bluuebunny/crossref_metadata_2025 huggingface dataset:
The impact of an electronic nursing documentation system on efficiency of documentation by caregivers in a residential aged care facility
Authors: Munyisia Esther N , Yu Ping , Hailey David
Published: July 2012

Aims and objectives.  To examine the effect of the introduction of an electronic nursing documentation system on the efficiency of documentation in a residential aged care facility.

Background.  Modern technology has the potential to free caregivers in residential aged care facilities from their burden of paper documentation and allow them more time to care for residents. To date, there is inadequate evidence to verify this assumption.

Design.  Longitudinal cohort study with work sampling method for data collection.

Methods.  This study was conducted between 2009–2011; two months before and 3, 6, 12 and 23 months after implementation of an electronic documentation system. A work classification tool was used by an observer to record documentation activities being performed on paper or on a computer by the caregivers.

Results.  When compared with the proportion of time caregivers spent on documentation in the preimplementation period, personal carers’ proportion reduced at three months after implementation. The proportion increased from six months and then dropped at 23 months. Recreational activity officers’ proportion increased at three months after implementation. It stabilised at six months and increased again at 12 months. At 23 months, the proportion returned to the preimplementation level. Less than half of the caregivers’ time on documentation after implementation was associated with computer‐related tasks.

Conclusions.  Introduction of an electronic documentation system may not necessarily lead to efficiency in documentation for the caregivers. Charting some information items on paper and others on a computer may hinder realization of documentation efficiency.

Relevance to clinical practice.  To optimise the efficiency benefit of electronic documentation in a residential aged care facility, it is not only necessary to automate all nursing forms but also to ensure that the system is aligned with caregivers’ documentation practice. Continuous education and mentor support is essential to ensure caregivers’ effective usage of the electronic system.
Factors influencing the adoption of home telecare by elderly or chronically ill people: a national survey
Authors: Peeters José M , de Veer Anke JE , van der Hoek Lucas , Francke Anneke L
Published: July 2012

Aims and objectives.  The primary aim is to provide insight into client characteristics and characteristics of home telecare contacts, which may influence the adoption of home telecare. Secondary aim is to examine the applicability of four perceived attributes in Rogers’ diffusion of innovations theory, which may influence the adoption: relative advantage, compatibility, complexity and observability.

Background.  Western countries face strongly increasing healthcare demands. At the same time, a growing nursing shortage exists. The use of home telecare may be instrumental in improving independence and safety and can provide support to older and chronically ill people, but a precondition for its uptake is that clients consider it as a useful and helpful technological tool.

Design.  A survey conducted among clients of seven home care organisations in the Netherlands connected to a home telecare system.

Methods.  In 2007, a postal questionnaire was distributed to 468 older or chronically ill clients: 254 responded (54%). The data were analysed by regression techniques, employing a theoretical model.

Results.  This study showed that clients’ perceived attributes – relative advantage, compatibility, complexity and observability – have a significant effect on adoption of home telecare explaining 61% of the variance. The chance of adoption is higher when a client already receives long‐term personal and/or nursing care, he/she lives alone and when there are fixed daily contacts via the home telecare system. The perception of possible benefits can still be enhanced.

Conclusions.  The concept of perceived attributes, derived from Rogers’ diffusion of innovation theory, has been useful to explain clients’ adoption of home telecare.

Relevance to clinical practice.  Home care organisations can best focus on clients already in care and people living alone, in offering home telecare. Nurses, who aim to enhance the client’s adoption of home telecare, have to take into account clients’ perceived attributes of such new technology.
CYP1A2 polymorphisms in slow melatonin metabolisers: a possible relationship with autism spectrum disorder?
Authors: Braam W. , Keijzer H. , Struijker Boudier H. , Didden R. , Smits M. , Curfs L.
Published: July 2012

Background  In some of our patients with intellectual disabilities (ID) and sleep problems, the initial good response to melatonin disappeared within a few weeks after starting treatment. In these patients melatonin levels at noon were extremely high (>50 pg/ml). We hypothesise that the disappearing effectiveness is associated with slow metabolisation of melatonin because of a single nucleotide polymorphism (SNP) of CYP1A2.

Method  In this pilot study we analysed DNA extracted from saliva samples of 15 consecutive patients with disappearing effectiveness of melatonin. Saliva was collected at noon and 4 pm for measuring melatonin levels.

Results  In all patients' salivary melatonin levels at noon were >50 or melatonin half time was >5 h. A SNP was found in eight of 15 patients. The allele *1C was found in two patients and in six patients the *1F allele was found.

Conclusions  Of 15 patients with disappearing effectiveness of melatonin, seven were diagnosed with autism spectrum disorder, and in four of them a SNP was found. The other eight patients were known with a genetic syndrome. In six of them behaviour was considered to be autistic‐type and in three of them a SNP was found. This finding may give a new direction for research into the genetic background of autism.
Distinct Pattern of Immunophenotypic Features of Innate and Adaptive Immunity as a Putative Signature of Clinical and Laboratorial Status of Patients with Localized Cutaneous Leishmaniasis
Authors: Freitas‐Teixeira P. M. , Silveira‐Lemos D. , Giunchetti R. C. , Baratta‐Masini A. , Mayrink W. , Peruhype‐Magalhães V. , Rocha R. D. R. , Campi‐Azevedo A. C. , Teixeira‐Carvalho A. , Martins‐Filho O. A.
Published: July 2012

In this study, we have analysed the phenotypic features of innate/adaptive immunity of patients with localized cutaneous leishmaniasis (LCL), categorized according to their clinical/laboratorial status, including number of lesion (L1; L2–4), days of illness duration (≤60;>60) and positivity in the Montenegro skin test (MT−;MT+). Our findings highlighted a range of phenotypic features observed in patients with LCL (↑%HLA‐DR+ neutrophils; ↑CD8+ HLA‐DR+/CD4+ HLA‐DR+ T cell ratio; ↑HLA‐DR in B lymphocytes, ↑%CD23+ neutrophils, monocytes and B cells; ↑α‐Leishmania IgG and ↑serum  + ). Selective changes were observed in L1 (↑%HLA‐DR+ neutrophils, ↑CD8+ HLA‐DR+/CD4+ HLA‐DR+ T cell ratio and ↑serum  + ) as compared to L2–4 (↑%CD5− B cells; ↑CD23+ B cells and ↑α‐Leishmania IgG). Whilst ≤60 presented a mixed profile of innate/adaptive immunity (↓%CD28+ neutrophils and ↑%CD4+ T cells), >60 showed a well‐known leishmanicidal events (↑CD8+ T cells; ↑serum  +  and ↑α‐Leishmania IgG). MT+ patients showed increased putative leishmanicidal capacity (↑%HLA‐DR+ neutrophils; ↑%CD23+ monocytes; ↑CD8+ HLA‐DR+/CD4+ HLA‐DR+ T cell ratio and ↑ serum  + ). Overall, a range of immunological biomarkers illustrates the complex immunological network associated with distinct clinical/laboratorial features of LCL with applicability in clinical studies.
WOX2 and STIMPY‐LIKE/WOX8 promote cotyledon boundary formation in Arabidopsis
Authors: Lie Catharine , Kelsom Corey , Wu Xuelin
Published: July 2012

One of the key events in dicot plant embryogenesis is the emergence of the two cotyledon primordia, which marks the transition from radial symmetry to bilateral symmetry. In Arabidopsis thaliana, the three CUP‐SHAPED COTYLEDON (CUC) genes are responsible for determining the boundary region between the cotyledons. However, the mechanisms controlling their transcription activation are not well understood. Previous studies found that several WOX family homeobox transcription factors are involved in embryo apical patterning and cotyledon development. Here we show that WOX2 and STIMPY‐LIKE (STPL/WOX8) act redundantly to differentially regulate the expression of the CUC genes in promoting the establishment of the cotyledon boundary, without affecting the primary shoot meristem. Loss of both WOX2 and STPL results in reduced CUC2 and CUC3 expression in one side of the embryo, but an expansion of the CUC1 domain. Furthermore, we found that STPL is expressed in the embryo proper, and its activation is enhanced by the removal of WOX2, providing an explanation for the functional redundancy between WOX2 and STPL. Additional evidence also showed that WOX2 and STPL function independently in regulating different aspects of local auxin gradient formation during early embryogenesis.
Are all meticillin‐resistantStaphylococcus aureus(MRSA) equal in all hosts? Epidemiological and genetic comparison between animal and human MRSA
Authors: McCarthy Alex J. , Lindsay Jodi A. , Loeffler Anette
Published: July 2012

Meticillin‐resistantStaphylococcus aureus(MRSA) continues to pose a major threat to human health. In animals, MRSA has become established as a veterinary pathogen in pets and horses; in livestock, it presents a concern for public health as a reservoir that can infect humans and as a source of transferrable resistance genes.

Genetic analyses have revealed that the epidemiology of MRSA is different in different animal hosts. While human hospital‐associated MRSA lineages are most commonly involved in pet infection and carriage, horse‐specific MRSA most often represent ‘traditional’ equineS. aureuslineages. A recent development in the epidemiology of animal MRSA is the emergence of pig‐adapted strains, such as CC398 and CC9, which appear to have arisen independently in the pig population.

Recent insight into the genome structure and the evolution ofS. aureushas helped to explain key aspects of these three distinct epidemiological scenarios. This nonsystematic literature review summarizes the structure and variations of theS. aureusgenome and gives an overview of the current distribution of MRSA lineages in various animal species. It also discusses present knowledge about the emergence and evolution of MRSA in animals, adaptation to different host species and response to selective pressure from animal‐specific environments.

An improved understanding of the genetics and selective pressure that underpin the adaptive behaviour ofS. aureusmay be used in the future to predict new developments in staphylococcal diseases and to investigate novel control strategies required at a time of increasing resistance to antimicrobial agents.
Comparison of once‐daily versus twice‐weekly terbinafine administration for the treatment of canine Malassezia dermatitis – a pilot study
Authors: Berger Darren J. , Lewis Thomas P. , Schick Anthea E. , Stone Richard T.
Published: July 2012

Background –  Terbinafine, an allylamine antifungal, is used in pulsatile dose regimens for superficial mycoses in human medicine.

Objectives –  To compare the clinical efficacy of twice‐weekly versus once‐daily terbinafine administration to determine whether preliminary proof‐of‐concept evidence exists for pulsatile administration of terbinafine in the treatment of canine Malassezia dermatitis and to determine whether twice‐weekly treatment results in fewer clinical and owner‐perceived adverse events.

Animals –  Twenty client‐owned dogs with Malassezia dermatitis.

Methods –  In this randomized, single‐blinded clinical trial, dogs were randomly assigned to receive terbinafine (30 mg/kg) either once daily for 21 days (n = 10) or once daily on two consecutive days per week for six doses (n = 10). On day 0 and day 21, a mean yeast count was calculated from eight anatomical locations via adhesive tape‐strip cytology, clinical lesion scores were assigned to the same locations, and owners assessed pruritus using a visual analog scale.

Results –  There was no significant difference between treatment groups with respect to the reduction in mean yeast count (P = 0.343) and clinical lesion scores (P = 0.887). Pruritus measured by visual analog scale was significantly decreased in the twice‐weekly treatment group compared with the daily treatment group (P = 0.047). Seven of 20 dogs had a clinically measurable or owner‐reported adverse event during treatment that included gastrointestinal disturbances, excessive panting and elevated hepatic enzymes, with no significant difference noted between treatment groups.

Conclusions and clinical importance –  This pilot study indicates that twice‐weekly terbinafine administration may be an effective alternative treatment for canine Malassezia dermatitis and merits further investigation.
Optogenetic inhibition of cocaine seeking in rats
Authors: Stefanik Michael T. , Moussawi Khaled , Kupchik Yonatan M. , Smith Kyle C. , Miller Rachel L. , Huff Mary L. , Deisseroth Karl , Kalivas Peter W. , LaLumiere Ryan T.
Published: July 2012

Inhibitory optogenetics was used to examine the roles of the prelimbic cortex (PL), the nucleus accumbens core (NAcore) and the PL projections to the NAcore in the reinstatement of cocaine seeking. Rats were microinjected into the PL or NAcore with an adeno‐associated virus containing halorhodopsin or archaerhodopsin. After 12 days of cocaine self‐administration, followed by extinction training, animals underwent reinstatement testing along with the presence/absence of optically induced inhibition via laser light. Bilateral optical inhibition of the PL, NAcore or the PL fibers in the NAcore inhibited the reinstatement of cocaine seeking.
MiR‐146a polymorphism is associated with asthma but not with systemic lupus erythematosus and juvenile rheumatoid arthritis in Mexican patients
Authors: Jiménez‐Morales S. , Gamboa‐Becerra R. , Baca V. , Del Río‐Navarro B. E. , López‐Ley D. Y. , Velázquez‐Cruz R. , Saldaña‐Alvarez Y. , Salas‐Martínez G. , Orozco L.
Published: July 2012

Extensive research has shown that aberrant expression of microRNAs (miRNAs) plays an important role in innate and adaptive immune responses. The rs2910164 polymorphism has been identified as a functional variant, which affects the transcription and expression level of miR‐146a and, thereby, contributes to the pathogenesis of several inflammatory and autoimmune diseases. To investigate whether the rs2910164 G/C polymorphism was associated with asthma, systemic lupus erythematosus (SLE) or juvenile rheumatoid arthritis (JRA), we performed an association study in a pediatric Mexican cohort. We included 979 pediatric patients (asthma: 402, SLE: 367 and JRA: 210) and 531 control subjects without inflammatory or immune diseases. Genotyping was performed using the 5′ exonuclease technique. The genotype distribution of the rs2910164 polymorphism was in Hardy–Weinberg equilibrium in each group. No significant differences were detected in the distribution of this polymorphism between cases and controls (P = 0.108, 0.609 and 0.553 for subjects with asthma, JRA and SLE, respectively). However, stratification by gender showed a statistically significant difference between asthmatic and control females, where the C allele was significantly associated with protection to asthma (odds ratio = 0.694, 95% confidence interval 0.519–0.929, P = 0.0138). Our results provide evidence that rs2910164 may play a role in the susceptibility to childhood‐onset asthma, but not SLE or JRA in Mexicans. Further association studies may contribute to determining the role of miR‐146a single‐nucleotide polymorphisms in immune‐mediated diseases.
Fatal human metapneumovirus and influenza B virus coinfection in an allogeneic hematopoietic stem cell transplant recipient
Authors: Ghattas C. , Mossad S.B.
Published: July 2012

Human metapneumovirus (hMPV) infection can occur in all age groups with significant morbidity and mortality. Coinfection with influenza virus occurs mainly with influenza type A and all reported cases recovered completely. We report the case of a 61‐year‐old man who had hematopoietic stem cell transplant for myelodysplastic syndrome. He was admitted to hospital for septic shock and neutropenia, and blood culture was positive for Pseudomonas aeruginosa. He rapidly developed respiratory failure and required ventilator support. His respiratory culture grew P. aeruginosa and hMPV. His course was complicated by persistent shock requiring vasopressor support, and repeat nasopharyngeal swab was positive for influenza type B and hMPV. His condition rapidly deteriorated, his family elected comfort care, and the patient died shortly thereafter. Coinfection with hMPV and influenza virus type B may have a poor outcome and can be fatal, especially in immunocompromised patients.
A case of wrist tenosynovitis caused by Mycobacterium kansasii in a renal transplant recipient
Authors: Chan A. , Findlay A. , Abeygunasekara S.
Published: July 2012

Mycobacterial infection in an organ transplant recipient is a diagnostic and therapeutic challenge. Diagnosis is often delayed, resulting in significant morbidity. Anti‐microbial chemotherapy needs careful selection to prevent potentially significant complications, such as organ rejection and dose‐related toxicities. We present the case of a 61‐year‐old Caucasian male kidney transplant recipient with chronic tenosynovitis of the left wrist. Histological findings of the synovial biopsy revealed multinucleated giant cell epithelioid granuloma. Culture of synovial fluid grew Mycobacterium kansasii. Treatment with rifampicin, ethambutol, and clarithromycin proved curative, but the patient developed irreversible ethambutol‐related optic neuritis.
In vitro Antioxidant and Anti‐inflammatory Activities of Extracts from Nicotiana tabacum L. (Solanaceae) Leafy Galls Induced by Rhodococcus fascians
Authors: Nacoulma Aminata P. , Compaoré Moussa , de Lorenzi Manuella , Kiendrebeogo Martin , Nacoulma Odile G.
Published: July 2012

Plant galls are widely distributed, and their extracts are used in traditional medicine worldwide. Traditional remedies containing extracts of plant galls in China, India and some African countries have effective in the treatment of various pathologies. To open a new promising procedure for screening bioactive compounds from plant galls, standardized plant materials were generated in vitro and used for phytochemical and biological investigations. Methanol aqueous chloroform and hexane extracts of Nicotiana tabacum leafy galls induced by Rhodococcus fascians were used to evaluate phenolic and flavonoid contents, and to investigate antioxidant activity by 2,2‐diphenyl‐1‐picrylhydrazyl radical scavenging and ferric reducing antioxidant/power assays and anti‐inflammatory activity by the lipoxygenase inhibition assay. Infection by R. fascians modifies significantly the phytochemical profile of N. tabacum as well as its biological properties. The total polyphenolic content was increased (120–307%), and that of flavonoids was reduced (20–42.5%). Consequently, antioxidant and anti‐inflammatory activities of non‐infected tobacco extracts are significantly modified compared to plants treated with leafy gall extracts. This shows that infection by R. fascians favoured the production of anti‐inflammatory and antioxidant compounds in N. tabacum. The study indicates the benefit of plant galls used in traditional medicines against various pathologies.
Enhancing organ pool by statins: Is this the future?
Authors: Gracia‐Sancho Jorge
Published: July 2012

See article in J. Gastroenterol. Hepatol. 2012; 27: 1353–1361.
Primary prevention of Type 2 diabetes in South Asians — challenges and the way forward
Authors: Ambady R. , Snehalatha C. , Samith Shetty A. , Nanditha A.
Published: July 2012

Preventing diabetes is of enormous value, particularly for the South Asian countries, which have a huge healthcare burden from the onslaught of the disease. Type 2 diabetes has been proved to be preventable using lifestyle changes, even in South Asians despite their heightened risk profile. Strategies to improve awareness about diabetes and translation of preventive measures by innovative, culturally specific programmes have to be implemented at national levels. Integrated involvement of the government, community, media, healthcare and education services, and financial support from national and international organizations, are required. South Asian countries have initiated national programmes for diabetes prevention and management. It is also encouraging to note that joint ventures between developed countries such as the USA, UK and other European countries and centres of excellence in South Asia have been initiated to develop large‐scale, community‐oriented, pragmatic intervention strategies.
Entrepôt Trade and Smuggling in West Africa: Benin, Togo and Nigeria
Authors: Golub Stephen S.
Published: July 2012

Official trade statistics indicate very little intra‐African trade, but this is often because of the prevalence of unrecorded trade, particularly smuggling. This paper explores smuggling from Benin and Togo into Nigeria. Nigeria has very high import tariffs and bans on certain products. Togo and Benin have deliberately maintained low import barriers to facilitate an Entrepôt role vis‐à‐vis Nigeria and land‐locked Sahelian countries. Togo competes at a geographic disadvantage relative to Benin for access to the Nigerian market and compensates with lower transit taxes. The volume and composition of cross‐border trade is analysed using data obtained from Benin and Togo customs authorities, as well as interviews with traders and customs officials in both countries. Benin and to a lesser extent Togo are the origin of a very large volume of transshipment of precisely those products which are heavily protected in Nigeria, such as used cars, cloth and rice. It is common knowledge in Benin and Togo that these imports, although declared for domestic consumption or transit to other countries, are in fact overwhelmingly intended for Nigeria. Smuggling is a major source of income and employment in Benin and Togo, but provides a fragile and unreliable foundation for economic development.
The Politics of Japan–China Trade and the Role of the World Trade System
Authors: Armstrong Shiro P.
Published: July 2012

The large and rapidly growing trade relationship between Japan and China has occurred against a backdrop of political tensions. This study measures performance of the trade relationship, benchmarking it against other trade flows worldwide, and examines the impact of the politics on bilateral trade performance. To do this, a frontier gravity model is estimated using core determinants of trade. This gives a benchmark against which to measure trade performance, explained using resistances to trade. While the economic relationship is not independent from the politics, an important conclusion is that trade has not been diminished or disturbed by politics to a significant extent. China’s commitment to the global trading system from the mid‐1980s and its accession to the WTO in 2001 has meant that tensions in the political relationship with Japan from time to time have not derailed, but rather have increasingly come to be dominated, by the economic relationship.
Social Security Systems, Human Capital, and Growth in a Small Open Economy
Authors: KAGANOVICH MICHAEL , MEIER VOLKER
Published: July 2012

We consider a small open economy in which the level of public education funding is determined by popular vote. We show that growth can be enhanced by the introduction of pay‐as‐you‐go pensions even if the growth rate of aggregate wages falls short of the interest rate. The reason is that the pay‐as‐you‐go (PAYG) system allows future retirees to partially internalize positive externalities of public education due to the positive effect of higher future labor productivity on their pension benefits. The majority support for education funding will be especially strong when the PAYG benefit formula is flat, i.e., progressively redistributive. If a flat benefit PAYG pension system is in place then the economy will achieve the highest growth rate relative to the alternative pension system designs. While such PAYG pension system may be opposed by the majority of working individuals due to inferior returns to their pension contributions relative to a funded scheme, it is likely to be politically sustained by a coalition of older individuals and lower income workers.
Should Educational Policies Be Regressive?
Authors: GOTTLIEB DANIEL , MOREIRA HUMBERTO
Published: July 2012

In this paper, we study optimal educational policies when the ability to benefit from education is private information. We extend the framework of De Fraja (2002) in two directions. First, we replace his specification of the government’s budget constraint, which prevents the government to use tax revenues from an older generation to subsidize the education of a younger generation, by the usual one. We show that the optimal educational policies achieve the first best, are not regressive, and can be decentralized through Pigouvian taxes and credit provision. Second, we consider utility functions that are not quasi‐linear. In this case, we show that the first best can no longer be reached, education may not be monotonic in ability, and progressivities of education are locally welfare‐improving.
LOSS OF SELF AS ETHICAL LIMIT
Authors: Brintnall Kent L.
Published: July 2012

This Comment argues that Stephen Bush's critique of Georges Bataille's meditative practice fails to recognize how the disruption of the self, and the challenge to goal‐oriented activity that comprise the heart of that practice, serve as an ethical limit that protects against sadistic and violent engagement with the world. The ethical disposition fostered by Bataille's practice is a dissolution of the self.
In vitro and in vivo assessment of the effect of Laurus novocanariensis oil and essential oil in human skin
Authors: Viciolle E. , Castilho P. , Rosado C.
Published: July 2012

Synopsis

Laurus novocanariensis is an endemic plant from the Madeira Island forest that derives a fatty oil, with a strong spicy odour, from its berries that has been used for centuries in traditional medicine to treat skin ailments. This work aimed to investigate the effect of the application of both the oil and its essential oil on normal skin, to assess their safety and potential benefits. Diffusion studies with Franz cells using human epidermal membranes were conducted. The steady‐state fluxes of two model molecules through untreated skin were compared with those obtained after a 2‐h pre‐treatment with either the oil or the essential oil. Additionally, eleven volunteers participated in the in vivo study that was conducted on the forearm and involved daily application of the oil for 5 days. Measurements were performed every day in the treated site with bioengineering methods that measure erythema, irritation and loss of barrier function. Slightly higher steady‐state fluxes were observed for both the lipophilic and the hydrophilic molecule when the epidermal membranes were pre‐treated. Nevertheless, such differences had no statistical significance, which seems to confirm that neither the oil nor the essential oil impaired the epidermal barrier. Results collected with the Chromameter, the Laser Doppler Flowmeter and the visual scoring are in agreement with those established in the in vitro study. They indicate that the repeated application of the oil did not cause erythema, because the results observed in the first day of the study were maintained throughout the week. Application of the oil did not affect the skin barrier function, because the transepidermal water loss remained constant throughout the study. The stratum corneum hydration was slightly reduced on days 4 and 5. This work shows that both the oil and the essential oil were well tolerated by the skin and did not cause significant barrier impairment or irritation.
Extra‐facial melasma: clinical, histopathological, and immunohistochemical case‐control study
Authors: Ritter C.G. , Fiss D.V.C. , Borges da Costa J.A.T. , de Carvalho R.R. , Bauermann G. , Cestari T.F.
Published: July 2012

Background  Extra‐facial melasma is a prevalent dermatosis in some populations with special characteristics in relation to its clinical aspects and probable etiopathogenic factors. Few studies have attempted to address this alteration of pigmentation, which has become a challenge in clinical Dermatology.

Objective  To assess the clinical histopathological and immunohistochemical characteristics of extra‐facial melasma, comparing affected, and unaffected sites.

Methods  Case‐control study with 45 patients in each group (melasma and disease‐free volunteers), assessing their clinical characteristics. In 36 patients, biopsies were performed on the lesion and the normal perilesional skin. Specimens were stained with HE and Fontana‐Masson, and melanocytes analysed by immunohistochemistry. Objective measurements were accomplished by a specifically designed image analysis software.

Results  The melasma group had a mean age ± SD of 56.67 ± 8 years, the majority of them were women (86.7%) and 82.1% of the female cases had reached menopause. There were no significant differences between groups in terms of presence of comorbidities, use of medications or hormone therapies. For extra‐facial melasma patients, family history of this dermatose and of previous facial melasma was significantly higher than in the control group (P < 0.05). The HE staining showed increased rectification and basal hyperpigmentation, solar elastosis, and collagen degeneration in the pigmented area (P < 0.05). There was a significant increase in melanin density in melasma biopsies, but the immunohistochemical tests did not detect a difference between the groups in terms of number of melanocytes.

Conclusion  Extra‐facial melasma appears to be related to menopause, family history, and personal history of facial melasma, in the studied population. Histopathology revealed a pattern similar to what has been described for facial melasma, with signs of solar degeneration, and a similar number of melanocytes, when comparing patients, and controls, suggesting that the hyperpigmentation is most likely the result of abnormal melanin production or distribution.
The Nominal Group Technique as an Evaluation Tool for Solution‐focused Coaching
Authors: Roeden John M. , Maaskant Marian A. , Curfs Leopold M. G.
Published: July 2012

Background

Solution‐focused coaching (SFC) helps individuals or groups to achieve their preferred outcomes by evoking and co‐constructing solutions. SFC has been shown to be helpful for persons with ID as well as for teams coaching people with ID. Nominal Group Technique (NGT) helps to organize people's thoughts with regard to a single question. This study examines the perceived strengths of and recommendations for SFC for teams coaching people with ID via NGT, as well as the extent to which the NGT results reflect the results of an SFC questionnaire.

Methods

In total, 54 staff members participated in SFC. Of these, 18 participated in NGT, while 36 completed the SFC questionnaire. The strengths of and recommendations for SFC were obtained via NGT. Interrater agreement was calculated via Cohen's kappa.

Results

The strengths of SFC include ‘exploring hidden successes’ and ‘focusing on solutions’. It was recommended that ‘the results be consolidated in follow‐up meetings’. The participants agreed on the content of the strengths and recommendations, but differed in terms of priorities (κ ≤ 0.1).

Conclusions

NGT is a valuable tool in exploring people's opinions and priorities, but further research is needed to elucidate the perceived priorities of SFC for teams coaching persons with ID.
Evaluating forest refugial models using species distribution models, model filling and inclusion: a case study with 14Brazilian species
Authors: Porto Tiago Jordão , Carnaval Ana Carolina , da Rocha Pedro Luís Bernardo
Published: July 2012

Aim

We aimed to assess the generality of existing models of lateQuaternary biodiversity refugia in the Brazilian Atlantic forest by testing whether taxonomic identity and range descriptors influence the extent by which previously proposed models of forest (habitat) refugia successfully predict species' inferred refugial areas.

Location

Brazilian rain forest.

Methods

We compiled and filtered records of 14 animal species that belong to distantly related groups (spiders, harvestmen, scorpions, amphibians, birds, lizards and mammals) and show distinct distribution patterns within theAtlantic rain forest. UsingMAXENT, we generated three distribution models for each species under different climatic scenarios (current, 6000 and 21,000 years ago). Species‐specific historically stable areas (refugia) were identified through the intersection of the three models. We then measured the amount of ‘inclusion’ of species‐specific refugia within published forest refugia, and quantified ‘filling’ of the biome refugia by species‐specific refugia. The influence of taxonomic distance between species and range descriptors were analysed.

Results

Current distribution models generated for the 14 species had high accuracy (AUC> 0.9). Inclusion and filling, two uncorrelated metrics, varied among species and were not influenced by taxonomic identity. Species range characteristics influenced forest model filling only, with higher values found in widely distributed species (i.e. occurring from Northeastern to SoutheasternBrazil).

Main conclusions

Species‐specific and forest refugial areas are not necessarily the same. The power of forest refugial models to predict species‐specific refugial area differs among species and may be influenced by range attributes. Species data suggests the existence of a large refugium in Southeast ofBrazil, a result at odds with the currently available forest‐wide models. The predictive power of forest refugial models is narrowed; we now better understand their applicability limits.
Pharmacological mechanisms involved in the antinociceptive effects of dexmedetomidine in mice
Authors: Rangel Rafael A. S. , Marinho Bruno G. , Fernandes Patrícia D. , de Moura Roberto S. , Lessa Marcos A.
Published: July 2012

Dexmedetomidine (DEX) is a α2‐adrenoceptor (α2‐AR) agonist used as an anesthetic adjuvant and as sedative in critical care settings. Typically, α2‐AR agonists release nitric oxide (NO) and subsequently activate NO‐GMPc pathway and have been implicated with antinociception. In this study, we investigate the pharmacological mechanisms involved in the antinociceptive effects of DEX, using an acetic acid‐induced writhing assay in mice. Saline or DEX (1, 2, 5, or 10 μg/kg) was intravenously injected 5 min before ip administration of acetic acid and the resulting abdominal constrictions were then counted for 10 min. To investigate the possible mechanisms related to antinociceptive effect of DEX (10 μg/kg), the animals were also pretreated with one of the following drugs: 7‐nitroindazole (7‐NI; 30 mg/kg ip); 1H‐[1,2,4] oxadiazole [4,3‐a] quinoxaline‐1‐one (ODQ; 2.5 mg/kg, ip); yohimbine (YOH; 1 mg/kg, ip); atropine (ATRO; 2 mg/kg, ip); glibenclamide (GLIB; 1 mg/kg, i.p.) and naloxone (NAL; 0.2 mg/kg, ip). A rotarod and open‐field performance test were performed with DEX at 10 μg/kg dose. DEX demonstrated its potent antinociceptive effect in a dose‐dependent manner. The pretreatment with 7‐NI, ODQ, GLIB, ATRO, and YOH significantly reduced the antinociceptive affects of DEX. However, NAL showed no effecting DEX‐induced antinociception. The rotarod and open‐field tests confirmed there is no detectable sedation or even significant motor impairment with DEX at 10 μg/kg dose. Our results suggest that the α2‐AR and NO‐GMPc pathways play important roles in the systemic antinociceptive effect of DEX in a murine model of inflammatory pain. Furthermore, the antinociceptive effect exerted by DEX appears to be dependent on KATP channels, independent of opioid receptor activity.
Comparison of two doses of ketoprofen to treat pain: a double‐blind, randomized, noninferiority trial
Authors: Riou Bruno , Plaisance Patrick , Lecomte François , Soulat Louis , Orcel Philippe , Mazoit Jean‐Xavier
Published: July 2012

The aim of our study was to compare the efficacy and safety of two doses of ketoprofen (200 mg vs. 300 mg/day) in ambulatory emergency patients with pain related to traumatic and nontraumatic bone and joint diseases. We tested the hypothesis that the efficacy of the lower dose was not lower than that of the higher dose in a double‐blind, randomized, noninferiority trial. Patients included in the study were aged 18–65 years with closed benign trauma of the motor system or acute noninfectious rheumatologic conditions, with a resting pain intensity ≥3/10 on a numeric pain scale (NPS), requiring ketoprofen for 5 days. The main end‐point was based on two efficacy co‐criteria: (i) mean change from baseline of resting pain intensity at the end of the day over 5 days and (ii) total intake of concomitant analgesics. We included 409 patients: 200 in the 200‐mg group and 209 in the 300‐mg group. The mean change in pain intensity at rest (difference between groups: 0.0, 95% CI −0.4 to 0.4; P = 1.00) and in analgesic consumption (difference between groups: −0.6, 95% CI −1.9 to 0.6; P = 0.33) was not significantly different between the two groups, and the differences were lower than the predefined inferiority margins (0.5 and 1.5, respectively), thus demonstrating noninferiority. No significant difference was noted in the incidence of adverse events (21% vs. 20%, P = 0.71). The efficacy of the 200‐mg daily dose of ketoprofen in relieving pain in emergency cases was not inferior to that of the 300‐mg dose.
Course and Treatment of Buprenorphine/Naloxone Withdrawal: An Analysis of Case Reports
Authors: Westermeyer Joseph , McCance‐Katz Elinore F.
Published: July 2012

Currently published information on buprenorphinenaloxone withdrawal recommends a gradually decreasing dosage over weeks to months. In this case report, abrupt cessation of buprenorphine/naloxone at various doses, and after variable durations of treatment, resulted in mild opiate withdrawal lasting over approximately 1–2 days that did not require additional opioid medication or only specific symptom‐relieving, non‐opioid, medications. Lengthy withdrawal regimens might prolong withdrawal symptoms unnecessarily, perhaps increasing the risk of re‐addiction. Controlled studies of buprenorphine/naloxone withdrawal regimens over varying time frames would help to illuminate the most effective means of opioid discontinuation and inform clinical care. (Am J Addict 2012;00:1–3)
Projected Climate‐Induced Habitat Loss for Salmonids in the John Day River Network, Oregon, U.S.A.
Authors: RUESCH AARON S. , TORGERSEN CHRISTIAN E. , LAWLER JOSHUA J. , OLDEN JULIAN D. , PETERSON ERIN E. , VOLK CAROL J. , LAWRENCE DAVID J.
Published: July 2012

Abstract:  Climate change will likely have profound effects on cold‐water species of freshwater fishes. As temperatures rise, cold‐water fish distributions may shift and contract in response. Predicting the effects of projected stream warming in stream networks is complicated by the generally poor correlation between water temperature and air temperature. Spatial dependencies in stream networks are complex because the geography of stream processes is governed by dimensions of flow direction and network structure. Therefore, forecasting climate‐driven range shifts of stream biota has lagged behind similar terrestrial modeling efforts. We predicted climate‐induced changes in summer thermal habitat for 3 cold‐water fish species—juvenile Chinook salmon, rainbow trout, and bull trout (Oncorhynchus tshawytscha, O. mykiss, and Salvelinus confluentus, respectively)—in the John Day River basin, northwestern United States. We used a spatially explicit statistical model designed to predict water temperature in stream networks on the basis of flow and spatial connectivity. The spatial distribution of stream temperature extremes during summers from 1993 through 2009 was largely governed by solar radiation and interannual extremes of air temperature. For a moderate climate change scenario, estimated declines by 2100 in the volume of habitat for Chinook salmon, rainbow trout, and bull trout were 69–95%, 51–87%, and 86–100%, respectively. Although some restoration strategies may be able to offset these projected effects, such forecasts point to how and where restoration and management efforts might focus.
Public Willingness to Pay for Recovering and Downlisting Threatened and Endangered Marine Species
Authors: WALLMO KRISTY , LEW DANIEL K.
Published: July 2012

Abstract:  Nonmarket valuation research has produced economic value estimates for a variety of threatened, endangered, and rare species around the world. Although over 40 value estimates exist, it is often difficult to compare values from different studies due to variations in study design, implementation, and modeling specifications. We conducted a stated‐preference choice experiment to estimate the value of recovering or downlisting 8 threatened and endangered marine species in the United States: loggerhead sea turtle (Caretta caretta), leatherback sea turtle (Dermochelys coriacea), North Atlantic right whale (Eubalaena glacialis), North Pacific right whale (Eubalaena japonica), upper Willamette River Chinook salmon (Oncorhynchus tshawytscha), Puget Sound Chinook salmon (Oncorhynchus tshawytscha), Hawaiian monk seals (Monachus schauinslandi), and smalltooth sawfish (Pristis pectinata). In May 2009, we surveyed a random sample of U.S. households. We collected data from 8476 households and estimated willingness to pay for recovering and downlisting the 8 species from these data. Respondents were willing to pay for recovering and downlisting threatened and endangered marine taxa. Willingness‐to‐pay values ranged from $40/household for recovering Puget Sound Chinook salmon to $73/household for recovering the North Pacific right whale. Statistical comparisons among willingness‐to‐pay values suggest that some taxa are more economically valuable than others, which suggests that the U.S. public's willingness to pay for recovery may vary by species.
Congenital Nevus of the Nail Apparatus—Diagnostic Approach of a Case through Dermoscopy
Authors: Lazaridou Elizabeth , Giannopoulou Christina , Fotiadou Christina , Demiri Efterpi , Ioannides Demetrios
Published: July 2012

Abstract:  Melanonychia striata in childhood is primarily due to congenital nevi, but melanoma should be excluded. We report a case in which dermoscopy was used in an attempt to avoid incisional biopsy.
How Many Seed Transfer Zones Are Necessary for the Preservation of the Genetic Identity of Austrocedrus chilensis Natural Populations in Argentina?
Authors: Pastorino Mario J.
Published: July 2012

Two different studies based on isozymes that include genetic structure analysis have arrived at contrasting conclusions regarding the minimum number of seed transfer zones for Patagonian cypress (Austrocedrus chilensis) in Argentina that are required in order to avoid genetic contamination in restoration programs. Unfortunately, the more recent article lacks discussion on these controversial results, which is, therefore, the purpose of this article. The reliability of the markers used and the sampling performed in these studies are evaluated comparatively. The later study found higher levels of diversity and differentiation but paradoxically suggested that only two seed transfer zones would be enough to preserve the genetic identity of the natural populations of the species, whereas the earlier study concluded that at least five are necessary. Arguments are presented here for the case that definition of fewer than five genetically homogeneous groups is absolutely inappropriate and implies a probable risk of genetic contamination and maladaptation.
Environmental Variability and Ontogenetic Niche Shifts in Exotic Plants May Govern Reinvasion Pressure in Restorations of Invaded Ecosystems
Authors: Gabler Christopher A. , Siemann Evan
Published: July 2012

When restoring ecosystems dominated by exotic plants, reinvasion pressure, or the rate of new exotic recruitment following mature exotic removal, can vary broadly between similarly invaded habitats. Reinvasion pressure strongly influences restoration costs and outcomes but is difficult to predict. Ontogenetic niche shifts (ONSs, changes in niche breadth or position during development) in exotic species paired with interannual variation in abiotic conditions may decouple pre‐removal mature exotic density and average reinvasion pressure. Identifying such decouplings could improve restoration efficiency by informing site selection and management strategies, but requires estimates of average reinvasion pressure that mandate greater understanding of its principle drivers. We hypothesize that reinvasion pressure is predominantly driven by exotic propagule abundance and spatiotemporal availability of realized recruitment windows, which are periods of variable duration that permit exotic establishment from propagules. Realized recruitment windows are based on the “safe sites” concept but account for ONSs and are determined by abiotic conditions and interspecific interactions with recipient communities. Biotic resistance or facilitation may increase or decrease times required for establishment by influencing exotic growth rates or altering niche availability and may permit or preclude establishment in marginal abiotic conditions. We discuss factors influencing reinvasion pressure, basic approaches to estimate reinvasion pressure, and potential ways to increase management efficiency under different reinvasion pressure scenarios. Accurate estimates of reinvasion pressure could improve restoration efficacy, efficiency, and predictability in ecosystems dominated by exotic plants. We argue that greater theoretical and practical considerations of reinvasion pressure and ONSs are merited.
Rooting for Rewilding: Quantifying Wild Boar's Sus scrofa Rooting Rate in the Scottish Highlands
Authors: Sandom Christopher J. , Hughes Joelene , Macdonald David W.
Published: July 2012

Rewilding is emerging as a promising framework within restoration ecology to help restore ecosystem function through species reintroduction. To manage effectively such projects it is necessary to predict and quantify the interactions between the reintroduced species and their environment. To date, this has not been a priority in restoration ecology. Here, we quantify wild boar's rooting rate at a range of stocking densities to explore their potential to aid the restoration of the Caledonian pine forest in the Scottish Highlands by reinvigorating the disturbance regime. Eleven enclosures of c. 0.5 ha within heather moorland, dominated by Caluna vulgaris, were used, situated on the Alladale Wilderness Reserve, 50 km north‐west of Inverness. Stocking densities varied between 4 and 15 boar/ha. The accumulation of rooted area was recorded weekly over a 13‐week period. A cost analysis was performed to compare the use of wild boar with other ground preparation techniques. The median per capita rooting rate was 42.4 m2/week (interquartile range [IQR] 45.5), but rooting rate varied temporally. Median rooting rates varied between 21.6 and 75.3 m2/week (IQR 5.6) in periods that varied in suitability for rooting. Rooting rates were consistent across stocking densities. The cost of using wild boar as a ground preparation tool ranged between £184 and £1,961 per hectare depending on stocking density and rate of rooting. This experiment has direct application for managing the impact of wild boar within free range farming conditions, managed woodland regeneration schemes, rewilding projects, and in the wild.