bluuebunny/crossref_metadata_2025 huggingface dataset:
Nursing contribution to the rehabilitation of older patients: patient and family perspectives
Authors: Tyrrell Elaine F. , Levack William M. , Ritchie Lorraine H. , Keeling Sally M.
Published: February 2012

tyrrell e.f., levack w.m., ritchie l.h. & keeling s.m. (2012) Nursing contribution to the rehabilitation of older patients: patient and family perspectives. Journal of Advanced Nursing68(11), 2466–2476.

Aims.  This article reports a study of the perspective of older patients and their family members on the role of nurses in inpatient rehabilitation.

Background.  Rehabilitation services are used increasingly by older patients as life expectancy increases. The role of rehabilitation nurses in the multidisciplinary team has, however, yet to be clearly articulated. Previous research has focussed on the views of health professionals about nursing involvement in rehabilitation, but none has sought family members’ perspectives. With the expectation of patient‐centred care, it is important to consider what older patients and their families expect and require from nurses.

Design.  Grounded theory was used to collect and analyse data from interviews in an inpatient rehabilitation unit in New Zealand with seven patients, aged 72–89 years, and six family members, during 2009–2010.

Findings.  A substantive theory was developed which recognizes that the older patient values the relationship they build with nurses more than any specific role nurses perform. Participants acknowledged that rehabilitation nurses’ roles included ‘looking after’, ‘stepping in’ and ‘coaching independence’ but ‘best fit’ nurses were identified by patients based on their ‘nature’, ‘being available’ and ‘being attuned’ to the patient’s individual needs. If a ‘connection’ was formed, then this ‘best fit relationship’ maximized the older person’s motivation to participate in his or her rehabilitation therapy.

Conclusion.  Patients and family members appreciate ‘best fit relationships’ where nurses seek to enter into the older person’s world of disability to form a partnership which enhances their motivation to achieve independence.
Spatial variation in egg size and egg number reflects trade‐offs and bet‐hedging in a freshwater fish
Authors: Morrongiello John R. , Bond Nicholas R. , Crook David A. , Wong Bob B. M.
Published: February 2012

1. Maternal reproductive investment is thought to reflect a trade‐off between offspring size and fecundity, and models generally predict that mothers inhabiting adverse environments will produce fewer, larger offspring. More recently, the importance of environmental unpredictability in influencing maternal investment has been considered, with some models predicting that mothers should adopt a diversified bet‐hedging strategy whilst others a conservative bet‐hedging strategy.

2. We explore spatial egg size and fecundity patterns in the freshwater fish southern pygmy perch (Nannoperca australis) that inhabits a diversity of streams along gradients of environmental quality, variability and predictability.

3. Contrary to some predictions, N. australis populations inhabiting increasingly harsh streams produced more numerous and smaller eggs. Furthermore, within‐female egg size variability increased as environments became more unpredictable.

4. We argue that in harsh environments or those prone to physical disturbance, sources of mortality are size independent with offspring size having only a minor influence on offspring fitness. Instead, maternal fitness is maximized by producing many small eggs, increasing the likelihood that some offspring will disperse to permanent water. We also provide empirical support for diversified bet‐hedging as an adaptive strategy when future environmental quality is uncertain and suggest egg size may be a more appropriate fitness measure in stable environments characterized by size‐dependent fitness. These results likely reflect spatial patterns of adaptive plasticity and bet‐hedging in response to both predictable and unpredictable environmental variance and highlight the importance of considering both trait averages and variance.

5. Reproductive life‐history traits can vary predictably along environmental gradients. Human activity, such as the hydrological modification of natural flow regimes, alters the form and magnitude of these gradients, and this can have both ecological and evolutionary implications for biota adapted to now non‐existent natural environmental heterogeneity.
Key factors and related principles in the conservation of largeAfrican carnivores
Authors: Winterbach H. E. K. , Winterbach C. W. , Somers M. J. , Hayward M. W.
Published: February 2012

Large carnivores are a critical component ofAfrica's biodiversity, and their conservation requires a clear understanding of interactions between large carnivores and people.

By reviewing existing literature, we identify 14 key factors that influence largeAfrican carnivore conservation, including ecological (biodiversity conservation, interspecific competition, ranging behaviour, ecological resilience, prey availability, livestock predation, disease and population viability), socio‐economic (people's attitudes and behaviours and human costs and benefits of coexistence with large carnivores) and political (conservation policy development and implementation, conservation strategies and land use zoning) factors.

We present these key factors in a model illustrating the levels of impact on largeAfrican carnivore conservation.

We identify the key principle that underpins each factor and its implications for both large carnivore conservation and human–carnivore conflict.

We provide a synthesis of the key factors and related principles in largeAfrican carnivore conservation and highlight the importance of the site‐specific and species‐specific context in conservation policy and implementation, formulated through an interdisciplinary and adaptive approach.
A turning point for natural product discovery – ESF‐EMBO research conference: synthetic biology of antibiotic production
Authors: Takano Eriko , Bovenberg Roel A. L. , Breitling Rainer
Published: February 2012

Synthetic Biology is in a critical phase of its development: it has finally reached the point where it can move from proof‐of‐principle studies to real‐world applications. Secondary metabolite biosynthesis, especially the discovery and production of antibiotics, is a particularly relevant target area for such applications of synthetic biology. The first international conference to explore this subject was held in Spain in October 2011. In four sessions on General Synthetic Biology, Filamentous Fungal Systems, Actinomyces Systems, and Tools and Host Structures, scientists presented the most recent technological and scientific advances, and a final‐day Forward Look Plenary Discussion identified future trends in the field.
Neck compartmentalization as the molecular basis for the different endocytic behaviour of Chs3 during budding or hyperpolarized growth in yeast cells
Authors: Sacristan Carlos , Reyes Abigail , Roncero Cesar
Published: February 2012

Yeast cells normally grow by budding, but under certain specific conditions they are also able to grow in hyperpolarized forms reminiscent of hyphal growth. During vegetative growth, the synthesis of the septum that physically separates yeast cells during cytokinesis depends on the correct assembly of the septin ring. Septins and actin patches are assembled at the neck, forming two concentric rings where the actin patch ring occupies the external‐most part. This specific positioning defines a plasma membrane region at the neck from which other lateral membrane compartments are excluded. In this scenario, correct assembly of the chitin ring is dependent on the anchoring of Chs3 to the septin ring through Chs4. The anchoring of Chs3 to septins through Chs4 prevents the arrival of this protein at endocytic sites, thus reducing the endocytosis of Chs3. This allows an equilibrium to be set up between the antero‐ and retrograde transport of Chs3, facilitating the synthesis of the chitin ring at the neck. In contrast, hyperpolarized growth is characterized by a reduced endocytic turnover of Chs3, which in turn lead to the accumulation of Chs3 at the plasma membrane and a concomitant increase in chitin synthesis.
Effectiveness of chin‐down posture to prevent tracheal aspiration in dysphagia secondary to acquired brain injury. A videofluoroscopy study
Authors: Terré R. , Mearin F.
Published: February 2012

Background  The chin‐down posture is generally recommended in patients with neurogenic dysphagia to prevent tracheal aspiration; however, its effectiveness has not been demonstrated.

Aim  To videofluoroscopically (VDF) assess the effectiveness of chin‐down posture to prevent aspiration in patients with neurogenic dysphagia secondary to acquired brain injury.

Methods  Randomized, alternating, cross‐over study (with and without the chin‐down posture) in 47 patients with a VDF diagnosis of aspiration [31 stroke, 16 traumatic brain injury (TBI)] and 25 controls without aspiration (14 stroke, 11 TBI).

Key Results  During the chin‐down posture, 55% of patients avoided aspiration (40% preswallow aspiration and 60% aspiration during swallow). The percentage was similar in both etiologies (58% stroke and 50% TBI). Fifty‐one percent of patients had silent aspiration; of these, 48% persisted with aspiration while in the chin‐down posture. A statistically significant relationship was found between the existence of pharyngeal residue, cricopharyngeal dysfunction, pharyngeal delay time and bolus volume with the persistence of aspiration. The chin‐down posture did not change swallow biomechanics in patients without aspiration.

Conclusions & Inferences  Only half the patients with acquired brain injury avoided aspiration during cervical flexion; 48% of silent aspirators continued to aspire during the maneuver. Several videofluoroscopic parameters were related to inefficiency of the maneuver. Therefore, the indication for chin‐down posture should be evaluated by videofluoroscopic examination.
Transition from symmetry to asymmetry during continental rifting: an example from the Bight Basin–Terre Adélie (Australian and Antarctic conjugate margins)
Authors: Espurt Nicolas , Callot Jean‐Paul , Roure François , Totterdell Jennifer M. , Struckmeyer Heike I. M. , Vially Roland
Published: February 2012

Terra Nova, 24, 167–180, 2012

The rifting history of the magma‐poor conjugate margins of Australia and Antarctica is still a controversial issue. In this article, we present a model for lithosphere‐scale rifting and deformation history from initial Jurassic rifting to Late Cretaceous breakup for the conjugate Bight Basin–Terre Adélie section of the margin, based on the interpretation of two regional conjugate seismic profiles of the margins, and the construction of a lithosphere‐scale, balanced cross‐section, sequentially restored through time. The model scenario highlights the symmetric pattern of initial stretching resulting from pure shear at lithospheric‐scale accompanied by the development of four conjugate detachments and crustal half‐graben systems. This system progressively evolves to completely asymmetric shearing along a single south‐dipping detachment at the scale of the lithosphere. Antarctica plays the role of the upper plate and Australia, the lower plate. The detachment accounts for the exhumation of the mantle part of the Australian lithosphere, and the isolation of a crustal klippe separated from the margin by a serpentinized peridotite ridge. The total elongation amount of the Australian–Antarctic conjugate system reaches ∼473 km (178%). Elongation was partitioned through time: ∼189 and ∼284 km during symmetric and asymmetric stages respectively. During the symmetric stage, both margins underwent approximately the same degree of crustal stretching [∼105 km (75%) and ∼84 km (67%) for Australia and Antarctica respectively]. Again, both margins accommodated relatively the same elongation during the asymmetric stage: the Antarctic upper plate records an elongation amount of ∼284 km (88%) as crustal/mantle stretching, above the inferred low‐angle south‐dipping detachment zone, whereas the Australian lower plate underwent ∼270 km (206%) of elongation through mantle exhumation. Although the restoration process does not allow reconstruction of the precise geometry before deformation, we propose that the Jurassic early geometric evolution of the margins may have been controlled by the inherited structure or rheological heterogeneities of the continental crust; its later evolution is thought to relate to the mechanical evolution of the crustal and mantle material during exhumation, with a strong increase in localization of shear in the lower crust and mantle part of the Australian margin. The geometry of the rifted margins is comparable to other magma‐poor rifted margin such as the Newfoundland–Iberia margins or the exhumed Alpine Tethys margin exposed in the Central Alps.
Service quality perceptions in primary health care centres in Greece
Authors: Papanikolaou Vicky , Zygiaris Sotiris
Published: February 2012

Context  The paper refers to the increased competition between health care providers and the need for patient‐centred services in Greece. Using service quality methodology, this paper investigates service quality perceptions of patients in Greek public primary health centres.

Objective  To test the internal consistency and applicability of SERVQUAL in primary health care centres in Greece.

Strategy  SERVQUAL was used to examine whether patients have different expectations from health care providers and whether different groups of patients may consider some dimensions of care more important than others.

Results  The analysis showed that there were gaps in all dimensions measured by SERVQUAL. The largest gap was detected in empathy. Further analysis showed that there were also differences depending on gender, age and education levels. A separate analysis of expectations and perceptions revealed that this gap was because of differences in patients’ perceptions rather than expectations.

Discussion and conclusions  This paper raises a number of issues that concern the applicability of SERVQUAL in health care services and could enhance current discussions about SERVQUAL improvement. Quality of health care needs to be redefined by encompassing multiple dimensions. Beyond a simple expectations–perceptions gap, people may hold different understandings of health care that, in turn, influence their perception of the quality of services.
Making choices about medical interventions: the experience of disabled young people with degenerative conditions
Authors: Mitchell Wendy A.
Published: February 2012

Background  Current western policy, including the UK, advocates choice for service users and their families, taking greater control and being more involved in decision making. However, children’s role in health decision making, especially from their own perspective, has received less research attention compared to doctors and parents’ perspectives.

Objective  To explore the perspective and experiences of disabled young people with degenerative conditions as they face significant medical interventions and engage in decision‐making processes.

Design and methods  Findings from a longitudinal qualitative study of 10 young people (13–22 years) with degenerative conditions are reported. Individual semi‐structured interviews were conducted with participants over 3 years (2007–2010); the paper reports data from all three interview rounds. Interviews focused on medical intervention choices the young people identified as significant.

Results  Although the young people in this study felt involved in the medical intervention choices discussed, findings demonstrate a complex and diverse picture of decision making. Results highlighted different decisional roles adopted by the young people, the importance of information heuristics and working with other people whilst engaging in complex processes weighing up different decisional factors.

Discussion  Young people’s experiences demonstrate the importance of moving beyond viewing health choices as technical or rational decisions. How each young person framed their decision was important. Recognizing this diversity and the importance of emerging themes, such as living a normal life, independence, fear of decisions viewed as ‘irreversible’ and the role of parents and peers in decision making highlights that, there are clear practice implications including, active practitioner listening, sensitivity and continued holistic family working.
Thermographic imaging during nasal peanut challenge may be useful in the diagnosis of peanut allergy
Authors: Clark A. , Mangat J. , King Y. , Islam S. , Anagnostou K. , Foley L. , Deighton J. , Ewan P.
Published: February 2012

Background

Double‐blinded challenges are widely used for diagnosing food allergy but are time‐consuming and cause severe reactions. Outcome relies on subjective interpretation of symptoms, which leads to variations in outcome between observers. Facial thermography combined with nasal peanut challenge was evaluated as a novel objective indicator of clinical allergy.

Methods

Sixteen children with positive blinded peanut challenge underwent nasal challenge with 10 μg peanut protein or placebo. Mean skin temperatures were recorded from the mouth and nose using infrared thermography over 18 min.

Results

The area under curve of nasal skin temperature was significantly elevated after peanut vs placebo (18.2 vs 4.8°Cmin). The maximum increase in temperature was also significantly greater after peanut: mean difference +0.9°C.

Conclusion

This feasibility study shows thermography can detect inflammation caused by nasal challenges whilst employing one thousand‐fold less peanut than an oral challenge. This novel technique could be developed to provide a rapid, safe and objective clinical allergy test.
Stüve–Wiedemann syndrome and related bent bone dysplasias
Authors: Akawi N A , Ali B R , Al‐Gazali L
Published: February 2012

Akawi NA, Ali BR, Al‐Gazali L. Stüve–Wiedemann syndrome and related bent bone dysplasias.

Stüve–Wiedemann syndrome (SWS) is a severe congenital skeletal dysplasia associated with life threatening dysautonomic manifestations. Newborns affected with this condition exhibit distinctive shortening and bowing of the long bones with reduced bone volume. The majority of affected newborns die early due to neuromuscular complications namely hyperthermia, apnea, and swallowing difficulties. In this review, we provide an overall picture on the clinical, including long‐term management, molecular and cellular aspects of SWS and discuss briefly other related bent bone dysplasias.
Multi‐locus HLA class I and II allele and haplotype associations with follicular lymphoma
Authors: Skibola C. F. , Akers N. K. , Conde L. , Ladner M. , Hawbecker S. K. , Cohen F. , Ribas F. , Erlich H. A. , Goodridge D. , Trachtenberg E. A. , Smith M. T. , Bracci P. M.
Published: February 2012

Follicular lymphoma (FL) is an indolent, sometimes, fatal disease characterized by recurrence at progressively shorter intervals and is frequently refractive to therapy. Genome‐wide association studies have identified single nucleotide polymorphisms (SNPs) in the human leukocyte antigen (HLA) region on chromosome 6p21.32‐33 that are statistically significantly associated with FL risk. Low to medium resolution typing of single or multiple HLA genes has provided an incomplete picture of the total genetic risk imparted by this highly variable region. To gain further insight into the role of HLA alleles in lymphomagenesis and to investigate the independence of validated SNPs and HLA alleles with FL risk, high‐resolution HLA typing was conducted using next‐generation sequencing in 222 non‐Hispanic White FL cases and 220 matched controls from a larger San Francisco Bay Area population‐based case–control study of lymphoma. A novel protective association was found between the DPB1*03:01 allele and FL risk [odds ratio (OR) = 0.39, 95% confidence interval (CI) = 0.21–0.68]. Extended haplotypes DRB1*01:01‐DQA1*01:01‐DQB1*05:01 (OR = 2.01, 95% CI = 1.22–3.38) and DRB1*15‐DQA1*01‐DQB1*06 (OR = 0.55, 95% CI = 0.36–0.82) also influenced FL risk. Moreover, DRB1*15‐DQA1*01‐DQB1*06 was highly correlated with an established FL risk locus, rs2647012. These results provide further insight into the critical roles of HLA alleles and SNPs in FL pathogenesis that involve multi‐locus effects across the HLA region.
Molecular phylogenetics reveals a pattern of biome conservatism in New World anchovies (family Engraulidae)
Authors: BLOOM D. D. , LOVEJOY N. R.
Published: February 2012

Evolutionary transitions between marine and freshwater biomes are relatively rare events, yielding a widespread pattern of biome conservatism among aquatic organisms. We investigated biome transitions in anchovies (Engraulidae), a globally distributed clade of economically important fishes. Most anchovy species are near‐shore marine fishes, but several exclusively freshwater species are known from tropical rivers of South America and were previously thought to be the product of six or more independent freshwater invasions. We generated a comprehensive molecular phylogeny for Engraulidae, including representatives from 15 of 17 currently recognized genera. Our data support previous hypotheses of higher‐level relationships within Engraulidae, but show that most New World genera are not monophyletic and in need of revision. Ancestral character reconstruction reveals that New World freshwater anchovies are the product of a single marine to freshwater transition, supporting a pattern of biome conservatism. We argue that competition is the principal mechanism that regulates aquatic biome transitions on a continental scale.
Ventilatory mechanics from maniraptoran theropods to extant birds
Authors: TICKLE P. G. , NORELL M. A. , CODD J. R.
Published: February 2012

Shared behavioural, morphological and physiological characteristics are indicative of the evolution of extant birds from nonavian maniraptoran dinosaurs. One such shared character is the presence of uncinate processes and respiratory structures in extant birds. Recent research has suggested a respiratory role for these processes found in oviraptorid and dromaeosaurid dinosaurs. By measuring the geometry of fossil rib cage morphology, we demonstrate that the mechanical advantage, conferred by uncinate processes, for movements of the ribs in the oviraptorid theropod dinosaur, Citipati osmolskae, basal avialan species Zhongjianornis yangi, Confuciusornis sanctus and the more derived ornithurine Yixianornis grabaui, is of the same magnitude as found in extant birds. These skeletal characteristics provide further evidence of a flow‐through respiratory system in nonavian theropod dinosaurs and basal avialans, and indicate that uncinate processes are a key adaptation facilitating the ventilation of a lung air sac system that diverged earlier than extant birds.
Effects of (−)‐Epigallocatechin Gallate on the Motility and Penetrability of Frozen–Thawed Boar Spermatozoa Incubated in the Fertilization Medium
Authors: Kaedei Y , Naito M , Naoi H , Sato Y , Taniguchi M , Tanihara F , Kikuchi K , Nagai T , Otoi T
Published: February 2012

Contents

Epigallocatechin gallate (EGCG) is the major polyphenol in green tea (Camellia sinensis) and is known for its antioxidant effects. The objective of the present study was to examine the effects of EGCG during in vitro fertilization (IVF) on the sperm quality and penetrability into oocytes. In the first experiment, the effects of concentration and incubation period of EGCG on the motility and penetrability of spermatozoa were examined. When frozen–thawed spermatozoa were incubated in IVF medium supplemented with 0 (control), 1, 50 and 100 μm EGCG for 1, 3 and 5 h, supplementation with 50 and 100 μm EGCG improved motility of the spermatozoa (p < 0.05), but not viability, as compared with the control group. When frozen–thawed spermatozoa were co‐incubated with in vitro‐matured (IVM) oocytes in IVF medium supplemented with 50 and 100 μm EGCG for 5 h, supplementation of EGCG had positive effects on sperm penetration rates. In the second experiment, the effects of supplementation of EGCG in IVF medium on penetrability of sperm from different boars and development of fertilized oocytes were evaluated. When frozen–thawed spermatozoa from six boars were co‐incubated with IVM oocytes in IVF medium supplemented with 50 μm EGCG, the effect of EGCG on sperm penetration and development of oocytes after fertilization was found to vary with individual boar. Our results indicate that motility and penetrability of boar spermatozoa are improved by co‐incubation with 50 μm EGCG, but the effects vary with individual boars.
Significance of Group III and IV muscle afferents for the endurance exercising human
Authors: Amann Markus
Published: February 2012

With the onset of dynamic whole‐body exercise, contraction‐induced mechanical and biochemical stimuli within locomotor muscle cause an increase in the discharge frequency of thinly myelinated (Group III) and unmyelinated (Group IV) nerve fibres located within the muscle.

These thin fibre muscle afferents project to various sites within the central nervous system and thereby substantially influence the exercising human.

First, Group III/IV muscle afferents are the afferent arm of cardiovascular and ventilatory reflex responses that are mediated in the nucleus tractus solitarius and the ventrolateral medulla. Therefore, neural feedback from working skeletal muscle is a vital component in providing a high capacity for endurance exercise because muscle perfusion and O2 delivery determine the fatigability of skeletal muscle.

Second, Group III/IV muscle afferents facilitate ‘central fatigue’ (failure, or unwillingness, of the central nervous system to ‘drive’ motoneurons) by exerting inhibitory influences on central motor drive during exercise.

Thus, Group III/IV muscle afferents play a substantial role in a human's susceptibility to fatigue and capacity for endurance exercise.
Biomarkers of endothelial dysfunction in patients with primary focal segmental glomerulosclerosis
Authors: ZHANG QINGYAN , ZENG CAIHONG , FU YOUJUAN , CHENG ZHEN , ZHANG JIONG , LIU ZHIHONG
Published: February 2012

Aim:  Endothelial dysfunction occurs in nephrotic syndrome (NS) and may constitute a link between NS and vascular complications. Focal segmental glomerulosclerosis (FSGS) is a common cause of NS. This study aimed to assess endothelial markers at different stages of FSGS and define whether they were associated with thromboembolic complications and disease activity.

Methods:  Forty‐four patients with nephrotic‐range proteinuria and biopsy‐proven primary FSGS were included in this study. Nine of them had concurrent thromboembolisms. Thirty‐two sex‐ and age‐ matched healthy volunteers served as controls. Endothelial markers including circulating endothelial cells (CECs), soluble thrombomodulin (sTM), von Willebrand factor (vWf), soluble vascular cell adhesion molecule‐1 (sVCAM‐1) and sE‐selectin were assessed at the commencement of the study in all participants and were repeated at 2, 6 and 12 months of follow‐up in patients without thromboembolisms.

Results:  Patients with FSGS during active stage showed significantly higher levels of CECs, sTM, vWf, sVCAM‐1 and sE‐selectin when compared with controls. Moreover, patients with thromboembolisms had higher CECs and vWf than those without thromboembolisms. In patients without thromboembolisms, endothelial markers except sE‐selectin had inverse correlations with serum albumin and were positively related to cholesterol. Multiple analyses showed that cholesterol and serum albumin were independent predictors of CECs and sTM, and vWf and sVCAM‐1, respectively. At follow‐up, these markers systematically decreased as the disease went into remission, but the increase in vWf and sVCAM‐1 persisted even in patients obtaining complete remission for nearly a year. In patients with no response, levels of endothelial markers exhibited no obvious change.

Conclusion:  Patients with FSGS had elevated markers of endothelial dysfunction, which were largely related to the activity of the disease. Meanwhile, levels of CECs and vWf were higher in patients concurrent with thromboembolisms.
Association of childhood family environments with the risk of social withdrawal (‘hikikomori’) in the community population in Japan
Authors: Umeda Maki , Kawakami Norito ,   The World Mental Health Japan Survey Group 2002–2006
Published: February 2012

Aims:  Hikikomori is a form of social withdrawal among those who retreat from social interaction for protracted periods of time. This study examines family‐related childhood factors for hikikomori using the retrospective data derived from a population‐based survey.

Methods:  We derived data from World Mental Health Survey Japan. The subjects of this study were community residents aged 20–49 years (n = 708). Multiple logistic regression was applied to examine the association between the lifetime experience of hikikomori and childhood family environment, adjusting for sex, age, and respondents' history of common mental disorders.

Results:  Father's high educational level (odds ratio [OR] = 6.0, 95% confidence interval [CI] = 1.6–22.9), mother's common mental disorders (OR = 5.9, 95%CI = 1.1–33.3), and mother's panic disorders (OR = 6.6, 95%CI = 1.1–39.1) were significantly and positively associated with hikikomori after controlling for respondents' sex, age, and history of mental disorders.

Conclusions:  Our findings suggest that hikikomori cases are more likely to occur in families where the parents have high levels of education. Maternal panic disorder may be another risk factor for children to develop hikikomori.
Transmission of the major skin microbiota, Malassezia, from mother to neonate
Authors: Nagata Rie , Nagano Hiroshi , Ogishima Daiki , Nakamura Yasushi , Hiruma Masataro , Sugita Takashi
Published: February 2012

Background:  Skin surface colonization starts after birth. It is thought that early microbial colonization affects the development of skin immune functions. Although Malassezia is the predominant fungus in the skin microbiota in healthy individuals, the microorganism is associated with atopic dermatitis and seborrheic dermatitis. In the present study, transmission of skin microbiota from mothers to their neonates was elucidated using the Malassezia microbiota as an indicator.

Methods:  Temporal changes in the level of Malassezia colonization of the skin from 27 neonates and mothers were investigated by real‐time polymerase chain reaction assay. The genotypes of Malassezia colonizing the neonate and mother were also determined.

Results:  Malassezia was detected from 89% and 100% of neonate samples on days 0 and 1 after birth, respectively. Subsequently, the level of Malassezia colonization of the neonates increased with time, whereas that of the mothers did not change. The Malassezia diversity of neonates shifted to the adult type by day 30. The genotype of Malassezia colonizing the skin of neonates agreed well with that of Malassezia colonizing the skin of the mothers.

Conclusion:  Fungal microbiota colonization of neonates began on day 0, and the fungal microbiota of neonates had changed to the adult type by day 30. To our knowledge, this is the first report of a molecular analysis of the fungal microbiota of neonates.
Clinical characteristics of neonates With VACTERL association
Authors: Oral Akgun , Caner Ibrahim , Yigiter Murat , Kantarci Mecit , Olgun Hasim , Ceviz Naci , Salman Ahmet Bedii
Published: February 2012

Background:  The VACTERL association (VA) is the non‐random co‐occurrence of vertebral anomalies, anal atresia, cardiovascular malformations, tracheoesophageal fistula and/or esophageal atresia, renal anomalies, and/or limb anomalies, and is referred to by the first letters of its components. Studies investigating the clinical characteristics of VA patients and probing of the observed current six component types are limited, and none of them is focused on neonates. We investigated the clinical characteristics of our patients diagnosed as having VA in the newborn period.

Methods:  We retrospectively reviewed the neonates whose final diagnosis was VACTERL association. Presence of at least three components of previously reported six anomalies was accepted as VACTERL association. Sex, birthweight, gestational age, postnatal age, anomalies of the systems that are included in VA, and the other features were recorded.

Results:  There was a male predominance (14/11) of 28 patients; and there were three patients with ambiguous genitalia. The most common observed VACTERL component was vertebral anomalies (n= 26), followed by anal atresia (n= 19), tracheoesophageal fistula/esophageal atresia (n= 17), renal anomalies (n= 15), limb anomalies (n= 15) and cardiac anomalies (n= 14). The most frequent combination was VCTL (n= 4). Fifteen (57%) patients had non‐VACTERL anomalies and the most frequent of these was ambiguous genitalia (n= 3).

Conclusion:  VA patients may have different clinical characteristics in different populations, and clinicians may miss some component features if the patients are evaluated after the neonatal period.
Isoproterenol stress test during catheterization of patients with coarctation of the aorta
Authors: Kim Ki‐Sung , Eryu Yoshihiko , Asakai Hiroko , Hayashi Taiyu , Kaneko Masahide , Kato Hitoshi
Published: February 2012

Background:  The exercise test is considered useful in selecting high‐risk patients with repaired coarctation of the aorta (CoA), but it is difficult to obtain the cooperation of pediatric patients. The present study determines the feasibility of the isoproterenol stress test (IST) among pediatric patients with CoA.

Methods:  Thirteen patients with repaired or mild preoperative CoA aged 1–207 (median 13) months underwent 16 IST during cardiac catheterization. Peak‐to‐peak pressure gradients (PG) over the coarctation site were measured at baseline and at IST. Balloon angioplasty (BAP) was applied to patients with significant stenosis on angiography.

Results:  The PG between the ascending and the descending aorta was significantly higher at IST than at baseline (20.5 ± 11.5 vs 5.6 ± 3.9 mmHg, P < 0.0001). Heart rate, the systolic blood pressure measured at the ascending aorta, and pulse pressure were all significantly higher at IST than at baseline. The PG at IST decreased >10 mmHg in three of six patients after BAP.

Conclusions:  Significant pressure gradients over the coarctation site develop at IST in pediatric patients with repaired CoA or in preoperative patients with mild coarctation.
Lens thickness and associated factors
Authors: Jonas Jost B , Nangia Vinay , Gupta Rajesh , Sinha Ajit , Bhate Karishma
Published: February 2012

Abstract

Background:  To determine the normative data for lens thickness and its associated factors in a population‐based study.

Design:  Population‐based study.

Participants:  The Central India Eye and Medical Study included 4711 subjects (aged 30+ years).

Methods:  The subjects underwent a detailed ophthalmological examination including measurement of the lens thickness by sonography.

Main Outcome Measure:  Sonographic lens thickness measurement.

Results:  After excluding pseudophakic or aphakic eyes, lens thickness measurements were available for 9046 eyes of 4610 (97.9%) subjects with a mean age of 49.1 ± 13.2 years (range: 30–100 years) and a mean refractive error of −0.11 ± 1.77 dioptres (median, 0 dioptres; range, −21.75 to +7.75 dioptres). Mean lens thickness was 3.95 ± 0.49 mm. In multivariate analysis, a thick lens was significantly associated with higher age (P < 0.001), male gender (P < 0.001), higher body stature (P = 0.02), higher body mass index (P = 0.003), thicker central cornea (P = 0.008), shallower anterior chamber depth (P < 0.001) and hyperopic refractive error (P < 0.001). After adjustment for ocular and systemic parameters, lens thickness decreased with higher degree of nuclear cataract.

Conclusions:  In the rural Central Indian population, a thick lens was associated with higher age, male gender, high body stature, high body mass index, hyperopia, thick central cornea, shallow anterior chamber depth and nuclear cataract. The data may be helpful to explain anatomic relationships of the anterior segment of the eye and to elucidate risk factors of diseases associated with ocular dimensions.
Incidence of visual impairment and blindness in indigenous Australians within Central Australia: the Central Australian Ocular Health Study
Authors: Landers John , Henderson Tim , Craig Jamie E
Published: February 2012

Abstract

Background:  To estimate the incidence and causes of visual impairment and blindness among indigenous Australians living in Central Australia.

Design:  Clinic‐based cohort study.

Participants:  A total of 1884 individuals aged ≥20 years living in one of 30 remote communities within the statistical local area of ‘Central Australia’.

Methods:  From those initially recruited, 608 (32%) participants were reviewed again between 6 months and 3 years (median 2 years). Patients underwent Snellen visual acuity testing and subjective refraction. Following this, an assessment of their anterior and posterior segments was made. Baseline results were compared with those who were reviewed.

Main Outcome Measures:  The annual incidence rates and causes of bilateral visual impairment (vision worse than Snellen visual acuity 6/12 in the better eye) and bilateral blindness (Snellen visual acuity worse than 6/60 in the better eye).

Results:  The annual incidence of bilateral visual impairment and blindness was 6.82% (8.12% for those aged ≥40 years) per year and 0.50% (0.62% for those aged ≥40 years) per year, respectively. Refractive error, followed by cataract and diabetic retinopathy, were the main causes for incident bilateral visual impairment and blindness.

Conclusion:  This study has demonstrated rates of incident bilateral blindness and visual impairment among the indigenous Australian population within Central Australia, which are substantially higher than those from the non‐indigenous population. Services need to address the underlying causes of this incident vision loss to reduce visual morbidity in indigenous Australians living in central Australia.
Effects of once weekly dual‐task training in older adults: A pilot randomized controlled trial
Authors: Plummer‐D'Amato Prudence , Cohen Zachary , Daee Nadia A , Lawson Sarah E , Lizotte Marissa R , Padilla Anna
Published: February 2012

Aim:  To compare single‐task and dual‐task training on obstacle avoidance, gait speed and balance in healthy community‐dwelling older adults.

Methods:  A total of 17 older adults (65–83 years) participated in a group circuit class, once weekly for 45 min for 4 weeks. The dual‐task group carried out cognitive activities simultaneously with gait and balance exercises. The single‐task training group carried out identical gait and balance activities without cognitive tasks. We assessed time to complete a 6‐m obstacle course under single‐task and three different dual‐task conditions (spontaneous speech, alphabet recitation and coin transfer), 25‐ft gait speed, Timed Up and Go, and the Activities‐specific Balance Confidence Scale.

Results:  Both groups showed significant improvement in gait speed and Timed Up and Go. In addition, the proportion of participants who achieved gait speed >1.0 m/s increased in both groups. There were no within‐ or between‐subjects differences in obstacle course performance under single or dual‐task conditions after the intervention.

Conclusion:  Once weekly group circuit training focusing on balance, gait and agility, with or without simultaneous cognitive tasks, resulted in significantly improved walking speed among older adults. Group‐format dual‐task training once per week did not improve walking time or dual‐task cost on an obstacle negotiation task. Geriatr Gerontol Int 2012; ••: ••–••.
Both conventional indices of cognitive function and frailty predict levels of care required in a long‐term care insurance program for memory clinic patients in Japan
Authors: Takechi Hajime , Sugihara Yuriko , Kokuryu Atsuko , Nishida Maiko , Yamada Hiroko , Arai Hidenori , Hamakawa Yoshiyuki
Published: February 2012

Aim:  To delineate relationships among cognitive function, frailty and level of care required in the Japanese long‐term care insurance program (LTCIP) in outpatient memory clinic patients.

Methods:  This was a cross‐sectional study carried out at an outpatient memory clinic. Participants were 201 cognitively impaired patients. Cognitive function was measured by the Mini‐Mental State Examination (MMSE). Frailty was measured by Timed Up & Go (TUG) and grip strength. Waist circumference, body mass index, living arrangement and level of care required in the LTCIP (rank 1 minor disability to rank 7 severe disability) were also assessed.

Results:  Mean age, MMSE score, TUG score and grip strength were 78.8 ± 6.9 years, 19.6 ± 6.1, 14.6 ± 6.7 s and 16.9 ± 7.5 kg, respectively. A total of 70 patients (34.8%) had not applied for the certification, at least in part because of their younger age and existence of family caregivers. LTCIP rank was correlated both with MMSE score (β: −0.49, P = 0.001), grip strength (β: −0.27, P = 0.005) and living alone (β: −0.18, P = 0.03), but not with TUG score (β: 0.14, P = 0.105).

Conclusion:  In outpatients of a memory clinic, care ranks, which define the upper limit of monthly benefit in the Japanese LTCIP, were influenced by age, cognitive function, frailty and living arrangements. Understanding the relationship among these parameters would be useful in predicting the needs of cognitively impaired patients and important when comparing the possible services provided by long‐term care systems for them worldwide. Geriatr Gerontol Int 2012; ••: ••–••.
Interactions of odorants with olfactory receptors and receptor neurons match the perceptual dynamics observed for woody and fruity odorant mixtures
Authors: Chaput M. A. , El Mountassir F. , Atanasova B. , Thomas‐Danguin T. , Le Bon A. M. , Perrut A. , Ferry B. , Duchamp‐Viret P.
Published: February 2012

The present study aimed to create a direct bridge between observations on peripheral and central responses to odorant mixtures and their components. Three experiments were performed using mixtures of fruity (isoamyl acetate; ISO) and woody (whiskey lactone; WL) odorants known to contribute to some of the major notes in Burgundy red wine. These experiments consisted of (i) calcium imaging of human embryonic kidney cells (HEK293T) transfected with olfactory receptors (ORs); (ii) single‐unit electrophysiological recordings from olfactory receptor neurons (ORNs) and analyses of electro‐olfactogram (EOG) responses in the rat nose in vivo; and (iii) psychophysical measurements of the perceived intensity of the mixtures as rated by human subjects. The calcium imaging and electrophysiological results revealed that ISO and WL can act simultaneously on single ORs or ORNs and confirm that receptor responses to mixtures are not the result of a simple sum of the effects of the individual mixture compounds. The addition of WL to ISO principally suppressed the ORN activation induced by ISO alone and was found to enhance this activation in a subset of cases. In the human studies, the addition of high concentrations of WL to ISO decreased the perceived intensity of the ISO. In contrast, the addition of low concentrations of WL enhanced the perceived intensity of the fruity note (ISO) in this mixture, as it enhanced EOG responses in ORNs. Thus, both OR and ORN responses to ISO + WL mixtures faithfully reflected perceptual response changes, so the odour mixture information is set up after the peripheral stage of the olfactory system.
Early olfactory experience induces structural changes in the primary olfactory center of an insect brain
Authors: Arenas A. , Giurfa M. , Sandoz J. C. , Hourcade B. , Devaud J. M. , Farina W. M.
Published: February 2012

The antennal lobe (AL) is the first olfactory center of the insect brain and is constituted of different functional units, the glomeruli. In the AL, odors are coded as spatiotemporal patterns of glomerular activity. In honeybees, olfactory learning during early adulthood modifies neural activity in the AL on a long‐term scale and also enhances later memory retention. By means of behavioral experiments, we first verified that olfactory learning between the fifth and eighth day of adulthood induces better retention performances at a late adult stage than the same experience acquired before or after this period. We checked that the specificity of memory for the odorants used was improved. We then studied whether such early olfactory learning also induces long‐term structural changes in the AL consistent with the formation of long‐term olfactory memories. We also measured the volume of 15 identified glomeruli in the ALs of 17‐day‐old honeybees that either experienced an odor associated with sucrose solution between the fifth and eighth day of adulthood or were left untreated. We found that early olfactory experience induces glomerulus‐selective increases in volume that were specific to the learned odor. By comparing our volumetric measures with calcium‐imaging recordings from a previous study, performed in 17‐day‐old bees subjected to the same treatment and experimental conditions, we found that glomeruli that showed structural changes after early learning were those that exhibited a significant increase in neural activity. Our results make evident a correlation between structural and functional changes in the AL following early olfactory learning.
Inactivation of the central nucleus of the amygdala reduces the effect of punishment on cocaine self‐administration in rats
Authors: Xue YueQiang , Steketee Jeffery D. , Sun WenLin
Published: February 2012

Continued cocaine use despite the negative consequences is a hallmark of cocaine addiction. One such consequence is punishment, which is often used by society to curb cocaine use. Unfortunately, we know little about the mechanism involved in regulation by punishment of cocaine use. The fact that cocaine addicts continue to use cocaine despite potentially severe punishment suggests that the mechanism may be impaired. Such impairment is expected to critically contribute to compulsive cocaine use. This study was aimed at testing the hypothesis that the central nucleus of the amygdala (CeN) plays a critical role in such regulation. To this end, rats were trained to press a lever to self‐administer cocaine under a chained schedule: a response on one lever (cocaine‐seeking lever) led to access to the other lever (cocaine‐taking lever), on which a response was reinforced by cocaine and cues. Thereafter, responses on the seeking lever were punished by footshock with a probability of 0.5. Cocaine self‐administration (SA) was significantly suppressed by punishment in an intensity‐dependent manner. Interestingly, rats trained with daily 6‐h (extended access) but not 2‐h (limited access) sessions showed resistance to the lower intensity of punishment. Inactivation of the CeN induced a robust anti‐punishment effect in both groups. These data provided evidence that the CeN is a critical neural substrate involved in regulation by punishment of cocaine SA. Rats with a history of extended cocaine SA appeared to be less sensitive to punishment. The decreased sensitivity could result from the neuroplastic changes induced by extended cocaine SA in the CeN.