cells, via the ERα or the ERβ‐mediated pathway, but it did increase ERα phosphorylation at Ser118.

Conclusions and implications:  Our results indicate that icariin exerts anabolic effects in bone possibly by activating ER in a ligand‐independent manner. Its ability to prevent OVX‐induced bone loss without inducing uterotrophic effects supports its use as an alternative regimen for management of postmenopausal osteoporosis.
The effect of tyrosine nitration of L‐type Ca2+channels on excitation–transcription coupling in colonic inflammation
Authors: Kang M , Ross GR , Akbarali HI
Published: January 2010

Background and purpose: Excitation–transcriptional coupling involves communication between plasma membrane ion channels and gene expression in the nucleus. Calcium influx through L‐type Ca2+channels induces phosphorylation of the transcription factor, cyclic‐AMP response element binding protein (CREB) and downstream activation of the cyclic‐AMP response element (CRE) promoter regions. Tyrosine nitration of Ca2+channels attenuates interactions with c‐Src kinase, decreasing Ca2+channel currents and smooth muscle contraction during colonic inflammation. In this study we examined the effect of tyrosine nitration and colonic inflammation on Ca2+channel mediated phosphorylation of CREB and CRE activation.

Experimental approach: CREB and phospho‐CREB were detected by Western blots and CRE activation measured by dual luciferase assay. Chinese hamster ovary (CHO) cells were transfected with hCav1.2b and hCav1.2b c‐terminal mutants. Colonic inflammation was induced by intracolonic instillation of 2,4,6 trinitrobenzene sulphonic acid in mouse colon.

Key results: In hCav1.2b transfected CHO cells and in native colonic smooth muscle, depolarization with 80 mM KCl induced CREB phosphorylation (pCREB). Treatment with peroxynitrite inhibited KCl‐induced pCREB. Following experimental colitis, KCl‐induced CREB phosphorylation was abolished in smooth muscle, concomitant with tyrosine nitration of Ca2+channels. Depolarization increased CRE activation in hCav1.2b CHO cells by 2.35 fold which was blocked by nifedipine and by protein nitration of Ca2+channels with peroxynitrite. The Src‐kinase inhibitor, PP2, blocked depolarization‐induced CRE activation. Mutation of the C‐terminus tyrosine residue, Y2134F, but not Y1861F, blocked CRE activation.

Conclusions and implications: Post‐translational modification of Ca2+channels due to tyrosine nitration modified excitation–transcriptional coupling in colonic inflammation.
More or Better? A Model for Changes in Household Greenhouse Gas Emissions due to Higher Income
Authors: Girod Bastien , De Haan Peter
Published: January 2010

Households exert an important influence on total greenhouse gas (GHG) emissions. Therefore, their consumption behavior is of interest in evaluations of climate policy options and projections of future emission paths. While most evaluations of household consumption and its emissions are based on expenditure only, we use a household consumption model based on functional units (e.g., kg food, person kilometers, living square meters). The goal of this article is to assess changes in consumption with increasing affluence level of households and to compare the allocation of GHG emissions to monetary versus functional units. We find that (1) the model based on functional units provides good bottom‐up estimates for greenhouse emissions of Swiss households; (2) quality (price per functional unit) increases with income for many consumption categories, and therefore using functional instead of monetary units leads to a lower increase of greenhouse gas emissions with income; (3) the relevance of GHG emissions from goods and mobility will increase. We conclude that using household models based on monetary units only overestimates the impact of marginal consumption and neglects the potential of decoupling income and environmental impact by consuming better instead of more. For sustainable consumption, research and policy should aim at preventing goods of higher quality from having higher environmental impact in order to benefit from the increasing quality orientation with rising income.
Body Mass Index and Survival in Men and Women Aged 70 to 75
Authors: Flicker Leon , McCaul Kieran A. , Hankey Graeme J. , Jamrozik Konrad , Brown Wendy J. , Byles Julie E. , Almeida Osvaldo P.
Published: January 2010

OBJECTIVES: To examine in an older population all‐cause and cause‐specific mortality associated with underweight (body mass index (BMI)<18.5), normal weight (BMI 18.5–24.9), overweight (BMI 25.0–29.9), and obesity (BMI≥30.0).

DESIGN: Cohort study.

SETTING: The Health in Men Study and the Australian Longitudinal Study of Women's Health.

PARTICIPANTS: Adults aged 70 to 75, 4,677 men and 4,563 women recruited in 1996 and followed for up to 10 years.

MEASUReMENTS: Relative risk of all‐cause mortality and cause‐specific (cardiovascular disease, cancer, and chronic respiratory disease) mortality.

RESULTS: Mortality risk was lowest for overweight participants. The risk of death for overweight participants was 13% less than for normal‐weight participants (hazard ratio (HR)=0.87, 95% CI=0.78–0.94). The risk of death was similar for obese and normal‐weight participants (HR=0.98, 95% CI=0.85–1.11). Being sedentary doubled the mortality risk for women across all levels of BMI (HR=2.08, 95% CI=1.79–2.41) but resulted in only a 28% greater risk for men (HR=1.28 (95% CI=1.14–1.44).

CONCLUSION: These results lend further credence to claims that the BMI thresholds for overweight and obese are overly restrictive for older people. Overweight older people are not at greater mortality risk than those who are normal weight. Being sedentary was associated with a greater risk of mortality in women than in men.
Translating a Multifactorial Fall Prevention Intervention into Practice: A Controlled Evaluation of a Fall Prevention Clinic
Authors: Moore Meghann , Williams Barbara , Ragsdale Sally , LoGerfo James P. , Goss J. Richard , Schreuder Astrid B. , Phelan Elizabeth A.
Published: January 2010

Although multifactorial fall prevention interventions have been shown to reduce falls and injurious falls, their translation into clinical settings has been limited. This article describes a hospital‐based fall prevention clinic established to increase availability of preventive care for falls. Outcomes for 43 adults aged 65 and older seen during the clinic's first 6 months of operation were compared with outcomes for 86 age‐, sex‐, and race‐matched controls; all persons included in analyses received primary care at the hospital's geriatrics clinic. Nonsignificant differences in falls, injurious falls, and fall‐related healthcare use according to study group in multivariate adjusted models were observed, probably because of the small, fixed sample size. The percentage experiencing any injurious falls during the follow‐up period was comparable for fall clinic visitors and controls (14% vs 13%), despite a dramatic difference at baseline (42% of clinic visitors vs 15% of controls). Fall‐related healthcare use was higher for clinic visitors during the baseline period (21%, vs 12% for controls) and decreased slightly (to 19%) during follow‐up; differences in fall‐related healthcare use according to study group from baseline to follow‐up were nonsignificant. These findings, although preliminary because of the small sample size and the baseline difference between the groups in fall rates, suggest that being seen in a fall prevention clinic may reduce injurious falls. Additional studies will be necessary to conclusively determine the effects of multifactorial fall risk assessment and management delivered by midlevel providers working in real‐world clinical practice settings on key outcomes, including injurious falls, downstream fall‐related healthcare use, and costs.
Anticholinergics and Ketamine Sedation in Children: A Secondary Analysis of Atropine Versus Glycopyrrolate
Authors: Green Steven M. , Roback Mark G. , Krauss Baruch ,   for the Emergency Department Ketamine Meta‐analysis Study Group
Published: January 2010

Objectives: Adjunctive anticholinergics are commonly administered during emergency department (ED) ketamine sedation in children under the presumption that drying oral secretions should decrease the likelihood of airway and respiratory adverse events. Pharmacologic considerations suggest that glycopyrrolate might exhibit a superior adverse effect profile to atropine. The authors contrasted the adverse events noted with use of each of these anticholinergics in a large multicenter observational database of ketamine sedations.

Methods: This was a secondary analysis of an observational database of 8,282 ED ketamine sedations assembled from 32 prior series. The authors compared the relative incidence of six adverse events (airway and respiratory adverse events, laryngospasm, apnea, emesis, recovery agitation, and clinically important recovery agitation) between children who received coadministered atropine, glycopyrrolate, or no anticholinergic. Multivariable analysis using the specific anticholinergic as a covariate was performed, while controlling for other known predictors.

Results: Atropine was associated with less vomiting (5.3%) than either glycopyrrolate (10.7%) or no anticholinergic (11.4%) in both unadjusted and multivariable analyses. Glycopyrrolate was associated with significantly more airway and respiratory adverse events (6.4%) than either atropine (3.3%) or no anticholinergic (3.0%) and similarly more clinically important recovery agitation (2.1% vs. 1.2 and 1.3%). There were, however, no differences noted in odds of laryngospasm and apnea.

Conclusions: This secondary analysis unexpectedly found that the coadministered anticholinergic atropine exhibited a superior adverse event profile to glycopyrrolate during ketamine sedation. Any such advantage requires confirmation in a separate trial; however, our data cast doubt on the traditional premise that glycopyrrolate might be superior. Further, neither anticholinergic showed efficacy in decreasing airway and respiratory adverse events.

ACADEMIC EMERGENCY MEDICINE 2010; 17:157–162 © 2010 by the Society for Academic Emergency Medicine
Screening Adolescents in the Emergency Department for Weapon Carriage
Authors: Cunningham Rebecca M. , Resko Stella M. , Harrison Stephanie Roahen , Zimmerman Marc , Stanley Rachel , Chermack Stephen T. , Walton Maureen A.
Published: January 2010

Objectives:  The objective was to describe the prevalence and correlates of past‐year weapon involvement among adolescents seeking care in an inner‐city emergency department (ED).

Methods:  This cross‐sectional study administered a computerized survey to all eligible adolescents (age 14–18 years), 7 days a week, who were seeking care over an 18‐month period at an inner‐city Level 1 ED. Validated measures were administered, including measures of demographics, sexual activity, substance use, injury, violent behavior, weapon carriage, and/or weapon use. Zero‐inflated Poisson (ZIP) regression models were used to identify correlates of the occurrence and past‐year frequency of these weapons variables.

Results:  Adolescents (n = 2069, 86% response rate) completed the computerized survey. Fifty‐five percent were female; 56.5% were African American. In the past year, 20% of adolescents reported knife or razor carriage, 7% reported gun carriage, and 6% pulled a knife or gun on someone. Although gun carriage was more frequent among males, females were as likely to carry a knife or pull a weapon in the past year.

Conclusions:  One‐fifth of all adolescents seeking care in this inner‐city ED have carried a weapon. Understanding weapon carriage among teens seeking ED care is a critical first step to future ED‐based injury prevention initiatives.

ACADEMIC EMERGENCY MEDICINE 2010; 17:168–176 © 2010 by the Society for Academic Emergency Medicine
Accuracy of Very Low Pretest Probability Estimates for Pulmonary Embolism Using the Method of Attribute Matching Compared with the Wells Score
Authors: Kline Jeffrey A. , Mark Courtney D. , Than Martin P. , Hogg Kerstin , Miller Chadwick D. , Johnson Charles L. , Smithline Howard A
Published: January 2010

Objectives:  Attribute matching matches an explicit clinical profile of a patient to a reference database to estimate the numeric value for the pretest probability of an acute disease. The authors tested the accuracy of this method for forecasting a very low probability of venous thromboembolism (VTE) in symptomatic emergency department (ED) patients.

Methods:  The authors performed a secondary analysis of five data sets from 15 hospitals in three countries. All patients had data collected at the time of clinical evaluation for suspected pulmonary embolism (PE). The criterion standard to exclude VTE required no evidence of PE or deep venous thrombosis (DVT) within 45 days of enrollment. To estimate pretest probabilities, a computer program selected, from a large reference database of patients previously evaluated for PE, patients who matched 10 predictor variables recorded for each current test patient. The authors compared the outcome frequency of having VTE [VTE(+)] in patients with a pretest probability estimate of <2.5% by attribute matching, compared with a value of 0 from the Wells score.

Results:  The five data sets included 10,734 patients, and 747 (7.0%, 95% confidence interval [CI] = 6.5% to 7.5%) were VTE(+) within 45 days. The pretest probability estimate for PE was <2.5% in 2,975 of 10,734 (27.7%) patients, and within this subset, the observed frequency of VTE(+) was 48 of 2,975 (1.6%, 95% CI = 1.2% to 2.1%). The lowest possible Wells score (0) was observed in 3,412 (31.7%) patients, and within this subset, the observed frequency of VTE(+) was 79 of 3,412 (2.3%, 95% CI = 1.8% to 2.9%) patients.

Conclusions:  Attribute matching categorizes over one‐quarter of patients tested for PE as having a pretest probability of <2.5%, and the observed rate of VTE within 45 days in this subset was <2.5%.

ACADEMIC EMERGENCY MEDICINE 2010; 17:133–141 © 2010 by the Society for Academic Emergency Medicine
Emergency Management of Pediatric Skin and Soft Tissue Infections in the Community‐associated Methicillin‐resistant Staphylococcus aureus Era
Authors: Mistry Rakesh D. , Weisz Keith , Scott Halden F. , Alpern Elizabeth R.
Published: January 2010

Objectives:  Skin and soft tissue infections (SSTIs) are increasing in incidence, yet there is no consensus regarding management of these infections in the era of community‐associated methicillin‐resistant Staphylococcus aureus (CA‐MRSA). This study sought to describe current pediatric emergency physician (PEP) management of commonly presenting skin infections.

Methods:  This was a cross‐sectional survey of subscribers to the American Academy of Pediatrics Section on Emergency Medicine (AAP SoEM) list‐serv. Enrollment occurred via the list‐serv over a 3‐month period. Vignettes of equivocal SSTI, cellulitis, and skin abscess were presented to participants, and knowledge, diagnostic, and therapeutic approaches were assessed.

Results:  In total, 366 of 606 (60.3%) list‐serv members responded. The mean (± standard deviation [SD]) duration of practice was 13.6 (±7.9) years, and 88.6% practiced in a pediatric emergency department. Most respondents (72.7%) preferred clinical diagnosis alone for equivocal SSTI, as opposed to invasive or imaging modalities. For outpatient cellulitis, PEPs selected clindamycin (30.6%), trimethoprim‐sulfa (27.0%), and first‐generation cephalosporins (22.7%); methicillin‐sensitive S. aureus (MSSA) was routinely covered, but many regimens failed to cover CA‐MRSA (32.5%) or group A streptococcus (27.0%). For skin abscesses, spontaneous discharge (67.5%) was rated the most important factor in electing to perform a drainage procedure; fever (19.9%) and patient age (13.1%) were the lowest. PEPs elected to prescribe trimethoprim‐sulfamethoxazole (TMP‐Sx; 50.0%) or clindamycin (32.7%) after drainage; only 5% selected CA‐MRSA–inactive agents. All PEPs suspected CA‐MRSA as the etiology of skin abscesses, and many attributed sepsis (22.1%) and invasive pneumonia (20.5%) to CA‐MRSA, as opposed to MSSA. However, 23.9% remained unaware of local CA‐MRSA prevalence for even common infections.

Conclusions:  Practice variation exists among PEPs for management of SSTI. These results can be used to measure changes in SSTI practices as standardized approaches are delineated.

ACADEMIC EMERGENCY MEDICINE 2010; 17:187–193 © 2010 by the Society for Academic Emergency Medicine
Early postnatal growth variables are related to morphologic and functional ophthalmologic outcome in children born preterm
Authors: Hök‐Wikstrand M , Hård A‐L , Niklasson A , Hellström A
Published: January 2010

Aim:  To evaluate the association between gestational age (GA), early and late postnatal growth variables and ophthalmologic outcome in ex‐preterm children.

Methods:  Children (GA < 32 weeks, n = 66), previously examined regarding insulin‐like growth factor 1 (IGF‐1) serum concentrations in relation to ROP, underwent ophthalmologic examination at median 5.6 years. Weight, height, and head circumference (HC) were measured and expressed as SDS. Growth variables were analysed in relation to ophthalmologic outcome.

Results:  At follow‐up 74% had some ophthalmologic abnormality and 17% had visual impairment. Poor visual acuity was correlated with low GA (rs = 0.29, p = 0.019), low weight at 32 weeks (rs = 0.30, p = 0.013), and low weight (rs = 0.37, p = 0.0025), height (rs = 0.41, p = 0.0007) and HC (rs = 0.55, p < 0.0001) at follow‐up. Hyperopic children (25%) had low neonatal IGF‐1 (p = 0.0096) and HC at follow‐up (p = 0.022). Poor visual perception was correlated with low early weight (rs = 0.38, p = 0.0036) and HC at follow‐up (rs = 0.39, p = 0.0024). Head circumference at follow‐up was correlated with GA (rs = 0.40, p = 0.0012), neonatal IGF‐1 (rs = 0.37, p = 0.0031), and early weight (rs = 0.27, p = 0.035).

Conclusions:  In very preterm children, early and later postnatal growth is closely related to visual acuity and perception at follow‐up. In addition, IGF‐1 concentrations and early growth are correlated with head circumference and refraction at follow‐up.