bluuebunny/crossref_metadata_2025 huggingface dataset:
Telemedical Interventional Monitoring in Heart Failure (TIM‐HF), a randomized, controlled intervention trial investigating the impact of telemedicine on mortality in ambulatory patients with heart failure: study design
Authors: Koehler Friedrich , Winkler Sebastian , Schieber Michael , Sechtem Udo , Stangl Karl , Böhm Michael , Boll Herbert , Kim Simone S. , Koehler Kerstin , Lücke Stephanie , Honold Marcus , Heinze Peter , Schweizer Thomas , Braecklein Martin , Kirwan Bridget‐Anne , Gelbrich Goetz , Anker Stefan D. ,   on behalf of the TIM‐HF Investigators
Published: November 2010

Aims

Remote patient management (telemonitoring) may help to detect early signs of cardiac decompensation, allowing optimization of and adherence to treatments in chronic heart failure (CHF). Two meta‐analyses have suggested that telemedicine in CHF can reduce mortality by 30–35%. The aim of the TIM‐HF study was to investigate the impact of telemedical management on mortality in ambulatory CHF patients.

Methods

CHF patients [New York Heart Association (NYHA) II/III, left ventricular ejection fraction (LVEF) ≤35%] with a history of cardiac decompensation with hospitalization in the past or therapy with intravenous diuretics in the prior 24 months (no decompensation required if LVEF ≤ 25%) were randomized 1:1 to an intervention group of daily remote device monitoring (electrocardiogram, blood pressure, body weight) coupled with medical telephone support or to usual care led by the patients’ local physician. In the intervention group, 24/7 physician‐led medical support was provided by two central telemedical centres. A clinical event committee blinded to treatment allocation assessed cause of death and reason for hospitalization. The primary endpoint was total mortality. The first secondary endpoint was a composite of cardiovascular mortality or hospitalization due to heart failure. Other secondary endpoints included cardiovascular mortality, all‐cause and cause‐specific hospitalizations (all time to first event) as well as days lost due to heart failure hospitalization or cardiovascular death (in % of follow‐up time), and changes in quality of life and NYHA class. Overall, 710 CHF patients were recruited. The mean follow‐up was 21.5 ± 7.2 months, with a minimum of 12 months.

Perspective

The study will provide important prospective outcome data on the impact of telemedical management in patients with CHF.
Localized disruption of Narp in medial prefrontal cortex blocks reinforcer devaluation performance
Authors: Johnson Alexander W. , Han Sungho , Blouin Ashley M. , Saini Jasjit , Worley Paul F. , During Matthew J. , Holland Peter C. , Baraban Jay M. , Reti Irving M.
Published: November 2010

Neuronal activity regulated pentraxin (Narp) is a secreted protein that regulates α-amino-3-hydroxyl-5-methyl-4-isoxazole-propionate receptors (AMPAR) aggregation and synaptogenesis. Mapping of Narp-positive neurons in brain has revealed it is prominently expressed in several limbic system projection pathways. Consistent with this localization pattern, Narp knockout mice show deficits in using the current value of a reinforcer to guide behavior, a critical function of the limbic system. To help assess whether this behavioral deficit is due to impairment of synaptogenesis during development or in modulating synaptic signaling in the mature brain, we have used a dominant negative Narp viral construct which blocks trafficking of endogenous Narp to axons. Focal injection of this viral construct into the medial prefrontal cortex (mPFC) of adult mice, a region containing Narp-positive projection neurons, blocked reinforcer devaluation. Thus, these results indicate that Narp released from mPFC neurons plays a key role in mediating synaptic changes underlying instrumental reinforcer devaluation.
Novel X‐linked inhibitor of apoptosis inhibiting compound as sensitizer for TRAIL‐mediated apoptosis in chronic lymphocytic leukaemia with poor prognosis
Authors: Frenzel Lukas P. , Patz Michaela , Pallasch Christian P. , Brinker Reinhild , Claasen Julia , Schulz Alexandra , Hallek Michael , Kashkar Hamid , Wendtner Clemens‐Martin
Published: November 2010

Given that aggressive DNA damaging chemotherapy shows suboptimal efficacy in chronic lymphocytic leukaemia (CLL), alternative therapeutic approaches are needed. Tumour necrosis factor‐related apoptosis‐inducing ligand (TRAIL) is able to induce tumour‐specific apoptosis. However, apoptosis might be inhibited by elevated levels of X‐linked inhibitor of apoptosis (XIAP). Use of XIAP‐inhibiting compounds might sensitize primary CLL cells towards TRAIL‐mediated apoptosis. A novel small molecule, compound A (CA), an inhibitor of XIAP, was used in combination with TRAIL to induce apoptosis in primary CLL cells (n = 48). XIAP was significantly more highly expressed in primary CLL cells (n = 28) compared to healthy B cells (n = 16) (P = 0·02). Our data obtained by specific knock‐down of XIAP by siRNA identified XIAP as the key factor conferring resistance to TRAIL in CLL. Combined treatment with CA/TRAIL significantly increased apoptosis compared to untreated (P = 8·5 × 10−10), solely CA (P = 4·1 × 10−12) or TRAIL treated (P = 4·8 × 10−10) CLL cells. CA rendered 40 of 48 (83·3%) primary CLL samples susceptible to TRAIL‐mediated apoptosis. In particular, cells derived from patients with poor prognosis CLL (ZAP‐70+, IGHV unmutated, 17p‐) were highly responsive to this drug combination. Our highly‐effective XIAP inhibitor CA, in concert with TRAIL, shows potential for the treatment of CLL cases with poor prognosis and therefore warrants further clinical investigation.
Effect of storage on resistant starch content and in vitro starch digestibility of some pressure‐cooked cereals and legumes commonly used in India
Authors: Yadav Baljeet S. , Sharma Alka , Yadav Ritika B.
Published: November 2010

Resistant starch (RS) is that fraction of starch, which escapes enzymic hydrolysis in the small intestine and passes in the colon. Effect of storage time (12 and 24 h) and temperature (4 °C and 25 °C) was studied on RS content of the pressure‐cooked cereal and legume grains/seeds and their flours. RS content was observed to increase in the stored cereals and legumes, with more enhanced increase in the flour samples stored at refrigeration temperature for longer duration (41.4% in wheat flour and 85.4% in pea flour). Significant positive correlations were observed between RS content (4 °C, 24 h) and amylose (y = 0.388 × –5.948, r = 0.840, P ≤ 0.05, n = 7) as well as between % increase in insoluble dietary fibre content (4 °0C, 24 h) and amylose (y = 2.257 × –27.724, r = 0.971, P ≤ 0.05, n = 7). Reduced in vitro starch digestibility of the cooked/stored samples (4 °C, 24 h) was observed when compared to freshly cooked samples.
Isolation of probiotic bacteria from turmeric (Curcuma longa Linn.) and its application in enriched beverages
Authors: Pianpumepong Plangpin , Noomhorm Athapol
Published: November 2010

The purpose of this study is to obtain lactic acid bacteria (LAB) from fresh turmeric rhizomes that could be used as starter culture with the ability to ferment turmeric and to investigate its influence on total phenolic content (TPC) and antioxidant activity. Three LAB strains, namely Enterococcus faecium, Lactococcus lactis subsp. lactis, and Lactobacillus plantarum, were isolated from turmeric rhizomes. These microorganisms showed similar characteristics as probiotic organisms. The TPC of fermented turmeric beverages was measured using the Folin–Denis reagent method, while the antioxidant activity assays were quantified by 2,2‐diphenyl‐1‐picrylhydrazyl (DPPH) and ferric reducing antioxidant power assay. This study confirms that bacteria isolated from turmeric can be used as starter. Moreover, fermentation time and LAB lead to dominant amount of TPC and that they have high levels of antioxidant activities.
A PCR assay to detect trace amounts of soybean in meat sausages
Authors: Soares Sónia , Mafra Isabel , Amaral Joana S. , Oliveira Maria Beatriz P.P.
Published: November 2010

Soybean proteins are the most widely used source vegetable proteins in the meat industry because of several interesting characteristics. As soybean is included in the group of ingredients potentially allergenic, if not declared, it can be considered a hidden allergen, representing a potential risk to sensitised individuals. The aim of this work was to optimise and apply DNA‐based techniques for soybean detection in meat products, as alternative to the currently used protein‐based methods. The optimised polymerase chain reaction (PCR) protocol targeting the soybean lectin gene enabled the detection of the addition of 0.1% and 0.5% of hydrated textured protein, which corresponded to 0.01% and 0.06% (w/w) of soybean protein in unprocessed and heat‐processed pork meats, respectively. The established PCR technique, when applied to commercial meat sausages (eighteen samples), confirmed the presence of soybean declared in nine samples and indicated the presence of soybean in four samples with no labelled information about soybean. Additionally, the event‐specific PCR detection of Roundup Ready® soybean was also performed, enabling the detection of transgenic DNA in three samples.
Variation among physical, chemical and technological properties in three Sicilian cultivars of Chickpea (Cicer arietinum L.)
Authors: Avola Giovanni , Patanè Cristina
Published: November 2010

Three Sicilian chickpea cultivars (‘Calia’, ‘Etna’ and ‘Principe’) were evaluated for physical, chemical and technological properties. Whereas no substantial differences were ascertained on seeds chemical composition, the cultivars greatly differed in terms of seed size, specific surface area (SSA) and seed coat incidence. These last two properties affected the technological properties of the seeds. In particular, a high SSA (‘Calia’) contributed to a faster softening, whilst a great coat thickness (‘Etna’) delayed both hydration and softening rate. The time required to obtain an acceptable firmness (cooking time) was greatly reduced by presoaking the seeds in salt solution (0.5% NaCl or NHCO3). ‘Calia’ required the lowest cooking time when soaked in distilled water or in 0.5% NaCl. Presoaking seed in NaHCO3 allowed halving the cooking time in all cultivars.
Preparation, digestibility, and glucose response in mice of rice coated with resistant starch type 4 using locust bean gum and agar
Authors: Choi Hea Jin , Lee Chang Joo , Cho Eun Ju , Choi Seung Jun , Moon Tae Wha
Published: November 2010

This study investigated the technical feasibility of coating type 4 resistant starch (RS4) onto rice with the edible polymers locust bean gum (LBG) and agar. The coating solutions were prepared using LBG, agar, and a mixture of LBG and agar at three concentrations (0.01%, 0.1% and 1%). The raw milled rice was soaked in the prepared coating solutions, rolled in RS4 powder and dried. Microscopic observation revealed that the RS4 coating on the rice surface with 0.1% and 1% LBG–agar mixture had a resistance to washing and cooking and covered the whole surface of the rice with good adherence. The thickness of the RS4 coating on the rice surface with 0.1% and 1% LBG–agar mixture was approximately 74 and 233 μm, respectively. Compared with uncoated rice and rice mixed with RS4, the RS4‐coated rice showed lower starch digestibility, a decreased glucose response and a slower rate of blood glucose decrease.
Influence of the degree of fusariosis on technological traits of wheat grain
Authors: Siuda Ryszard , Grabowski Andrzej , Lenc Leszek , Ralcewicz Maria , Spychaj‐Fabisiak Ewa
Published: November 2010

The paper aims to enlarge the current knowledge about the dependence of technological traits of wheat grain on its degree of infestation (DI) with fusariosis. Samples of grain of four wheat cultivars were obtained from naturally grown crops (control) and from crops inoculated with Fusarium culmorum from which three degrees of kernel infestation were selected. Samples were determined for thousand kernels weight (TKW), total protein, starch and wet gluten (WG) contents, Hagberg falling number (HFN) and sedimentation value (SV). Content of protein and wet gluten showed higher values for moderately infested kernels (up to 15 and 25%, respectively, when compared to control grain) than for kernels lightly or heavily infested. All the remaining traits had values lower than that for control grain and showed a decrease with increasing DI. Decrease for the heaviest infestation was on average: 8, 29, 31 and 34% for starch, TKW, HFN and SV, respectively.
Development of peanut milk–based fermented curd
Authors: Yadav Deep N. , Singh Krishan K. , Bhowmik Subrato N. , Patil Ramabhau T.
Published: November 2010

Fermented milk product (Indian curd) was developed by using peanut milk. The level of incubation period (IP), skimmed milk powder (SMP), carboxymethyl cellulose (CMC) was optimised using response surface methodology (RSM). Central composite rotatable design was used with three independent variables i.e. IP (16–20 h), SMP (3–5%) and CMC (0.1–0.3%). SMP had significant (P ≤ 0.05) positive effect on overall acceptability (OAA) of curd because of increase in the total solids that ultimately increased firmness of the curd. CMC was found effective in reducing the synersis of curd samples. The developed curd samples had moisture 84.8 ± 0.28%, protein 3.2 ± 0.12%, fat 3.5 ± 0.10%, ash 0.5 ± 0.05%, carbohydrate 8.0% (wb), peak viscosity 291.4 ± 3.52 cP, firmness 1.3 ± 0.15 N, synersis 32.1 ± 0.2 mL 100 g−1 and acidity (as % lactic acid) 0.58 ± 0.02. It had OAA score of 7.8 ± 0.2 on nine‐point hedonic scale. Based on compromise optimisation, the conditions recommended were IP as 18 h, SMP, 4.24% and CMC, 0.19% for making peanut milk–based fermented curd with 83.4% desirability.
Edible coating affects physico‐functional properties and shelf life of chicken eggs during refrigerated and room temperature storage
Authors: Wardy Wisdom , Torrico Damir D. , No Hong Kyoon , Prinyawiwatkul Witoon , Saalia Firibu K.
Published: November 2010

Effects of chitosan, whey protein concentrate (WPC), mineral oil (MO) and/or soybean oil (SO) coating on egg quality were compared at 25 and 4 °C, respectively, during 5 and 20 weeks of storage. Storage time and temperature, and type of coating significantly affected Haugh unit, yolk index, weight loss, albumen pH and emulsifying capacity. Shelf life was extended 4 weeks by MO and SO and 2 weeks by chitosan and WPC longer than that observed for noncoated eggs at 25 °C. MO‐ and SO‐coated eggs maintained AA grade for 20 weeks at 4 °C. Weight loss of SO‐coated eggs was <1% after 5 weeks at 25 °C and after 20 weeks at 4 °C. Yolk index and emulsifying capacity were more correlated at 25 °C than at 4 °C. MO and SO were more effective coating materials, with SO providing a more cost‐effective coating for extending egg shelf life.
Optimisation of a model food mixture using response surface methodology to evaluate the anti‐adhesive properties of cooking materials
Authors: Zorita Saioa , Niquet Céline , Bonhoure Jean‐Paul , Robert Nathalie , Tessier Frédéric J.
Published: November 2010

The composition of a model food was optimised to evaluate the anti‐adhesive properties of cooking materials. This optimisation was performed using a response surface methodology. When cooked at 201 °C, the model food was selected to leave the greatest quantity of cooked residue that cannot be removed easily from the utensil surface. The measurement of the surface covered by the cooked food left after cleaning was the response value of the experimental design. The effect of five macronutrients was evaluated. Glucose and ovalbumin factors showed the most important positive effect, while amylopectin presented a negative effect. The optimum concentration values of the food constituents where highest food adsorption was estimated were 34.5 mg mL−1 glucose, 14.5 mg mL−1 amylopectin, 39.0 mg mL−1 ovalbumin, 13.5 mg mL−1 casein and 32.8 mg mL−1 linoleic acid. The predicted results at the optimum point coincided well with experimental values. The optimum food mixture presented good precision as well.
Prospects for person‐centred diagnosis in general medicine
Authors: Klinkman Michael , van Weel Chris
Published: November 2010

Fundamental changes in health care delivery are revealing the limitations of our collective focus on disease‐specific and technology‐driven health care. We increasingly treat diseases, not persons, and it moves individuals from active participants in the care process to passive recipients of interventions. This problem is especially important for general medicine, where we must maintain the balance between person and disease, caring and technology. In this chapter, we focus on prospects for person‐centred diagnosis and treatment in general (primary care) medicine in this time of change. We describe one way to employ the biopsychosocial model to integrate person‐centred diagnosis in routine clinical practice, and we propose a ‘person‐centred path’ for primary care development with the health information technology tools we will need to develop to follow that path.
A systematic approach for uptake of evidence on sex‐specific issues in guidelines – a pilot study
Authors: Keuken Debby , Bindels Patrick , Klazinga Niek , Haafkens Joke
Published: November 2010

Rationale, aims and objectives  Increasing evidence indicates that sex‐specific issues may have impact on prevention, diagnosis, or treatment. These issues are not systematically considered during the development of Dutch clinical practice guidelines. The aim of this study is to identify how members of guideline development groups discuss sex‐specific evidence, and whether and how the outcomes of these discussions are reflected in the guideline.

Methods  Six guideline development committees (GDCs) were studied. Each committee was supported by a staff member from the guideline organization who was trained and received feedback to facilitate uptake of evidence on sex differences in the process of guideline development. Non‐participant observation and transcription of audio recordings from 22 GDC meetings were performed. Content analysis of meeting transcripts and guidelines were studied to analyse characteristics of discussion episodes on sex‐specific research data‐based issues (subject matter, initiator and group approach towards the topic and themes) and whether or not conclusions on evidence were reflected in the final guideline text.

Results  Of the 87 identified discussion episodes, 68 dealt with sex‐specific research evidence potentially relevant to guidelines. Respectively 51%, 28% and 21% of the latter episodes were initiated by committee members, staff members and chairpersons. Group approaches towards the subject matter were generally positive. Data from 60% of those episodes were reflected in the final guideline text. Sex‐specific data on reproductive issues were more often discussed and reflected in guideline texts than data on other health issues. Discussion episodes on sex‐specific evidence initiated by chairpersons were most often reflected in the guidelines.

Conclusions  This pilot study indicates that GDCs regularly focused on sex‐specific issues. The participation of a trained staff member contributed to this.
Simple and direct detection of Aeromonas hydrophila infection in the goldfish, Carassius auratus (L.), by dot blotting using specific monoclonal antibodies
Authors: Longyant S , Chaiyasittrakul K , Rukpratanporn S , Chaivisuthangkura P , Sithigorngul P
Published: November 2010

A combination of eight isolates of Aeromonas hydrophila was used to produce monoclonal antibodies (MAbs). Ten different groups of MAbs specific to Aeromonas were selected. The first five groups of MAbs demonstrated high specificity and bound to only one or two isolates of A. hydrophila. The sixth and the seventh groups of MAbs were A. hydrophila specific. They recognized seven of eight A. hydrophila isolates (AH1, 2, 3, 4, 5, 6, 8); however, the MAb in the seventh group also showed cross‐reactivity to one isolate of Aeromonas caviae (AC3). The eighth MAb group recognized two isolates of A. hydrophila (AH2 and AH5) and demonstrated cross‐reactivity to one isolate of Aeromonas sobria (AS1) and one isolate of A. caviae (AC3). The tenth group of MAbs bound to all isolates of Aeromonas spp. tested (AH1‐8, AS1‐6, AC1‐5, Aeromonas veronii and Aeromonas jandaei) without cross‐reactivity to any of the other bacteria tested. MAbs in the ninth group showed similar specificity to those in the tenth group but did not recognize two isolates of A. sobria (AS4 and AS6) or A. jandaei. All the MAbs could be used to identify Aeromonas by dot blotting with a sensitivity ranging from 105 to 107 CFU mL−1. However, the sensitivity of detection was increased to 102–103 CFU mL−1 after inoculation of the sample in tryptic soy broth for 3–6 h before performing the dot blotting. The dot blot method can be used for the direct detection of A. hydrophila infection in symptomatic and asymptomatic goldfish. This study demonstrated a convenient immunological tool that can be used for the direct detection of A. hydrophila and Aeromonas infections in a complex sample without the requirement for separation of the bacteria or isolation and biochemical tests.
Dietary fatty acids and inflammation in the vertebral column of Atlantic salmon, Salmo salar L., smolts: a possible link to spinal deformities
Authors: Gil Martens L , Lock E J , Fjelldal P G , Wargelius A , Araujo P , Torstensen B E , Witten P E , Hansen T , Waagbø R , Ørnsrud R
Published: November 2010

Vegetable oils (Vo) are an alternative to fish oil (Fo) in aquaculture feeds. This study aimed to evaluate the effect of dietary soybean oil (Vo diet), rich in linoleic acid, and of dietary fish oil (Fo diet) on the development of spinal deformities under bacterial lipopolysaccharide (LPS)‐induced chronic inflammation conditions in Atlantic salmon, Salmo salar L. Fish [25 g body weight (BW)] were fed the experimental diets for 99 days. On day 47 of feeding (40 g BW), fish were subjected to four experimental regimes: (i) intramuscular injections with LPS, (ii) sham‐injected phosphate‐buffered saline (PBS), (iii) intraperitoneally injected commercial oil adjuvant vaccine, or (iv) no treatment. The fish continued under a common feeding regime in sea water for 165 more days. Body weight was temporarily higher in the Vo group than in the Fo group prior to immunization and was also affected by the type of immunization. At the end of the trial, no differences were seen between the dietary groups. The overall prevalence of spinal deformities was approximately 14% at the end of the experiment. The Vo diet affected vertebral shape but did not induce spinal deformities. In groups injected with LPS and PBS, spinal deformities ranged between 21% and 38%, diet independent. Deformed vertebrae were located at or in proximity to the injection point. Assessment of inflammatory markers revealed high levels of plasma prostaglandin E2 (PGE2) in the Vo‐fed and LPS‐injected groups, suggesting an inflammatory response to LPS. Cyclooxigenase 2 (COX‐2) mRNA expression in bone was higher in fish fed Fo compared to Vo‐fed fish. Gene expression of immunoglobulin M (IgM) was up‐regulated in bone of all LPS‐injected groups irrespective of dietary oil. In conclusion, the study suggests that Vo is not a risk factor for the development of inflammation‐related spinal deformities. At the same time, we found evidence that localized injection‐related processes could trigger the development of vertebral body malformations.
Morphology and distribution of granulomatous inflammation in freshwater ornamental fish infected with mycobacteria
Authors: Novotny L , Halouzka R , Matlova L , Vavra O , Bartosova L , Slany M , Pavlik I
Published: November 2010

Mycobacteriosis in fish is a chronic progressive ubiquitous disease caused by Mycobacterium marinum, M. gordonae and M. fortuitum in most cases. The aim of this study was to describe the morphology and distribution of lesions in 322 freshwater ornamental fish across 36 species. Granulomatous inflammation was diagnosed by gross examination and histopathology testing in 188 fish (58.4%); acid‐fast rods (AFR) were determined in only 96 (51.1%) fish from 19 species after Ziehl–Neelsen staining. The most often affected organs with AFR were the kidney (81.2%), digestive tract (54.1%), liver (48.2%), spleen (45.9%) and skin (21.2%); sporadically, AFR were found in the branchiae (9.4%) and gonads (4.7%). In 14 randomly selected fish originating from four different fish tanks, the distribution of mycobacterial infection was studied by culture examination of the skin, gills, muscle tissue, digestive tract, liver, spleen and kidney. In 12 fish, the species M. marinum, M. gordonae, M. fortuitum, M. triviale, and M. avium subsp. hominissuis (serotypes 6 and 8 and genotype IS901− and IS1245+) were detected; mixed infection caused by different mycobacterial species was documented in five of them.
Molecular diagnosis of Myxobolus spirosulcatus associated with encephalomyelitis of cultured yellowtail, Seriola quinqueradiata Temminck & Schlegel
Authors: Yokoyama H , Yanagida T , Freeman M A , Katagiri T , Hosokawa A , Endo M , Hirai M , Takagi S
Published: November 2010

Mass mortality of cultured yellowtail, Seriola quinqueradiata, has recently been reported from fish farms in western Japan. Previous studies revealed that diseased fish were characterized by encephalomyelitis and presporogonic stages of a myxosporean‐like parasite in the spinal cord. However, the parasite has remained unidentified because of the lack of mature stages being present. Thus, in the present study, analysis of the small subunit ribosomal DNA (18S rDNA) of the parasite as well as in situ hybridization (ISH) studies using histological sections of the infected tissue was conducted. The 18S rDNA of the myxosporean had higher sequence similarities with those of bile‐duct‐infecting myxosporeans rather than those infecting nervous tissues and was identified as Myxobolus spirosulcatus. The ISH using specific probes demonstrated that the DNA amplified was derived from the multinuclear organisms found in histological sections. A highly sensitive and specific PCR‐based assay for M. spirosulcatus was developed, which revealed a high prevalence of infection in cultured yellowtail that exhibited the clinical signs of encephalomyelitis.
Comparative analysis of the phenotypic characteristics of high‐ and low‐virulent strains ofEdwardsiella tarda
Authors: Wang Y , Zhang X H , Austin B
Published: November 2010

Edwardsiella tardais a causative agent of edwardsiellosis in freshwater and marine fish. Extracellular enzymic, haemolytic, hydrophobic and serum resistance activities, haemagglutination, autoagglutination and siderophores of high‐ and low‐ virulentE. tardastrains were examined. The results revealed different haemagglutination, autoagglutination, haemolytic, hydrophobic and serum resistance activities in different strains. Analysis of extracellular proteins (ECPs) and outer membrane proteins (OMPs) demonstrated several major, low molecular weight, virulent‐strain‐specific proteins, which could be virulence‐related. Based on the database search with MALDI‐TOF MS data, the closest homologies of the three protein bands Ed1, Ed2 and Ed3 were phosphotransferase enzyme family protein, nitrite reductase [NAD(P)H], large subunit and ATP‐dependent Lon protease, respectively. A comparison of pathogenicity of purified lipopolysaccharide (LPS) and lipid A from virulent and avirulent strains demonstrated that LPS was one of the virulence factors of theE. tardaisolates, and lipid A was a biologically active determinant of LPS.
Evidence for synergism of the antimicrobial peptide piscidin 2 with antiparasitic and antioomycete drugs
Authors: Zahran E , Noga E J
Published: November 2010

Piscidins are potent, broad‐spectrum, host‐produced antimicrobial peptides (AMPs) that appear to constitute the most common AMP family in teleost fish. Here, we show that piscidin 2 has potent activity against the water mould Saprolegnia, one of the most important pathogens of freshwater fish. The minimum oomyceticidal concentration (MOC100) of piscidin 2 against zoospores of three pathogenic isolates of Saprolegnia ranged from 12.5 to 25.0 μg mL−1. This piscidin concentration is well within levels that have been estimated to be present in at least some fish (1–32.5 μg mL−1). In the presence of either copper or malachite green, two drugs commonly used to treat water moulds, there was evidence for partial synergism (PSYN) with piscidin 2. There was also evidence for PSYN after exposure of the ciliate parasite Tetrahymena pyriformis to piscidin 2 plus copper. Our data provide further evidence that piscidins may be an important host defence against skin and gill pathogens and that the piscidin levels in host tissue might influence the success of drug treatments.
Drug–drug interactions that reduce the formation of pharmacologically active metabolites: a poorly understood problem in clinical practice
Authors: Mannheimer B. , Eliasson E.
Published: November 2010

Abstract. Mannheimer B, Eliasson E (Karolinska Institutet, Stockholm; Karolinska University Hospital Huddinge, Stockholm, Sweden) Drug–drug interactions that reduce the formation of pharmacologically active metabolites: a poorly understood problem in clinical practice (Review‐Symposium).J Intern Med2010;268: 540–548.

Drug–drug interactions can lead to reduced efficacy of medical treatment. Therapeutic failure may for instance result from combined treatment with an inhibitor of the specific pathway that is responsible for the generation of pharmacologically active drug metabolites. This problem may be overlooked in clinical practice. Several examples of drugs will be discussed –clopidogrel, losartan, tamoxifen and codeine – to illustrate differences in the potential impact on drug treatment in clinical practice. We conclude that the combined use of cytochrome P450‐blocking serotonin reuptake inhibitors and tamoxifen or codeine should be avoided, whereas the situation is much more complex regarding the use of proton pump inhibitors together with clopidogrel, and the evidence regarding cytochrome P450 inhibitor‐dependent activation of losartan is inconclusive.
Programmes for parents with a mental illness
Authors: REUPERT A. , MAYBERY D.
Published: November 2010

Accessible summary

Despite the benefits of parenting interventions for parents and children, there are few documented programmes for parents who have a mental illness, with older children.

Interviewing clinicians responsible for programmes specifically developed for parents with a mental illness identifies what clinicians believe is important for these parents and is one way of developing an evidence base.

According to clinicians, programmes need to be responsive to parents with a mental illness through flexibility in programme content, time and/or follow‐up with case management or house visits. Providing opportunities to learn from and with other parents who have a mental illness is also important.

Clinicians require support in articulating a sound theoretical basis for their programmes and when implementing evaluation strategies.

Parents with a mental illness experience the same parenting stressors that other parents do, and at the same time need to manage their mental illness. However, few programmes are designed for parents who have a mental illness, with older children (as opposed to interventions for mothers with infants). This study identified the common components across six programmes developed for parents with a mental illness who have older children. Australian clinicians, responsible for six parenting programmes for those with a mental illness, participated in individual, semi‐structured interviews, during 2008. Programme manuals and evaluation reports were also sourced. Analyses involved thematic analysis, inter‐rater reliability and respondent validation. Data were organized in three main areas: (1) programme description (format, goals, length and participants' inclusion criteria); (2) theoretical framework (including clinicians' beliefs and evidence underpinning programmes); and (3) evaluation designs and methodologies. It was found that clinicians facilitated education and support via a peer intervention model for parents with various mental illness diagnoses, responsive to the needs of parents and in a time flexible manner. At the same time, clinicians found it difficult to articulate the theoretical framework of their programmes and employed mostly simplistic evaluation strategies.
Forensic nursing educational development: an integrated review of the literature
Authors: KENT‐WILKINSON A.
Published: November 2010

Accessible summary

The importance of this paper's findings are:

Forensic nursing is a nursing specialty with subspecialties that focus on nursing practice who care for victims and offenders, living and deceased at the clinical legal interface.

The gaps identified in the literature indicate where educational development did not occur concurrently with role development of forensic nursing.

Role development occurred ahead of educational development for all subspecialty areas of forensic nursing except sexual assault nurse examiners, where it developed simultaneously.

Forensic nursing formal education did not develop sooner as infrastructures were not in place to support it.

The forensic area of practice has been a popular career choice and area of study for many of the health science disciplines. Forensic nursing is a nursing specialty with subspecialties that focus on nursing practice who care for victims and offenders, living and deceased at the clinical legal interface. This integrated review of the literature overviewed the historical development of each of the forensic nursing subspecialties and identified gaps in specialty nursing educational development. Although multiple studies for the last 30 years identified the need for forensic nursing education, recommendations did not soon translate into educational curriculum development. The literature showed that role development was not concurrent with educational development in all forensic nursing subspecialties.
Development of a real‐time PCR assay for Pseudomonas cichorii, the causal agent of midrib rot in greenhouse‐grown lettuce, and its detection in irrigating water
Authors: Cottyn B. , Baeyen S. , Pauwelyn E. , Verbaendert I. , De Vos P. , Bleyaert P. , Höfte M. , Maes M.
Published: November 2010

Midrib rot is an emerging disease in greenhouse production of lettuce caused by Pseudomonas cichorii, and probably introduced through contaminated irrigation water. Concentrations of 100 CFU mL−1 are enough to induce the typical midrib rot symptoms. A sensitive real‐time PCR assay was developed, based on a 90‐bp amplicon from the pathogenicity gene cluster hrcRST and a Taqman Minor Groove Binding probe. Specificity of the assay was tested with 39 P. cichorii strains, including the type strain, and 89 strains from 83 other Pseudomonas species. The relationship between detection signals and P. cichorii DNA concentrations was linear over 6‐logs. Detection threshold with excellent reproducibility was 500 fg of DNA or about 70 genome copies. Sample preparation and DNA isolation were optimized to allow detection in 1 L water samples. The assay was first evaluated with greenhouse irrigation water spiked with serial dilutions of P. cichorii. The calculated cell numbers obtained with real‐time PCR were 10‐fold lower than plate counts of actual spiked cells. However, the assay consistently detected 100 CFU per reaction, corresponding to the detection of 1 CFU mL−1 of irrigation water, which is well below the concentration needed for midrib rot infection. Finally, the assay proved to be valuable for detecting infective P. cichorii concentrations in the irrigation water of a commercial lettuce production greenhouse.
Epidemiology, histopathology and aetiology of olive anthracnose caused by Colletotrichum acutatum and C. gloeosporioides in Portugal
Authors: Talhinhas P. , Mota‐Capitão C. , Martins S. , Ramos A. P. , Neves‐Martins J. , Guerra‐Guimarães L. , Várzea V. , Silva M. C. , Sreenivasaprasad S. , Oliveira H.
Published: November 2010

Anthracnose is an important disease affecting mature olive fruits, causing significant yield losses, and poor fruit and oil quality. In Portugal, high anthracnose incidence was recorded during 2003–2007 with 41% of 908 orchards surveyed displaying disease symptoms. In another 14% of the orchards, the pathogen was recorded in symptomless plants. Disease severity was on average 36%, frequently reaching 100%. In Portugal, anthracnose is endemic to neglected orchards of susceptible cultivars, but under favourable conditions it can also severely affect less susceptible cultivars. Pathogens were genetically heterogeneous, with Colletotrichum acutatum genetic group A2 as the most frequent (80%), followed by group A4 (12%) and group A5 along with C. gloeosporioides (3–4%), while groups A3 and A6 of C. acutatum were sporadic. Important geographic variations were observed in the frequencies of these populations, accompanied by year‐to‐year populational shifts. Epidemiology and histopathology studies showed the presence of the pathogens on vegetative organs year‐round, particularly on olive leaves and branches, and on weeds. These represent inoculum reservoirs where secondary conidiation occurs, and conidia are then dispersed by spring rains reaching flowers and young fruits or by autumn rains reaching pre‐mature fruits. Unripe fruits were colonized without showing symptoms up to penetration of the cuticle, but further colonization and symptom production was completed only as fruits matured. These findings challenge current control practices, particularly the timing of fungicide treatment, and contribute to improved disease management.
Quantifying particle aggregation in sediments
Authors: HABERLAH DAVID , MCTAINSH GRANT H.
Published: November 2010

Sediments often occur as non‐normal size distributions composed of discrete, partially aggregated particle populations. These populations reflect provenance, dispersal pathways and their depositional environments. Recent experimental laboratory studies describing mud flocculation in turbulent marine systems prompted this investigation of the potential of aggregates to record size‐sensitive transport dynamics in a terrestrial fluvial system. Here, sediment‐size distributions in their natural condition of particle–aggregate mixtures are analysed by parametric statistics. A practical and freely available decompositional approach is outlined and field tested, which allows sediment to be viewed in both its conventional particulate form and as its naturally occurring mixture of transport‐stable aggregates and elementary particles. From a sequence of upward‐fining slack water couplets in the Flinders Ranges, South Australia, it is demonstrated that the characteristics, provenance and depositional history of fine‐grained sediments consisting of particle‐aggregate mixtures can best be understood fully by quantifying aggregation.
Matching dimorphic sexes and immature stages with adults: resolving the systematics of the Bekilya group of Malagasy assassin bugs (Hemiptera: Reduviidae: Peiratinae)
Authors: ZHANG GUANYANG , WEIRAUCH CHRISTIANE
Published: November 2010

The Madagascar endemic assassin bugs Bekilya Villiers and Hovacoris Villiers were described from macropterous male specimens with striking colour patterns, and are currently monotypic. Mutillocoris Villiers, with two species from Madagascar, was based on brachypterous female specimens that resemble female mutillid wasps. To investigate the validity of the three genera, recently collected specimens from Madagascar were studied with both morphological and molecular techniques. Morphology alone appeared to be of limited value for associating males with females, and immature stages with adults, because of drastic differences between the sexes and the life stages. However, the use of morphology in conjunction with molecular data resolved these associations and showed that species of Mutillocoris represent females of Bekilya and Hovacoris, which we transfer accordingly to these two genera and refer to them as the Bekilya group. The type species of Mutillocoris belongs in Bekilya, resulting in the synonymy of these two genera (Mutillocorissyn.n.). The Bekilya group is diagnosed and several new species are described: Bekilya mahafalyasp.n., Bekilya tenebrasp.n., Bekilya tulearasp.n., Hovacoris bicolornotumsp.n., Hovacoris melanocepssp.n. and Hovacoris rufiventrissp.n. A total of ten species are recognized within the Bekilya group. The monophyly of Bekilya, Hovacoris and the Bekilya group is confirmed by morphological and molecular phylogenetic analyses.
Disease profile of children under 5 years attending primary health care clinics in a high HIV prevalence setting in South Africa
Authors: Horwood Christiane , Butler Lisa M. , Vermaak Kerry , Rollins Nigel , Haskins Lyn , Nkosi Phumla , Neilands Torsten B. , Qazi Shamim
Published: November 2010

Objective  To describe the presenting complaints and disease profile of children attending primary health care (PHC) clinics in two provinces of South Africa.

Methods  Participants were sick children 2–59 months old presenting for care at PHC clinics in KwaZulu‐Natal (KZN) and Limpopo provinces from 2006–2007. Children were assessed by an expert Integrated Management of Childhood Illnesses (IMCI) practitioner. Children for whom parental/guardian consent was obtained were tested for HIV.

Results  A total of 1357 children attending one of 74 clinics were assessed. HIV seroprevalence overall was 7.1%, but was significantly higher in KZN than Limpopo (7.5 vs. 2.4%; OR = 3.3, 95%CI 1.9–5.8%). Commonest presenting complaints were cough (72%), skin conditions (22%) and diarrhoea (19%). Of 1349 children, 120 (8.9%) had a weight below the third percentile; 108/1357 (8.0%) children required urgent referral, most commonly for severe pneumonia (53.7%) and severe malnutrition (16.7%). In multivariate analyses, severe pneumonia, growth faltering and urgent referral were independently associated with younger age, residence in KZN and HIV infection (P < 0.05).

Conclusions  Many children with severe illnesses and undiagnosed HIV infection present to PHC facilities. PHC staff require skills to correctly manage these conditions and undertake HIV testing. Although IMCI provides evidence‐based guidelines, implementation must be improved to achieve adequate coverage of life‐saving interventions.
Role of risk factors and socio‐economic status in pulmonary tuberculosis: a search for the root cause in patients in a tertiary care hospital, South India
Authors: Gupta Soham , Shenoy Vishnu Prasad , Mukhopadhyay Chiranjay , Bairy Indira , Muralidharan Sethumadhavan
Published: November 2010

Objective  To determine the frequency of underlying risk factors and the socio‐economic impact based on occupation in the development of tuberculosis.

Method  Retrospective analysis of 207 clinically and microbiologically diagnosed patients with pulmonary tuberculosis (PTB) admitted to Kasturba Hospital in 2005 and 2006. Demographic details and underlying risk factors were statistically evaluated.

Results  Diabetes mellitus (DM) (30.9%) was the most prevalent condition and significantly more common than other risk factors like smoking (16.9%), alcoholism (12.6%), HIV (10.6%), malignancy (5.8%), chronic liver diseases (3.9%), history of contact with TB (3.4%), chronic corticosteroid therapy (2.9%), chronic kidney diseases and malnourishment (1.5%). There were 82 patients (39.6%) with no underlying risk factor. Men (M:F = 3.7:1) and patients older than 40 years had a higher incidence of co‐existing conditions. PTB was significantly more common in blue‐collar (44%) and white‐collar (27.1%) workers than household workers (12.1%), students (10.6%) and retired/unemployed people (6.3%).

Conclusion  Pulmonary tuberculosis had a significant impact and predominated in male patients co‐existing with DM. Patients with DM and suggestive pulmonary symptoms should be screened for tuberculosis. More stringent health education and awareness programme should be implemented at the grass root level.
Bacterial hand contamination among Tanzanian mothers varies temporally and following household activities
Authors: Pickering Amy J. , Julian Timothy R. , Mamuya Simon , Boehm Alexandria B. , Davis Jennifer
Published: November 2010

Objective  To characterize mechanisms of hand contamination with faecal indicator bacteria and to assess the presence of selected pathogens on mothers’ hands in Tanzania.

Methods  A household observational study combined with repeated microbiological hand rinse sampling was conducted among 119 mothers in Dar es Salaam, Tanzania. All hand rinse samples were analysed for enterococci and Escherichia coli, and selected samples were analysed for genetic markers of Bacteroidales, enterovirus and pathogenic E. coli.

Results  Using the toilet, cleaning up a child’s faeces, sweeping, cleaning dishes, preparing food and bathing were all found to increase faecal indicator bacterial levels on hands. Geometric mean increases in colony forming units per two hands ranged from 50 (cleaning dishes) to 6310 (food preparation). Multivariate modelling of hand faecal indicator bacteria as a function of activities recently performed shows that food handling, exiting the household premises and longer time since last handwashing with soap are positively associated with bacterial levels on hands, while bathing is negatively associated. Genetic markers of Bacteroidales, enterovirus and pathogenic E. coli were each detected on a subset of mothers’ hands.

Conclusions  Escherichia coli and enterococci on hands can be significantly increased by various household activities, including those involving the use of soap and water. Thus, faecal indicator bacteria should be considered highly variable when used as indicators of handwashing behaviour. This work corroborates hands as important vectors of disease among Tanzanian mothers and highlights the difficulty of good personal hygiene in an environment characterized by the lack of networked sanitation and water supply services.
It is not a fixed drug eruption, it is a fixed “sunlight” eruption
Authors: Valdivieso Rommel , Cañarte Cecilia
Published: November 2010

Hyperpigmented fixed eruption is a phenomenon usually related with drug antigens, and known as fixed drug eruption. A woman had a skin condition with clinical and histopathologic indications of fixed drug eruption. The disease first appeared when she went to a swimming pool and left with hyperpigmented macules. Previously affected skin reactivated on three other occasions when she again visited swimming pools. Sunlight involvement (UVA‐UVB) was demonstrated through phototests. Sunlight should be considered as a cause of fixed drug‐like eruption and a possible cause of some cases of FDE without any apparent etiological factor.