bluuebunny/crossref_metadata_2025 huggingface dataset:
A Case of Ankyloblepharon, Ectodermal Dysplasia, and Cleft Lip/Palate Syndrome with Ectrodactyly: Are the p63 Syndromes Distinct After All?
Authors: Chiu Yvonne E. , Drolet Beth A. , Duffy Kelly J. , Holland Kristen E.
Published: October 2009

Abstract:  Ectodermal dysplasias are diseases with abnormal development of ectodermally derived tissues such as skin, hair, teeth, and nails. Mutations in the transcription factor p63 have been linked to several syndromes characterized by ectodermal, orofacial, and limb defects. We present the case of an infant with ankyloblepharon, cleft palate, scalp dermatitis, and ectrodactyly. She is unique for having a novel p63 mutation that has not been previously reported. Her case also points to the significant overlap between the p63‐associated ectodermal dysplasias and challenges the traditional diagnostic schema for these rare syndromes.
Optical Properties of Co3O4‐Doped ZnO–B2O3–SiO2–Al2O3 Glass System for a Transparent Dielectric Layer
Authors: Seo Byung‐Hwa , Kim Hyungsun , Suh Dong Hack
Published: October 2009

There has been a need to improve color temperature without using asymmetric cell structures using transparent dielectric layers with variation of Co3O4 contents in plasma display panel (PDP). In this study, ZnO–B2O3–SiO2–Al2O3 glasses with variations of the Co3O4 content (0, 0.5, 1.0, 1.5, and 2.0 wt%) were fabricated and the optical properties of these glasses were characterized. As the content of Co3O4 increased, the transmittance of the red region (from 580 to 780 nm) decreased more than of the blue region (from 380 to 500 nm). This change of transmittance induced the transition of the coordination of the color temperature toward the blue region. Therefore, the addition of 2 wt% Co3O4 can improve the color temperature from 6087 to 7378 K and the result was confirmed using simulation.
Serious Bacterial Infections in Febrile Outpatient Pediatric Heart Transplant Recipients
Authors: Yin Shan , Trainor Jennifer L. , Powell Elizabeth C.
Published: October 2009

Objectives:  The purpose of this study was to describe the incidence of serious bacterial infections (SBIs) in febrile outpatient pediatric heart transplant recipients and to assess the utility of using white blood cell (WBC) indices to identify patients at low risk for bacteremia.

Methods:  A retrospective study was conducted on all heart transplant recipients followed at a single children’s hospital. All outpatient visits from January 1, 1995, to June 1, 2007, in which fever was evaluated were reviewed. Patients with history of a primary immunodeficiency, receiving concurrent chemotherapy, or having had a stem cell or small bowel transplant were excluded. Demographic, historical, physical examination, laboratory, and radiographic data were then recorded.

Results:  Sixty‐nine patients had 238 individual episodes of fever evaluation; of these, 217 (91.2%) had blood cultures drawn with results available in their initial evaluation. There were six (2.8%) true‐positive blood cultures and eight (3.7%) false‐positive cultures. Chest radiography was done in 185 evaluations (77.8%), and 44 episodes of pneumonia (23.8%) were diagnosed. Of 112 urine cultures done, one (0.9%) was positive. Neither of two lumbar punctures performed were positive. In non–ill‐appearing children without indwelling central lines or focal bacterial infections (pneumonia, cellulitis), the incidence of bacteremia was 1.2%. In children with a focal bacterial infection, the rate of bacteremia was 6.3%. WBC indices were not significantly different between bacteremic and nonbacteremic patients. A band‐to‐neutrophil ratio (BNR) of ≥0.25 and a published guideline for identifying low‐risk infants using WBC indices identified all bacteremic patients, each with a sensitivity of 100% (95% confidence interval [CI] = 48% to 100% and 54% to 100%, respectively).

Conclusions:  The incidence of bacteremia was low in febrile, outpatient pediatric heart transplant patients, especially in those who were not ill‐appearing and did not have a focus of serious infection. Two different low‐risk criteria performed well in identifying the bacteremic patients, although given the low number of true‐positive cultures, the CIs for the sensitivities of these tests were extremely wide, and neither test could be reliably used at present. A prospective multicenter study is required to confirm the low incidence of bacteremia and low‐risk criteria in this population.
National Study of Patient, Visit, and Hospital Characteristics Associated With Leaving an Emergency Department Without Being Seen: Predicting LWBS
Authors: Pham Julius Cuong , Ho George K. , Hill Peter M. , McCarthy Melissa L. , Pronovost Peter J.
Published: October 2009

Objectives:  The objective was to estimate the national left‐without‐being‐seen (LWBS) rate and to identify patient, visit, and institutional characteristics that predict LWBS.

Methods:  This was a retrospective cross‐sectional analysis using the National Hospital Ambulatory Medical Care Survey (NHAMCS) from 1998 to 2006. Bivariate and multivariate analyses were performed to identify predictors of LWBS.

Results:  The national LWBS rate was 1.7 (95% confidence interval [CI] = 1.6 to 1.9) patients per 100 emergency department (ED) visits each year. In multivariate analysis, patients at extremes of age (<18 years, odds ratio [OR] = 0.80, 95% CI = 0.66 to 0.96; and ≥65 years, OR = 0.46, 95% CI = 0.32 to 0.64) and nursing home residents (OR = 0.29, 95% CI = 0.08 to 1.00) were associated with lower LWBS rates. Nonwhites (black or African American (OR = 1.41, 95% CI = 1.22 to 1.63) and Hispanic (OR = 1.25, 95% CI = 1.04 to 1.49), Medicaid (OR = 1.47, 95% CI = 1.27 to 1.70), self‐pay (OR = 1.96, 95% CI = 1.65 to 2.32), or other insurance (OR = 2.09, 95% CI = 1.74 to 2.52) patients were more likely to LWBS. Visit characteristics associated with LWBS included visits for musculoskeletal (OR = 0.70, 95% CI = 0.57 to 0.85), injury/poisoning/adverse event (OR = 0.65, 95% CI = 0.53 to 0.80), and miscellaneous (OR = 1.56, 95% CI = 1.19 to 2.05) complaints. Visits with low triage acuity were more likely to LWBS (OR = 3.59, 95% CI = 2.81 to 4.58), whereas visits that were work‐related were less likely to LWBS (OR = 0.19, 95% CI = 0.12 to 0.29). Institutional characteristics associated with LWBS were visits in metropolitan areas (OR = 2.11, 95% CI = 1.66 to 2.70) and teaching institutions (OR = 1.33, 95% CI = 1.06 to 1.67).

Conclusions:  Several patient, visit, and hospital characteristics are independently associated with LWBS. Prediction and benchmarking of LWBS rates should adjust for these factors.
Feasibility of an Interactive Voice Response Tool for Adolescent Assault Victims
Authors: Blackstone Mercedes M. , Wiebe Douglas J. , Mollen Cynthia J. , Kalra Avash , Fein Joel A.
Published: October 2009

Background:  Assault‐injured adolescents who are seen in the emergency department (ED) are difficult to follow prospectively using standard research techniques such as telephone calls or mailed questionnaires. Interactive voice response (IVR) is a novel technology that promotes active participation of subjects and allows automated data collection for prospective studies.

Objectives:  The objective was to determine the feasibility of IVR technology for collecting prospective information from adolescents who were enrolled in an ED‐based study of interpersonal violence.

Methods:  A convenience sample of assault‐injured 12‐ to 19‐year‐olds presenting to an urban, tertiary care ED was enrolled prospectively. Each subject completed a brief questionnaire in the ED and then was randomly assigned to use the IVR system in differently timed schedules over a period of 8 weeks: weekly, biweekly, or monthly calls. Upon discharge, each subject received a gift card incentive and a magnetic calendar with his or her prospective call‐in dates circled on it. Each time a subject contacted the toll‐free number, he or she used the telephone’s keypad to respond to computer‐voice questions about retaliation and violence subsequent to the ED visit. Using Internet access, we added $5 to the gift card for each call and $10 if all scheduled calls were completed. The primary outcome was the rate of the first utilization of the IVR system. The numbers of completed calls made for each of the three call‐in schedules were also compared.

Results:  Of the 95 subjects who consented to the follow‐up portion of the study, 44.2% (95% confidence interval [CI] = 34.0% to 54.8%) completed at least one IVR call, and 13.7% (95% CI = 7.5% to 22.3%) made all of their scheduled calls. There were no significant differences among groups in the percentage of subjects calling at least once into the system or in the percentage of requested calls made. The enrolled subjects had a high level of exposure to violence. At baseline, 85.3% (95% CI = 76.5% to 91.7%) had heard gunshots fired, and 84.2% (95% CI = 75.3% to 90.9%) had seen someone being assaulted. Twenty‐eight adolescents (29.5%, 95% CI = 20.6% to 39.7%) were reached for satisfaction interviews. All of those contacted found the IVR system easy to use and all but one would use it again.

Conclusions:  Interactive voice response technology is a feasible means of follow‐up among high‐risk violently injured adolescents, and this relatively anonymous process allows for the collection of sensitive information. Further research is needed to determine the optimal timing of calls and cost‐effectiveness in this population.
Trends in Midlevel Provider Utilization in Emergency Departments from 1997 to 2006
Authors: Menchine Michael D. , Wiechmann Warren , Rudkin Scott
Published: October 2009

Objectives:  The objective was to quantify the expansion of midlevel provider (MLP) practice in U.S. emergency departments (EDs) over the past decade. Specifically, we sought to quantify the absolute number of patients seen by MLPs, the annual growth rate of patients seen by MLPs, and the expansion in the proportion of EDs using MLPs.

Methods:  Data were analyzed from the ED portion of the 10 most recent years (1997 to 2006) National Hospital Ambulatory Medical Care Survey (NHAMCS), a nationally representative survey of ED visits compiled by the Centers for Disease Control and Prevention (CDC). The main outcomes of interest were the proportion and absolute numbers of ED patients seen by MLPs during the 10‐year study period. National estimates derived from sample weights are reported. In addition, a multivariate logistic regression model was created with “seen by midlevel provider” as the dependent variable to determine factors associated with being seen by a MLP.

Results:  Between 1997 and 2006, 8.23% (95% confidence interval [CI] = 7.31% to 9.15%) of ED patients were seen by a MLP. The proportion of ED patients seen by MLPs increased from 5.5% (95% CI = 3.8% to 7.1%) in 1997 to 12.7% (95% CI = 10.5% to 14.9%) in 2006 (13% annual growth). This corresponds to an increase in the number of ED patients seen by MLPs from 5.2 million in 1997 to 15.2 million in 2006. The proportion of hospitals using MLPs in the ED increased from 28.3% (95% CI = 22.4% to 34.1%) in 1997 to 77.2% (95% CI = 71.2% to 83.3%) in 2006 (17% annual growth). Slightly over half of MLP cases (54.9%; 95% CI = 49.1% to 60.7%) were also seen by staff physicians. On multivariate regression, younger patient age, non–southern geographic region, and triage acuity were associated with increased MLP use.

Conclusions:  The number of ED patients seen by MLPs has increased sharply, from 5.2 million in 1997 (5.5% of all ED cases) to 15.2 million in 2006 (12.7% of all ED cases). Similarly, the proportion of EDs reporting use of MLPs has increased from 28.3% in 1997 to 77.2% in 2006.
Disconnect Between Charted Vestibular Diagnoses and Emergency Department Management Decisions: A Cross‐sectional Analysis From a Nationally Representative Sample
Authors: Newman‐Toker David E. , Camargo, Jr Carlos A. , Hsieh Yu‐Hsiang , Pelletier Andrea J. , Edlow Jonathan A.
Published: October 2009

Objectives:  The most common vestibular disorders seen in the emergency department (ED) are benign paroxysmal positional vertigo (BPPV) and acute peripheral vestibulopathy (APV; i.e., vestibular neuritis or labyrinthitis). BPPV and APV are two very distinct disorders that have different clinical presentations that require different diagnostic and treatment strategies. BPPV can be diagnosed without imaging and is treated with canalith‐repositioning maneuvers. APV sometimes requires neuroimaging by magnetic resonance imaging (MRI) to exclude posterior fossa stroke mimics and should be treated with vestibular sedatives and corticosteroids. We sought to determine if emergency physicians (EPs) apply best practices to diagnose and treat these common vestibular disorders.

Methods:  This was a cross‐sectional study of ED visits from the National Hospital Ambulatory Medical Care Survey (NHAMCS). A weighted sample of U.S. ED visits (1993–2005) was used. Patients at least 16 years of age who were given a final ED diagnosis of BPPV (International Classification of Diseases, 9th Revision [ICD‐9], 386.11) or APV (ICD‐9 386.12 or 386.3x) comprised the study population. The frequency of imaging and drug therapy in those diagnosed as BPPV or APV versus controls was the main outcome measure.

Results:  A total of 9,472 dizzy patient visits were sampled over 13 years (weighted estimate 33.6 million U.S. ED visits over that period). A weighted estimate of 2.5 million patients (7.4%) were given a vestibular diagnosis, mostly BPPV (weighted 0.2 million) or APV (weighted 1.9 million). Patients given BPPV (19%) and APV (19%) diagnoses were more likely to undergo imaging (all by computed tomography [CT]) than controls (7%; p < 0.001). Patients given BPPV (58%) and APV (70%) diagnoses were more likely to receive meclizine than controls (0.1%; p < 0.001). Corticosteroid administration was rarely documented (2% BPPV, 1% APV).

Conclusions:  Patients given a vestibular diagnosis in the ED may not be managed optimally. Patients given BPPV and APV diagnoses undergo imaging (predominantly CT) with equal frequency, suggesting overuse of CT (BPPV) and probably underuse of MRI (APV). Most patients diagnosed with BPPV are given meclizine, which is not indicated. Specific therapy for APV (corticosteroids) is probably underutilized. Educational initiatives and clinical guidelines merit consideration.
Structure and Function of Emergency Care Research Networks: Strengths, Weaknesses, and Challenges
Authors: Papa Linda , Kuppermann Nathan , Lamond Katherine , Barsan William G. , Camargo Carlos A. , Ornato Joseph P. , Stiell Ian G. , Talan David A.
Published: October 2009

The ability of emergency care research (ECR) to produce meaningful improvements in the outcomes of acutely ill or injured patients depends on the optimal configuration, infrastructure, organization, and support of emergency care research networks (ECRNs). Through the experiences of existing ECRNs, we can learn how to best accomplish this. A meeting was organized in Washington, DC, on May 28, 2008, to discuss the present state and future directions of clinical research networks as they relate to emergency care. Prior to the conference, at the time of online registration, participants responded to a series of preconference questions addressing the relevant issues that would form the basis of the breakout session discussions. During the conference, representatives from a number of existing ECRNs participated in discussions with the attendees and provided a description of their respective networks, infrastructure, and challenges. Breakout sessions provided the opportunity to further discuss the strengths and weaknesses of these networks and patterns of success with respect to their formation, management, funding, best practices, and pitfalls. Discussions centered on identifying characteristics that promote or inhibit successful networks and their interactivity, productivity, and expansion. Here the authors describe the current state of ECRNs and identify the strengths, weaknesses, and potential pitfalls of research networks. The most commonly cited strengths of population‐ or disease‐based research networks identified in the preconference survey were access to larger numbers of patients; involvement of physician experts in the field, contributing to high‐level study content; and the collaboration among investigators. The most commonly cited weaknesses were studies with too narrow a focus and restrictive inclusion criteria, a vast organizational structure with a risk of either too much or too little central organization or control, and heterogeneity of institutional policies and procedures among sites. Through the survey and structured discussion process involving multiple stakeholders, the authors have identified strengths and weaknesses that are consistent across a number of existing ECRNs. By leveraging the strengths and addressing the weaknesses, strategies can be adopted to enhance the scientific value and productivity of these networks and give direction to future ECRNs.
Customer Satisfaction and Switching Barriers: Effects on Repurchase Intentions, Positive Recommendations, and Price Tolerance1
Authors: Vázquez‐Casielles Rodolfo , Suárez‐Álvarez Leticia , Del Río‐Lanza Ana Belén
Published: October 2009

The current article attempts to extend previous research by testing the effects of customer satisfaction and 2 types of switching barriers—negative and positive—on key manifestations of attitudinal loyalty (repurchase intentions, positive recommendations, and price tolerance). The work also studies whether the effect of customer satisfaction is linear or nonlinear. Finally, the paper analyzes whether switching barriers moderate the relative strength of the customer satisfaction/attitudinal loyalty relation. To this end, a total of 554 private mobile‐phone customers were surveyed. The distinction between negative and positive switching barriers is important to draw theoretical and managerial implications.
Examining Implementation Intentions in an Exercise Intervention: The Effects on Adherence and Self‐Efficacy in a Naturalistic Setting1
Authors: Murray Terra C. , Rodgers Wendy M. , Fraser Shawn N.
Published: October 2009

Some studies have found positive associations between implementation intentions and exercise, independent of motivational factors. However, most research has not been conducted in actual exercise contexts. In a naturalistic setting, implementation intentions may be associated with self‐efficacy (SE) beliefs. This study examined the effect of implementation intentions on adherence and SE over an 11‐week exercise program. Women (N = 72) were randomly assigned to an experimental (i.e., implementation intention) or a control group, with 52 participants completing the study. Results showed that while adherence decreased over time in both groups, the experimental group had better adherence than did the control group. Scheduling SE was also higher in the experimental group. Implementation intentions may help to maintain adherence and scheduling SE.
Attitude and Norm Accessibility and Cigarette Smoking
Authors: Rhodes Nancy , Ewoldsen David R.
Published: October 2009

Social norms and attitudes play a critical role in adolescent smoking initiation and maintenance. Focus theory predicts that making a norm more salient—and thereby temporarily increasing its accessibility from memory—will increase the influence of the norm on behavior for as long as the norm remains salient. Likewise, the process model of the attitude–behavior relationship predicts that accessible attitudes are more predictive of behavior. The present research examining the role of the chronic accessibility of smoking related normative beliefs and attitudes in predicting smoking behavior in college students. Attitude and norm accessibility independently accounted for significant variability in smoking behavior beyond that accounted for by traditional measures of attitude and subjective norm.
LMX and Subordinate Political Skill: Direct and Interactive Effects on Turnover Intentions and Job Satisfaction
Authors: Harris Kenneth J. , Harris Ranida B. , Brouer Robyn L.
Published: October 2009

Previous research has demonstrated a positive relationship between leader–member exchange (LMX) quality and positive outcomes. However, little is known about how the dispositional variable of subordinate political skill impacts LMX–consequence relationships. Thus, this study investigated this interaction in predicting turnover intentions and job satisfaction. Additionally, we employed a relatively unexamined multidimensional measure of LMX, which could then help to establish the generalizability of outcomes related to LMX. We investigated these hypotheses in a sample of 239 working employees, and found support for the moderating role of subordinate political skill.
Workplace Expression of Emotions and Escalation of Commitment1
Authors: O'Neill Olivia A.
Published: October 2009

These studies examined the effects of expressions of anger and guilt in the workplace on escalation of commitment. Study 1 examined the relationship between employees' reports of coworkers' emotion expressions and continued investment in a poorly performing subordinate. Study 2 tested the effects of leader expressions of anger and guilt on continued investment in a failing project. Results of both studies demonstrate that expressions of anger lead to greater escalation of commitment, while expressions of guilt lead to de‐escalation. Experimental results indicate that the effects of emotion expressions on escalation are strongest when individuals are collectively responsible for the initial decision, a finding that was mediated by feelings of psychological safety.
Standardized Goals and Performance Feedback Aggregated Beyond the Work Unit: Optimizing the Use of Engineered Labor Standards and Electronic Performance Monitoring
Authors: Goomas David T. , Ludwig Timothy D.
Published: October 2009

Electronic performance monitoring can monitor employee performance, while providing proximal goals and immediate feedback. A warehouse management system was enhanced to depict goal and performance on handheld wireless computers to improve order selection in an auto‐parts aftermarket distribution center. Upon the onset of the intervention of an engineered labor standard and electronic performance monitoring, performance immediately increased by 24 units picked per hour per person and was maintained for the duration of the study, an increase of 12.9%. Evidence from this study suggests that performance goals and feedback can be aggregated beyond the work‐unit level without decreasing the effectiveness of the intervention.
Perceived Investment in Permanent Employee Development and Social and Economic Exchange Perceptions Among Temporary Employees
Authors: Kuvaas Bård , Dysvik Anders
Published: October 2009

This study investigated the mediating roles of social and economic exchange perceptions on the relationship between perceived investment in permanent employee development in the client organization and exchange outcomes among 375 temporary employees. The results support full mediation by exchange perceptions, where social exchange perception is positively related to both task performance and organizational citizenship behavior, and economic exchange perception is negatively related to task performance. Implications for practice and directions for future research are discussed.
Melatonin inhibits 6‐hydroxydopamine production in the brain to protect against experimental parkinsonism in rodents
Authors: Borah Anupom , Mohanakumar Kochupurackal P.
Published: October 2009

Abstract: We tested the hypothesis that melatonin regulates formation of 6‐hydroxydopamine (6‐OHDA) in the brain and thereby protects animals from dopaminergic neurotoxicity and the development of parkinsonism in animals. Employing a ferrous‐ascorbate‐dopamine (FAD) hydroxyl radical (•OH) generating system, in the present study we demonstrate a dose‐dependent attenuation of 6‐OHDA generation by melatonin in vitro. Intra‐median forebrain bundle infusion of FAD caused significant depletion of striatal dopamine (DA), which was blocked by melatonin. Per‐oral administration ofl‐3,4‐dihydroxyphenylalanine(l‐DOPA) for 7 days caused a dose‐dependent increase in the formation of 6‐OHDA in the mouse striatum, which was increased synergistically by the systemic administration of the parkinsonian neurotoxin, 1‐methyl‐4‐phenyl‐1,2,3,6‐tetrahydropyridine (MPTP) on the 7th day ofl‐DOPA treatment. Melatonin treatment significantly attenuated both thel‐DOPA and MPTP‐induced increases in the levels of striatal 6‐OHDA, and protected against striatal DA depletion caused by the neurotoxin. These observations suggest a novel mode of melatonin‐induced dopaminergic neuroprotection in two models of Parkinson’s disease, and suggest the possible therapeutic use of this well‐known antioxidant indoleamine neurohormone in parkinsonism.
Concurrence between Interpupillary Line and Tangent to the Incisal Edge of the Upper Central Incisor Teeth
Authors: MALAFAIA FABIANO MARTINS , GARBOSSA MARCELO FRANCISCO , NEVES ANA CHRISTINA CLARO , DA SILVA‐CONCÍLIO LAÍS REGIANE , NEISSER MAXIMILIANO PIERO
Published: October 2009

Objective:  Dento‐facial harmony is essential to obtain adequate esthetics and a successful treatment. Therefore, the aim of the present study was to analyze the existence of polar symmetry, obtained by two parallel lines, one along the pupils and another along the incisal edge of the upper central incisor teeth of 102 dental students distributed across five Brazilian dental schools.

Materials and Methods:  One hundred and two students with no missing teeth, who had never been subjected to any kind of dental treatment, not even orthodontic treatment, were selected and photographed using a dental eye II camera (Yashica‐Kyocera Optics Inc., Somerset, NJ, USA) with a macro‐objective lens of 100 mm and using a scale of 1:10 of the natural size. All the individuals were positioned parallel to the plane of Frankfurt and to the ground, and were photographed smiling in order to expose the central incisors. The pictures were transformed into digital images (1,840 × 1,252 pixels) and analyzed later using Microsoft Office Power Point 2007 software. Two lines (along the pupils and another along the maxillary incisive teeth) were drawn, and the inclination obtained was generated by the program itself. Symmetrical cases were classified as “yes” (Y), and the remainder as “no” (N). Cases were also divided according to gender. Results were statistically assessed by analysis of variance and Student's t‐test (α = 0.05).

Results:  There was a statistically significant correlation between the line parallel with the pupils and the tangent of the incisal edge of the incisors, irrespective of gender.

Conclusion:  Regardless of gender, there is a correlation between the pupils and the tangent with the incisal edge of the maxillary central incisors.

CLINICAL SIGNIFICANCE

Despite diversity in individuals, facial and anatomic measurements may aid in the execution and planning of rehabilitation treatments.
Prevalence of Carious and Non‐carious Cervical Lesions in Archaeological Populations from North America and Europe
Authors: RITTER ANDRÉ V. , GRIPPO JOHN O. , COLEMAN THOMAS A. , MORGAN MICHÈLE E.
Published: October 2009

Purpose:  The purpose of this study was to report the prevalence of carious and non‐carious cervical lesions in the teeth of five archaeological populations. A secondary purpose was to report the association between age, gender, diet, tooth wear, carious cervical lesions, and non‐carious cervical lesions.

Materials and Methods:  One hundred and four archaeological specimens from subjects originating from five distinct geographical areas were examined to detect the presence of carious cervical lesions, non‐carious cervical lesions, and tooth wear. Data were tabulated and statistics used to describe prevalence and non‐causal associations.

Results:  Carious cervical lesions were prevalent in all populations except among Labradoreans, while non‐carious cervical lesions were found predominantly in Mexicans. The authors found no association between non‐carious cervical lesions and age, gender, and diet in any of the populations. Tooth wear was noted in all populations, but the highest rates of severe wear were noted among the Labradoreans and New Mexicans. Age was associated with tooth wear in all populations except Ohioans. There was no association between tooth wear and non‐carious cervical lesions.

Conclusions:  The prevalence of carious cervical lesions among the five archaeological populations studied ranged from 0 to 65%. Non‐carious cervical lesions were not prevalent among these populations, being found predominantly in Mexicans (26%).

CLINICAL SIGNIFICANCE

Historically, carious and non‐carious cervical lesions can be found in individuals with no access to modern oral hygiene tools. The findings of this study are not conclusive, however, as the associations described are not causal.
Harmine specifically inhibits protein kinase DYRK1A and interferes with neurite formation
Authors: Göckler Nora , Jofre Guillermo , Papadopoulos Chrisovalantis , Soppa Ulf , Tejedor Francisco J. , Becker Walter
Published: October 2009

DYRK1A is a dual‐specificity protein kinase that autophosphorylates a conserved tyrosine residue in the activation loop but phosphorylates exogenous substrates only at serine or threonine residues. Tyrosine autophosphorylation of DYRKs is a one‐off event that takes place during translation and induces the activation of the kinase. Here we characterize the beta‐carboline alkaloid harmine as a potent and specific inhibitor of DYRK1A both in vitro and in cultured cells. Comparative in vitro assays of four kinases of the DYRK family showed that harmine inhibited substrate phosphorylation by DYRK1A more potently than it inhibited substrate phosphorylation by the closely related kinase DYRK1B [half maximal inhibitory concentrations (IC50) of 33 nm versus 166 nm, respectively] and by the more distant members of the family, DYRK2 and DYRK4 (1.9 μm and 80 μm, respectively). Much higher concentrations of harmine were required to suppress tyrosine autophosphorylation of the translational intermediate of DYRK1A in a bacterial in vitro translation system (IC50 = 1.9 μm). Importantly, harmine inhibited the phosphorylation of a specific substrate by DYRK1A in cultured cells with a potency similar to that observed in vitro (IC50 = 48 nm), without negative effects on the viability of the cells. Overexpression of the DYRK1A gene on chromosome 21 has been implicated in the altered neuronal development observed in Down syndrome. Here, we show that harmine interferes with neuritogenesis in cultured hippocampal neurons. In summary, our data show that harmine inhibits DYRK1A substrate phosphorylation more potently than it inhibits tyrosine autophosphorylation, and provide evidence for a role of DYRK1A in the regulation of neurite formation.
Metabolic stabilization of p53 by FE65 in the nuclear matrix of osmotically stressed cells
Authors: Nakaya Tadashi , Kawai Tomoko , Suzuki Toshiharu
Published: October 2009

FE65 is a neural adaptor protein known to interact with a number of proteins, including Alzheimer’s amyloid β‐protein precursor (APP). Although several different functions have been proposed for FE65, its primary physiological role remains unclear. We previously showed that APP can liberate FE65 from the membrane as a result of APP phosphorylation, and that the liberated FE65 translocates into the nuclei of osmotically stressed cells. Within the nucleus, FE65 formed a patched structure at the nuclear matrix, which facilitated the induction of γH2AX [Nakaya T, Kawai T & Suzuki T (2008) J Biol Chem283, 19119–19131]. Here, we report that the tumor suppressor p53 is colocalized with FE65 in the nuclear patches and is stabilized by FE65 in sorbitol‐treated cells. In FE65 knockdown cells, protein levels of p53 targeted to the nuclear matrix were rapidly decreased through the proteasome degradation pathway after sorbitol treatment, as compared with control cells. These results suggest that the translocation of FE65 to the nuclear matrix, along with the formation of nuclear patches, is required for the stabilization of p53 by its suppression of the proteasome degradation pathway, thus facilitating the subsequent induction of γH2AX in osmotically stressed cells.

Structured digital abstract

 MINT‐7261896: Fe65 (uniprotkb:Q9QXJ1) and Tp53 (uniprotkb:P02340) colocalize (MI:0403) by fluorescence microscopy (MI:0416)

 MINT‐7261912: p53 (uniprotkb:P02340) and Fe65 (uniprotkb:Q9QXJ1) colocalize (MI:0403) by cosedimentation through density gradients (MI:0029)
d1 haem biogenesis – assessing the roles of three nir gene products
Authors: Zajicek Richard S. , Bali Shilpa , Arnold Simon , Brindley A. Amanda , Warren J. Martin , Ferguson Stuart J.
Published: October 2009

The synthesis of the modified tetrapyrrole known as d1 haem requires several dedicated proteins which are coded for by a set of genes that are often found adjacent to the structural gene, nirS, for cytochrome cd1 nitrite reductase. NirE, the product of the first gene in the nir biogenesis operon, was anticipated to catalyse the conversion of uroporphyrinogen III into precorrin‐2; this was confirmed, but it was shown that this enzyme is less sensitive to product inhibition than similar enzymes that function in other biosynthetic pathways. Sequence analysis suggesting that one of these proteins, NirN, is a c‐type cytochrome, and has similarity to the part of cytochrome cd1 that binds d1, was validated by recombinant production and characterization of NirN. A NirN–d1 haem complex was demonstrated to release the cofactor to a semi‐apo form of cytochrome cd1 from which d1 was extracted, suggesting a role for NirN in the assembly of cytochrome cd1 (NirS). However, inactivation of nirN surprisingly led to only a marginal attenuation of growth of Paracoccus pantotrophus under anaerobic denitrifying conditions. As predicted, NirC is a c‐type cytochrome; it was shown in vitro to be an electron donor to the NirN–d1 complex.
A Systematic Review of Literature About the Genetic Testing of Adolescents
Authors: Rew Lynn , Mackert Michael , Bonevac Daniel
Published: October 2009

PURPOSE.  Mapping of the human genome raises interest in and concern about the genetic testing of adolescents. Our purpose was to determine the attitudes and knowledge adolescents and their parents have about genetic testing.

DESIGN AND METHOD.  This paper is a report of a systematic review of the research literature (n = 56) about the attitudes and knowledge adolescents and their parents have about genetic testing.

RESULTS.  The majority of studies, which were descriptive in design, focused on a specific heritable disorder, were conducted in the United States, and over sampled well‐educated White females.

PRACTICE IMPLICATIONS.  Results suggest that adolescents and their families have relatively positive attitudes about genetic testing and may experience both harms and benefits from testing. Nurses may be in positions to assist adolescents and their families in making decisions about genetic testing, remaining sensitive to family dynamics and issues of privacy and autonomy.
A First Qualitative Project: Qualitative Descriptive Design for Novice Researchers
Authors: Magilvy Joan K. , Thomas Eileen
Published: October 2009

Joan K. Magilvy and Eileen Thomas Column Editor: Anne Marie Kotzer

Scientific Inquiry provides a forum to facilitate the ongoing process of questioning and evaluating practice, presents informed practice based on available data, and innovates new practices through research and experimental learning.
The age rank of the nearest pre-main-sequence groups
Authors: Lawson Warrick A. , Lyo A-Ran , Bessell M. S.
Published: October 2009

We address the age rank of the nearest pre-main-sequence (PMS) associations, using low-resolution spectrophotometry to measure gravity-sensitive indices in these stars. We compare spectral index-colour sequences for the PMS populations and rank them according to the strength of their gravity-sensitive features. The age rank using the gravity method is in general agreement with the ranking of these groups suggested by colour–magnitude (CM) diagram placement. Several of the groups have a kinematic origin in the Oph-Sco-Cen OB association. For three of them, their age rank is also in agreement with epochs resulting from a formation scenario for the OB association.
Primary care management of childhood and adolescent hypertension
Authors: Anglum Abigail
Published: October 2009

Purpose: To educate advance practice nurses on the diagnosis, pharmacologic, and nonpharmacologic management of hypertension in children and adolescents.

Data sources: Information was collected through a search of published literature and clinical practice guidelines.

Conclusions: Increasing rates of hypertension in children and adolescents are correlated to risk for coronary artery disease in adulthood. Nonpharmacologic management includes lifestyle modifications addressing weight reduction, physical activity, and dietary modification. Pharmacologic management is typically reserved for patients with severe hypertension or those who do not respond to lifestyle modifications. Early intervention is critical for preventing target‐organ damage and complications of long‐term hypertension.

Implications for practice: Nurse practitioners must identify and address elevated blood pressure levels in children and adolescents. Many children and adolescents can successfully lower blood pressure readings through nonpharmacologic lifestyle changes. Education about lifestyle modification strategies should focus on family‐based changes in order to increase likelihood of successful implementation.
Recipients' of implanted cardioverter‐defibrillators actual and perceived adaptation: a review of the literature
Authors: Zayac Susan , Finch Nancy
Published: October 2009

Purpose: To identify qualitative studies that have examined actual and perceived adaptation of patients to an implanted cardioverter‐defibrillator (ICD). The question explored was do recipients of ICDs experience real or perceived physical or psychological adaptation distress? Do themes expressed indicate a need for intervention that will facilitate postimplantation adjustment?

Data sources: A systematic search of the scientific literature uncovered 153 studies of which 12 met the following inclusion criteria: qualitative English research of psychological adaptation to the implantable defibrillator or qualitative research literature reviews. Exclusion criteria included unpublished studies, studies involving cardiac pacemaker devices without defibrillator, and quantitative research studies.

Conclusion: Multiple themes pertaining to adjustment to ICD therapy were identified, which warrants further study for potential therapeutic interventions. Themes identified by ICD recipients and their partners include perception of fear, anxiety, and dependence, and the desire for enhanced support and information. Increasing awareness of the complex adaptation issues related to ICD implantation should be a priority of primary care clinicians who provide follow‐up care for these patients.

Implications for Practice: ICD recipients have reported multiple physical and psychological adjustment issues that require further study to determine gravity and duration. Clinicians must be familiar with adjustment difficulty expressed by ICD recipients in order to facilitate appropriate tailored interventions. The findings of this literature review emphasize a need for support groups for ICD recipients and their partners; behavioral and sexual counseling; continued education after discharge; and a supportive healthcare provider who is knowledgeable in device adjustment issues. The research indicates a need for a post‐ICD implantation plan, and data are available for the design testing of tailored interventions.
Job satisfaction as self‐care within a restrictive regulatory environment: Nevada's study
Authors: Dunaway Linda J. , Running Alice
Published: October 2009

Purpose: Of western states, Nevada has experienced the greatest population growth and healthcare provider shortage, yet regulations remain restrictive and there are scarce published research data for nurse practitioner (NP) characteristics and none for job satisfaction. We viewed job satisfaction as reflective of professional self‐care based on Herzberg's job satisfaction theory and Orem's self‐care nursing theory.

Data sources: Surveys were mailed to 512 advanced practice nurses; only NPs were asked to respond.

Conclusions: The eligible NP sample was 315, or 61.5% of the total advanced nursing population. The sample was racially diverse, with a high male population. Job satisfaction was just over midway between “minimally satisfied” to “satisfied,” with the highest satisfaction in “challenge/autonomy” and the lowest in “professional growth.” Income was positively correlated with satisfaction for northern NPs earning less income and working fewer hours; bonuses were positively correlated for all. Those interested in higher education (e.g., doctorate) were younger, less experienced, part‐time, professional members, and urban (south).

Implications for practice: Findings provide insight for maximizing professional self‐care, particularly in areas of professional growth. Job satisfaction data assist leaders in maximizing the role for improving patient access to care, particularly in states with restrictive regulations.
Personal and social determinants of health services utilization by Mexican older people
Authors: De Córdova Maria Isabel Peñarrieta , Mier Nelda , Curi Ethel Jannet Mercado , Gómez Tranquilina Gutiérrez , Quirarte Nora Hilda Gonzales , Barrios Florabel Flores
Published: October 2009

de córdova m.i.p., mier n., curi e.j.m., gómez t.g., quirarte n.h.g. & barrios f.f. (2009) Personal and social determinants of health services utilization by Mexican older people. International Journal of Older People Nursing 5, 193–201 doi: 10.1111/j.1748‐3743.2009.00193.x

Background.  Increased healthcare needs among older individuals around the world demands a better understanding of factors influencing healthcare service utilization patterns.

Objective.  To examine personal and social correlates to health services utilization among Mexican older persons.

Design and methods.  This was a cross‐sectional study conducted between 2004 and 2006 with 2030 Mexican adults 60 years and older and based on a health services utilization framework. A two‐stage cluster sampling with probability proportionate to size was used. Participants were randomly selected and recruited in four metropolitan areas in Northeastern Mexico. Chi‐square and Pearson’s chi‐squared tests and logistic regression were used for data analyses.

Results.  Significantly more women than men had lost a spouse and were illiterate. Also, females reported significantly poorer health, higher nutritional risk and lower ability to perform activities of daily and instrumental living than males. Predictors of healthcare utilization were: Having a caregiver during an illness; perceiving to have a health problem; being able to afford food, and having children.

Conclusions.  Predisposing, enabling and need factors are strong predictors of health services utilization among Mexican older persons. In addition, gender differences exist among this population in relation to health status, but not to health services demands.
‘Alone with my pain – it can’t be explained, it has to be experienced’. A Norwegian in‐depth interview study of pain in nursing home residents
Authors: Gran Siv Venke , Festvåg Line S. , Landmark Bjørg Th
Published: October 2009

gran s.v., festvåg l.s. & Landmark b.t. (2009) ‘Alone with my pain – it can’t be explained, it has to be experienced’. A Norwegian in‐depth interview study of pain in nursing home residents. International Journal of Older People Nursing 5, 25–33 doi: 10.1111/j.1748‐3743.2009.00195.x

Background.  Nursing home residents often have pain as their everyday experiences and experience pain in silence.

Objectives.  The aim of this study was to gain an understanding of how nursing home residents experienced pain and how it influenced their lives and daily living.

Design.  The present study applied a descriptive design. Fifteen residents from nursing homes were recruited among the participants in a larger quantitative study who reported having pain.

Methods.  A qualitative method using in‐depth interviews was used. The data were analysed applying Kvale’s method of interpretive analysis.

Results.  Two dimensions of pain were identified: physical pain and pain as suffering. These are described in relation to factors that influence the intensity and the consequences of pain experiences.

Conclusions.  Physical pain may be relieved by various means of pain management. The residents experienced pain as suffering because pain management was not timely, inappropriate, or insufficient and also because of the nature of their social situation in nursing homes.

Relevance to clinical practice.  Caregivers in nursing homes need to understand how it feels for residents to live with pain, to be interested in and aware of their needs and finally to know how to respond to their pain and suffering.
Clinical efficacy and safety of a once‐daily formulation of carbimazole in cats with hyperthyroidism
Authors: Frénais R. , Rosenberg D. , Burgaud S. , Horspool L. J. I.
Published: October 2009

Objective:Evaluation of efficacy and safety of a novel controlled‐release formulation of carbimazole in feline hyperthyroidism.

Methods:A multicentre, self‐controlled study in 44 client‐owned cats with history and clinical signs of hyperthyroidism, and total thyroxine concentration greater than or equal to 50 nmol/l. Treatment was started at 15 mg once daily, response assessed after 10 days, and 3, 5, 8, 26 and 53 weeks and dose adjusted as required.

Results:The median dose of carbimazole was 10 mg (range 10 to 15 mg) and 15 mg (5 to 25 mg) once daily after 3 and 53 weeks, respectively. Median total thyroxine concentration dropped significantly from 118 nmol/l (50 to 320 nmol/l) at presentation to 33 nmol/l (n=40) after 10 days, 31 nmol/l (n=34) at 3 weeks and 21 nmol/l (n=18) at 53 weeks. Clinical signs improved or resolved in almost all cats within three weeks after starting treatment. Twenty‐one adverse reactions possibly (20) or probably (1) related to treatment were reported. During treatment, increased blood urea nitrogen concentration was observed in 25 per cent of the cats, eosinophilia in 20 per cent and lymphopenia in 16 per cent, while liver enzymes tended to improve.

ClinicalSignificance:Once daily administration of controlled‐release carbimazole tablets was effective and had expected tolerance in hyperthyroid cats during short‐ and long‐term treatment.
Intralesional corticosteroid injection in addition to endoscopic balloon dilation in a dog with benign oesophageal strictures
Authors: Fraune C. , Gaschen F. , Ryan Kirk
Published: October 2009

A three‐year‐old female spayed Golden retriever presented with a two‐week history of regurgitation due to oesophageal stricture formation. Further diagnostics revealed two oesophageal strictures located at the thoracic inlet and caudal to the heart base, respectively. Endoscopic balloon dilation was performed four times at weekly intervals but recurrence of stricture formation was noted clinically within a few days after each procedure and was confirmed endoscopically. Finally, intralesional injection of triamcinolone acetonide was performed in combination with the fifth balloon dilation procedure. The dog recovered clinically and a final endoscopic examination performed 16 weeks after the injection did not reveal any evidence of oesophageal strictures.