bluuebunny/crossref_metadata_2025 huggingface dataset:
Correction: Unscheduled Return Visits to the Emergency Department: Consequences for Triage
Authors: Sauvin Gabrielle , Freund Yonathan , Saïdi Khaled , Riou Bruno , Hausfater Pierre
Published: March 2013

Objectives

The objective was to conduct a survey of unscheduled revisits (URs) to the emergency department (ED) within 8 days of a prior visit, to test the hypothesis that patients making these URs are disproportionately likely to suffer short‐term mortality or manifest a need for any admission to the hospital (adverse events [AEs]) at the time of the UR, compared to patients triaged at the same level who did not have an unscheduled ED revisit within 8 days.

Methods

This was a 1‐year retrospective study of patients with an UR to the ED of an urban, 1,600‐bed tertiary care center and teaching hospital. The criteria for inclusion as an UR were: 1) making an emergency visit to our adult ED during 2008, without being admitted to our hospital nor being transferred to another hospital; and 2) subsequently making an UR to the same ED within 8 days following the first one. Patients who were contacted by members of our staff and specifically asked to make return visits to our ED (such as those who returned for wound care follow‐up visits), and those who made more than five visits to our ED during 2008, were excluded. AEs were defined as death or hospitalization within 8 days of the second visit.

Results

During 2008, there were 946 patients with URs (2% of patients treated and released after the first ED visit), and 931 were analyzed (n = 15 missing values). Associated with the second visit, an AE was noted for 276 (30%) patients. Eight variables were significantly associated with AE: age ≥ 65 years, previously diagnosed cancer, previously diagnosed cardiac disease, previously diagnosed psychiatric disease, presence of a relative at the time of the UR, arrival with a letter from a general practitioner at the time of the UR, a higher level of severity assigned at triage for the UR than for the first ED visit, and having had blood sample analysis performed during the first visit. The median triage score for the UR was not significantly different from that group's median triage score for the first ED visit, whereas the proportion of admissions to the hospital (29%) or to the intensive care unit (ICU; 2%) was greater overall in the UR group than in the patients making their first ED visit.

Conclusions

The authors observed that 2% of patients had an UR. This UR population was at greater risk of AE at the time of their URs compared to their initial visits, but the median triage nurse score was not significantly different between the first visit and the UR. This suggests that the triage score should be systematically upgraded for UR patients.
Endogenous Beliefs in Models of Politics
Authors: Minozzi William
Published: March 2013

In the standard rational choice model, actors have exogenously given beliefs that perfectly match objective probabilities. As such, these beliefs cannot be optimistic or motivated by preferences, even though substantial empirical evidence indicates that human beliefs routinely satisfy neither of these criteria. I present a tractable Endogenous Beliefs Model and apply it to three different political environments from across the subfields of political science. In the model, players form beliefs that maximize a utility function that represents preferences over outcomes and the anticipatory experience of uncertainty. Applications include voter turnout, taxation and collective choice, and crisis bargaining. The model captures the empirical evidence about belief formation much better than the standard model. Moreover, these applications show how rigidly insisting on the standard rational choice model rejects otherwise reasonable explanations by fiat, precisely because of its implausible assumptions about beliefs.
Aberrant deleted in liver cancer‐1 expression is associated with tumor metastasis and poor prognosis in urothelial carcinoma
Authors: Chen Wan‐Tzu , Yang Ching‐Hsiu , Wu Chun‐Chieh , Huang Ya‐Chun , Chai Chee‐Yin
Published: March 2013

This study explored the potential role of deleted in liver cancer‐1 (DLC‐1) as a prognostic indicator of cancer metastasis and survival in urothelial carcinoma (UC). Tissue microarrays were constructed from paraffin‐embedded specimens from 88 UC patients, and immunohistochemical staining was performed to investigate the association of DLC‐1 with clinicopathologic characteristics and clinical outcome. The DLC‐1 expression showed a significant positive correlation with tumor location (p = 0.041) and a significant negative correlation with advanced histological grade (p = 0.013). In tumors with low DLC‐1 expression, Bcl‐2 positivity was observed in 24.4% of cases. The DLC‐1 expression had significant negative associations with Bcl‐2 expression (p = 0.032) and with highly metastatic UC (p = 0.032). Kaplan–Meier analysis showed that DLC‐1 protein expression was negatively associated with both overall survival (OS) (p = 0.035) and with distant metastasis‐free survival (DMFS) (p = 0.041), but not with disease‐free survival. Multivariate analyses indicated that tumor size was the significant independent predictors of OS (p = 0.048); however, only DLC‐1 expression was a significant independent predictor of DMFS (p = 0.019). In conclusion, reduced DLC‐1 protein expression may be an important factor in tumor progression and a useful prognostic molecular marker in UC.
Dynamics of antibody response and viraemia following natural infection of porcine circovirus 2 (PCV‐2) in a conventional pig herd
Authors: Csank Tomáš , Pistl Juraj , Polláková Jana , Bhide Katarína , Herich Robert , Levkut Mikuláš
Published: March 2013

Porcine circovirus 2 (PCV‐2) is a primary agent of post‐weaning multi‐systemic wasting syndrome (PMWS), ubiquitous in pig herds. The course of viraemia and seroconversion in naturally infected pigs were investigated in piglets from the 2nd week of their life. Piglets were divided into seropositive (Ab+) and seronegative (Ab−) groups. Subsequently, after vaccination against PCV‐2 (Ingelvac® CIRCOFLEX™, Böehringer Ingelheim), they were further divided into non‐vaccinated seronegative (NVAC/Ab−) and seropositive (NVAC/Ab+), and vaccinated seronegative (VAC/Ab−) and seropositive (VAC/Ab+). PCV‐2 colostral antibodies failed to prevent development of natural PCV‐2 infection in conventional piglets; however, this occurred at a higher age in comparison with seronegative pigs. Neither colostral nor post‐infection antibodies prevented development of viraemia, which persisted up to the end of the study (the 19th week), but without clinical signs of PMWS. Vaccination failed to prevent development of natural PCV‐2 infection, but viraemia was limited to between the 8th and 10th week. The presence of colostral anti‐PCV‐2 antibodies did not show any untoward effect to vaccination; on the contrary, VAC/Ab+ animals showed the lowest titre of viraemia.
Angiotensin II causes imbalance between pro‐ and anti‐inflammatory cytokines by modulating GSK‐3β in neuronal culture
Authors: Agarwal Deepmala , Dange Rahul B , Raizada Mohan K , Francis Joseph
Published: March 2013

Background and Purpose

Emerging evidence indicates that the balance between pro‐inflammatory cytokines (PICs) and anti‐inflammatory cytokines (AICs) within the brain is an important determinant in the outcome of hypertension. However, the mechanism by which this dysregulation occurs is not known. We aimed to investigate whether AngII induces imbalance between PIC and AIC by modulating downstream transcription factors, NFκB and cyclic AMP response element‐binding protein (CREB), and whether AngII‐induced effects are mediated by glycogen synthase kinase‐3β (GSK‐3β).

Experimental Approach

CATH.a neurons were exposed to AngII (10 nM–1 μM) over a preset time course. In another set of experiments, GSK‐3β was knock down by using lentivirus containing short hairpin RNA targeting GSK‐3β (L‐sh‐GSK3β) before AngII exposure. Cell extracts were subjected to RT‐PCR, immunoblot and immunoprecipitation.

Key Results

AngII caused time‐dependent increase in PICs (TNF‐α and IL‐1β) and reduction in AIC (IL‐10). AngII exposure caused reduced phosphorylated CREB(Ser‐133) and increased p‐NFκB(Ser‐276) levels, leading to reduced CREB‐CBP and increased NFκB‐CBP binding. These results were accompanied by increased activation of GSK‐3β, as indicated by increased p‐GSK3(Tyr‐216) to p‐GSK3(Ser‐9) ratio. In a subsequent study, pretreatment with L‐sh‐GSK3β attenuated AngII‐induced alterations in PICs and IL‐10 by augmenting CREB‐CBP and attenuating NFκB‐CBP binding.

Conclusions and Implications

Collectively, these findings are the first to provide direct evidence that AngII‐induced dysregulation in cytokines is mediated by GSK‐3β‐mediated alterations in downstream transcription factors in neuronal cells. Our data also reveal that AngII‐induced effects could be alleviated by GSK‐3β inhibition, suggesting GSK‐3β as an important therapeutic target for hypertension that is characterized by increased PICs and NFκB activation.
MDMA‘ecstasy’ increases cerebral cortical perfusion determined by bolus‐tracking arterial spin labelling (btASL)MRI
Authors: Rouine J , Gobbo O L , Campbell M , Gigliucci V , Ogden I , McHugh Smith K , Duffy P , Behan B , Byrne D , Kelly M E , Blau C W , Kerskens C M , Harkin A
Published: March 2013

Background and Purpose

The purpose of this study was to assess cerebral perfusion changes following systemic administration of the recreational drug 3,4‐methylendioxymethamphetamine (MDMA‘ecstasy’) to rats.

Experimental Approach

Cerebral perfusion was quantified using bolus‐tracking arterial spin labelling (btASL)MRI. Rats receivedMDMA(20 mg·kg−1; i.p.) and were assessed 1, 3 or 24 h later. Rats receivedMDMA(5 or 20 mg·kg−1; i.p.) and were assessed 3 h later. In addition, rats receivedMDMA(5 or 10 mg·kg−1; i.p.) or saline four times daily over 2 consecutive days and were assessed 8 weeks later. Perfusion‐weighted images were generated in a 7 tesla (7T)MRIscanner and experimental data was fitted to a quantitative model of cerebral perfusion to generate mean transit time (MTT), capillary transit time (CTT) and signal amplitude.

Key Results

MDMAreducesMTTandCTTand increases amplitude in somatosensory and motor cortex 1 and 3 h following administration, indicative of an increase in perfusion. Prior exposure toMDMAprovoked a long‐term reduction in cortical 5‐HTconcentration, but did not produce a sustained effect on cerebral cortical perfusion. The response to acuteMDMAchallenge (20 mg·kg−1; i.p.) was attenuated in these animals indicating adaptation in response to priorMDMAexposure.

Conclusions and Implications

MDMAprovokes changes in cortical perfusion, which are quantifiable bybtASL MRI, a neuroimaging tool with translational potential. Future studies are directed towards elucidation of the mechanisms involved and correlating changes in cerebrovascular function with potential behavioural deficits associated with drug use.
N‐arachidonoyl glycine suppresses Na+/Ca2+ exchanger‐mediated Ca2+ entry into endothelial cells and activates BKCa channels independently of GPCRs
Authors: Bondarenko Alexander I , Drachuk Konstantin , Panasiuk Olga , Sagach Vadim , Deak Andras T , Malli Roland , Graier Wolfgang F
Published: March 2013

Background and Purpose

N‐arachidonoyl glycine (NAGly) is a lipoamino acid with vasorelaxant properties. We aimed to explore the mechanisms of NAGly's action on unstimulated and agonist‐stimulated endothelial cells.

Experimental Approach

The effects of NAGly on endothelial electrical signalling were studied in combination with vascular reactivity.

Key Results

In EA.hy926 cells, the sustained hyperpolarization to histamine was inhibited by the non‐selective Na+/Ca2+ exchanger (NCX) inhibitor bepridil and by an inhibitor of reversed mode NCX, KB‐R7943. In cells dialysed with Cs+‐based Na+‐containing solution, the outwardly rectifying current with typical characteristics of NCX was augmented following histamine exposure, further increased upon external Na+ withdrawal and inhibited by bepridil. NAGly (0.3–30 μM) suppressed NCX currents in a URB597‐ and guanosine 5′‐O‐(2‐thiodiphosphate) (GDPβS)‐insensitive manner, [Ca2+]i elevation evoked by Na+ removal and the hyperpolarization to histamine. In rat aorta, NAGly opposed the endothelial hyperpolarization and relaxation response to ACh. In unstimulated EA.hy926 cells, NAGly potentiated the whole‐cell current attributable to large‐conductance Ca2+‐activated K+ (BKCa) channels in a GDPβS‐insensitive, paxilline‐sensitive manner and produced a sustained hyperpolarization. In cell‐free inside‐out patches, NAGly stimulated single BKCa channel activity.

Conclusion and Implications

Our data showed that NCX is a Ca2+ entry pathway in endothelial cells and that NAGly is a potent G‐protein‐independent modulator of endothelial electrical signalling and has a dual effect on endothelial electrical responses. In agonist pre‐stimulated cells, NAGly opposes hyperpolarization and relaxation via inhibition of NCX‐mediated Ca2+ entry, while in unstimulated cells, it promotes hyperpolarization via receptor‐independent activation of BKCa channels.
Arylamine N‐acetyltransferases: a structural perspective
Authors: Zhou Xiaotong , Ma Zhiguo , Dong Dong , Wu Baojian
Published: March 2013

Arylamine N‐acetyltransferase (NAT) plays an important role in metabolism and detoxification of many compounds including drugs and environmental carcinogens through chemical modification of the amine group with an acetyl group. Recent studies have suggested that NATs are also involved in cancer cell growth and inhibition of the enzymes may be a potential target for cancer chemotherapy. Three‐dimensional (3D) structures are available for NATs from both prokaryotes and eukaryotes. These structures provide valuable insights into the acetylation mechanism, features of the active site and the structural determinants that govern substrate/inhibitor‐binding specificity. Such insights allow a more precise understanding of the structure–activity relationships for NAT substrates and inhibitors. Furthermore, the structural elucidation of NATs has generated powerful tools in the design of small molecule inhibitors that should alleviate cancer, based on the important role of the enzyme in cancer biology.
Stratigraphy and 40Ar/39Ar geochronology of the Santa Rosa basin, Baja California: Dynamic evolution of a constrictional rift basin during oblique extension in the Gulf of California
Authors: Seiler C. , Quigley M.C. , Fletcher J.M. , Phillips D. , Gleadow A.J.W. , Kohn B.P.
Published: March 2013

The Santa Rosa basin of northeastern Baja California is one of several transtensional basins that formed during Neogene oblique opening of the Gulf of California. The basin comprises Late Miocene to Pleistocene sedimentary and volcanic strata that define an asymmetric half‐graben above the Santa Rosa detachment, a low‐angle normal fault with ca. 4–5 km of SE‐directed displacement. Stratigraphic analysis reveals systematic basin‐scale facies variations both parallel and across the basin. The basin‐fill exhibits an overall fining‐upward cycle, from conglomerate and breccia at the base to alternating sandstone‐mudstone in the depocentre, which interfingers with the fault‐scarp facies of the detachment. Sediment dispersal was transverse‐dominated and occurred through coalescing alluvial fans from the immediate hanging wall and/or footwall of the detachment. Different stratigraphic sections reveal important lateral facies variations that correlate with major corrugations of the detachment fault. The latter represent extension‐parallel folds that formed largely in response to the ca. N‐S constrictional strain regime of the transtensional plate boundary. The upward vertical deflection associated with antiformal folding dampened subsidence in the northeastern Santa Rosa basin, and resulted in steep topographic gradients with a high influx of coarse conglomerate here. By contrast, the downward motion in the synform hinge resulted in increased subsidence, and led to a southwestward migration of the depocentre with time. Thus, the Santa Rosa basin represents a new type of transtensional rift basin in which oblique extension is partitioned between diffuse constriction and discrete normal faulting. 40Ar/39Ar geochronology of intercalated volcanic rocks suggests that transtensional deformation began during the Late Miocene, between 9.36 ± 0.14 Ma and 6.78 ± 0.12 Ma, and confirms previous results from low‐temperature thermochronology (Seiler et al., 2011). Two other volcanic units that appear to be part of a conformable syn‐rift sequence are, in fact, duplicates of pre‐rift volcanics and represent allochthonous, gravity‐driven slide blocks that originated from the hanging wall.
Suppression of autophagy by CUB domain‐containing protein 1 signaling is essential for anchorage‐independent survival of lung cancer cells
Authors: Uekita Takamasa , Fujii Satoko , Miyazawa Yuri , Hashiguchi Akinori , Abe Hitosi , Sakamoto Michiie , Sakai Ryuichi
Published: March 2013

CUB (C1r/C1s, urchin embryonic growth factor, BMP1) domain‐containing protein 1 (CDCP1) has been implicated in promoting metastasis of cancer cells through several mechanisms, including the inhibition of anoikis, which is cell death triggered by the loss of extracellular matrix interactions. However, the mechanism inhibiting cell death regulated by CDCP1 remains elusive. Inhibition of CDCP1 expression using small interfering RNA (siRNA) induced the cell death of suspended cancer cells without cleaving caspase‐3, a marker of apoptosis; cell death was not inhibited by a general caspase inhibitor, suggesting that the loss of CDCP1 induces caspase‐independent cell death. In contrast, knockdown of CDCP1 as well as protein kinase Cδ (PKCδ), a downstream effector of CDCP1, in a suspension culture of lung cancer cells resulted in marked induction of membranous microtubule‐associated protein 1 light chain 3 (LC3)‐II protein, a hallmark of autophagy, and caused the formation of an autophagosome structure visualized using green fluorescent protein‐tagged LC3‐II. Expression and phosphorylation of exogenous CDCP1 by Fyn kinase reduced the formation of autophagosomes and inhibited phosphorylation of CDCP1 by PP2, a Src kinase inhibitor or inhibited PKCδ by rottlerin, stimulating autophagosome formation. Moreover, death of suspended lung cancer cells induced by CDCP1 siRNA or by PKCδ siRNA was reduced by the autophagy inhibitor 3‐methyladenine. These results indicate that CDCP1‐PKCδ signaling plays a critical role in inhibiting autophagy, which is responsible for anoikis resistance of lung cancer cells.
Satellite tracking large numbers of individuals to infer population level dispersal and core areas for the protection of an endangered species
Authors: Schofield Gail , Dimadi Alexandra , Fossette Sabrina , Katselidis Kostas A. , Koutsoubas Drosos , Lilley Martin K. S. , Luckman Adrian , Pantis John D. , Karagouni Amalia D. , Hays Graeme C.
Published: March 2013

Aim

Tracking the dispersal patterns and habitat use of migratory species is necessary to delineate optimal areas for protection, with large sample sizes being more representative of the population. Here, we examine the dispersal patterns of a key Mediterranean loggerhead turtle (Caretta caretta) breeding population to identify priority foraging sites for protection.

Location

Zakynthos Island, Greece and the wider Mediterranean.

Method

We examined the dispersal patterns and foraging sites of 75 adult loggerheads (n = 38 males and 37 females) tracked from the breeding area of Zakynthos Island (Greece) from 2004 to 2011. We then combined our data with published sea turtle literature to identify key foraging sites for protection.

Results

While both males and females exhibited similar dispersal patterns, about 25% males remained < 100 km of Zakynthos, whereas all females (except one) migrated > 200 km. Integration of our data with the wider literature isolated 10 core sites in proximity to existing protected areas, which could potentially protect 64% of the Zakynthos population, while five sites support individuals from at least 10 other loggerhead breeding populations.

Main conclusions

Due to the widespread availability of neritic foraging grounds across the Mediterranean, sea turtles from Zakynthos exhibit disparate dispersal patterns. However, protecting only a few objectively defined important sites can encompass a large proportion of the foraging areas used and hence have considerable conservation benefit.
Passive muscle properties are altered in children with cerebral palsy before the age of 3 years and are difficult to distinguish clinically from spasticity
Authors: Willerslev‐Olsen Maria , Lorentzen Jakob , Sinkjær Thomas , Nielsen Jens BO
Published: March 2013

Aim

Clinical determination of spasticity is confounded by the difficulty in distinguishing reflex from passive contributions to muscle stiffness. There is, therefore, a risk that children with cerebral palsy (CP) receive antispasticity treatment unnecessarily. To investigate this, we aimed to determine the contribution of reflex mechanisms to changes in the passive elastic properties of muscles and tendons in children with CP.

Method

Biomechanical and electrophysiological measures were used to determine the relative contribution of reflex and passive mechanisms to ankle muscle stiffness in 35 children with spastic CP (21 males, 14 females; mean age 9y, SD 3y 4mo; range 3–15y) and 28 control children without CP (19 males, nine females; mean age 8y 11mo, SD 2y 10mo; range 3–15y). Twenty‐seven children were diagnosed as having spastic hemiplegia, six with spastic diplegia, and two with spastic tetraplegia. According to the Gross Motor Function Classification System, 31 children were classified in level I, two in level II, and two in level III.

Results

Only seven children with spastic CP showed reflex stiffness outside the range of the control children. In contrast, 20 children with spastic CP showed abnormal passive muscle stiffness (p<0.001). No correlation between increased reflex or increased passive muscle stiffness and age was observed within the age range studied.

Interpretation

These data suggest that increased reflex‐mediated muscle stiffness is difficult to distinguish clinically from changes in passive muscle stiffness and that signs of changes in muscle properties are already present from the age of 3 years in children with CP. This emphasizes the importance of accurately distinguishing different contributions to muscle stiffness to avoid unnecessary antispasticity treatment.
Objectively measured patterns of physical activity in primary school children in Coventry: the influence of ethnicity
Authors: Eyre E. L. J. , Duncan M. J. , Smith E. C. , Matyka K. A.
Published: March 2013

Aims

The aetiology of increased metabolic risk in South Asians is incompletely understood, but may include modifiable factors such as physical activity. This study assessed patterns of physical activity in UK primary school children and examined the influence of ethnicity.

Methods

We studied a community sample of children aged 8–9 years attending primary schools in Coventry, UK. One hundred and sixty‐one children wore combined physical activity and heart rate monitors for 7 days. Levels of activity and energy expenditure were compared between White European (n = 96) and South Asian children (n = 65). Patterns of physical activity during the school week were also described.

Results

Seventy‐three per cent of White Europeans compared with only 35% of South Asians achieved international recommendations of 60 minutes of moderate to vigorous physical activity daily (P < 0.0000). South Asians were less active during the week (106 ± 28 vs. 120 ± 32 counts/min, respectively, P = 0.0054) and at weekends (92 ± 34 vs. 108 ± 54 counts/min, P = 0.0118) compared with White Europeans. There were differences in energy expenditure with lower physical activity levels in South Asians (daily average 1.68 ± 0.13 vs. 1.76 ± 0.17, P < 0.0001). Differences were attributable to less activity after school in South Asians (97 ± 29 vs. 120 ± 43 counts/min, P < 0.0000) as daytime activity was comparable between groups (120 ± 41 vs. 124 ± 39 counts/min, P > 0.05).

Conclusion

South Asian children in Coventry do significantly less physical activity than White Europeans, mainly attributable to differences in after‐school activity. Ethnically tailored interventions should explore whether physical activity can be increased in South Asian children and, if so, whether this increased physical activity improves metabolic health.
Liver enzymes, race, gender and diabetes risk: the Atherosclerosis Risk in Communities (ARIC) Study
Authors: Schneider A. L. C. , Lazo M. , Ndumele C. E. , Pankow J. S. , Coresh J. , Clark J. M. , Selvin E.
Published: March 2013

Aims

To examine the associations of the liver enzymes alanine aminotransferase (ALT), aspartate aminotransferase(AST), and gamma‐glutamyl transferase (GGT) with diabetes risk and to determine whether associations differ by race and/or gender. We hypothesized that all liver enzymes would be associated with diabetes risk and that associations would differ by race and gender.

Methods

Prospective cohort of 7495 white and 1842 black participants without diabetes in the Atherosclerosis Risk in Communities Study. Poisson and Cox models adjusted for demographic, socio‐behavioural, and metabolic and health‐related factors were used.

Results

During a median of 12 years of follow‐up, 2182 incident cases of diabetes occurred. Higher liver enzyme levels were independently associated with diabetes risk: adjusted hazard ratios (95% confidence intervals) were 1.68 (1.49–1.89), 1.16 (1.02–1.31) and 1.95 (1.70–2.24) comparing the highest with the lowest quartiles of ALT, AST, and GGT, respectively. Gamma‐Glutamyl transferase was most strongly related to diabetes risk, even at levels considered within the normal range (≤ 60 U/l) in clinical practice. Adjusted incidence rates by quartiles of liver enzymes were similar by gender but higher in black versus white participants. Nonetheless, relative associations of ALT, AST, and GGT with diabetes were similar by race (P for interactions > 0.05).

Conclusions

Compared with ALT and AST, GGT was more strongly associated with diabetes risk. Our findings suggest that abnormalities in liver enzymes precede the diagnosis of diabetes by many years and that individuals with elevated liver enzymes, even within the normal range as defined in clinical practice, are at high risk for diabetes.
Dissociations between the horizontal and dorsoventral axes in body‐size perception
Authors: Hashimoto Teruo , Iriki Atsushi
Published: March 2013

Body size can vary throughout a person's lifetime, inducing plasticity of the internal body representation. Changes in horizontal width accompany those in dorsal‐to‐ventral thickness. To examine differences in the perception of different body axes, neural correlates of own‐body‐size perception in the horizontal and dorsoventral directions were compared using functional magnetic resonance imaging. Original and distorted (−30, −10, +10 and +30%) images of the neck‐down region of their own body were presented to healthy female participants, who were then asked whether the images were of their own body or not based explicitly on body size. Participants perceived body images distorted by −10% as their own, whereas those distorted by +30% as belonging to others. Horizontal width images yielded slightly more subjective own‐body perceptions than dorsoventral thickness images did. Subjective perception of own‐body size was associated with bilateral inferior parietal activity. In contrast, other‐body judgments showed pre‐supplementary motor and superior parietal activity. Expansion in the dorsoventral direction was associated with the left fusiform gyrus and the right inferior parietal lobule, whereas horizontal expansions were associated with activity in the bilateral somatosensory area. These results suggest neural dissociations between the two body axes: dorsoventral images of thickness may require visual processing, whereas bodily sensations are involved in horizontal body‐size perception. Somatosensory rather than visual processes can be critical for the assessment of frontal own‐body appearance. Visual body thickness and somatosensory body width may be integrated to construct a whole‐body representation.
The acute effects of light on murine sleep during the dark phase: importance of melanopsin for maintenance of light‐induced sleep
Authors: Muindi Fanuel , Zeitzer Jamie M. , Colas Damien , Heller H. Craig
Published: March 2013

Light exerts a direct effect on sleep and wakefulness in nocturnal and diurnal animals, with a light pulse during the dark phase suppressing locomotor activity and promoting sleep in the former. In the present study, we investigated this direct effect of light on various sleep parameters by exposing mice to a broad range of illuminances (0.2–200 μW/cm2; equivalent to 1–1000 lux) for 1 h during the dark phase (zeitgeber time 13–14). Fitting the data with a three‐parameter log model indicated that ∼0.1 μW/cm2 can generate half the sleep response observed at 200 μW/cm2. We observed decreases in total sleep time during the 1 h following the end of the light pulse. Light reduced the latency to sleep from ~30 min in darkness (baseline) to ~10 min at the highest intensity, although this effect was invariant across the light intensities used. We then assessed the role of melanopsin during the rapid transition from wakefulness to sleep at the onset of a light pulse and the maintenance of sleep with a 6‐h 20 μW/cm2 light pulse. Even though the melanopsin knockout mice had robust induction of sleep (~35 min) during the first hour of the pulse, it was not maintained. Total sleep decreased by almost 65% by the third hour in comparison with the first hour of the pulse in mice lacking melanopsin, whereas only an 8% decrease was observed in wild‐type mice. Collectively, our findings highlight the selective effects of light on murine sleep, and suggest that melanopsin‐based photoreception is primarily involved in sustaining light‐induced sleep.
Identification of an essential active‐site residue in the α‐d‐phosphohexomutase enzyme superfamily
Authors: Lee Yingying , Mehra‐Chaudhary Ritcha , Furdui Cristina , Beamer Lesa J.
Published: March 2013

Enzymes in the α‐d‐phosphohexomutase superfamily catalyze the conversion of 1‐phosphosugars to their 6‐phospho counterparts. Their phosphoryl transfer reaction has long been proposed to require general acid–base catalysts, but candidate residues for these key roles have not been identified. In this study, we show through mutagenesis and kinetic studies that a histidine (His329) in the active site is critical for enzyme activity in a well‐studied member of the superfamily, phosphomannomutase/phosphoglucomutase from Pseudomonas aeruginosa. Crystallographic characterization of an H329A mutant protein showed no significant changes from the wild‐type enzyme, excluding structural disruption as the source of its compromised activity. Mutation of the structurally analogous lysine residue in a related protein, phosphoglucomutase from Salmonella typhimurium, also results in significant catalytic impairment. Analyses of protein–ligand complexes of the P. aeruginosa enzyme show that His329 is appropriately positioned to abstract a proton from the O1/O6 hydroxyl of the phosphosugar substrates, and thus may serve as the general base in the reaction. Histidine is strongly conserved at this position in many proteins in the superfamily, and lysine is also often conserved at a structurally corresponding position, particularly in the phosphoglucomutase enzyme sub‐group. These studies shed light on the mechanism of this important enzyme superfamily, and may facilitate the design of mechanism‐based inhibitors.

Database

Structural data have been deposited in the Protein Data Bank with accession number 4IL8.
Mih1/Cdc25 is negatively regulated by Pkc1 in Saccharomyces cerevisiae
Authors: Yano Kouitiro , Uesono Yukifumi , Yoshida Satoshi , Kikuchi Akihiko , Kashiwazaki Jun , Mabuchi Issei , Kikuchi Yoshiko
Published: March 2013

Mitotic cyclin‐dependent kinase (CDK) is activated by Cdc25 phosphatase through dephosphorylation at the Wee1‐mediated phosphorylation site. In Saccharomyces cerevisiae, regulation of Mih1 (Cdc25 homologue) remains unclear because inactivation/degradation of Swe1 (Wee1 homologue) is the main trigger for G2/M transition. By deleting all mitotic cyclins except Clb2, a strain was created where Mih1 became essential for mitotic entry at high temperatures. Using this novel assay, the essential domain of Mih1 was identified and Mih1 regulation was characterized. Mih1(3E1D) with phosphomimetic substitutions of four putative PKC target residues in Mih1 had a reduced complementation activity, whereas Mih1(4A) with those nonphosphorylatable substitutions was active. The band pattern of Mih1 by SDS‐PAGE was similar to that of Mih1(4A) only after inactivation of Pkc1 in a pkc1ts mutant. Over‐expression of GFP‐tagged Mih1 or GFP‐Mih1(4A) accumulated as dot‐like structures in the nucleus, whereas GFP‐Mih1(3E1D) was localized in the cytoplasm. Over‐expression of an active form of Pkc1 excluded GFP‐Mih1 from the nucleus, but had minimal effect on GFP‐Mih1(4A) localization. Furthermore, addition of ectopic nuclear localization signal to the Mih1(3E1D) sequence recovered complementation activity and nuclear localization. These results suggest that Mih1 is negatively regulated by Pkc1‐mediated phosphorylation, which excludes it from the nucleus under certain conditions.
A review of the pharmacological management of type 2 diabetes in a rural Australian primary care cohort
Authors: Kellow Nicole , Khalil Hanan
Published: March 2013

Objectives

Multiple drug combination therapy aimed at controlling glucose, blood pressure, lipids and fibrinolysis significantly reduces micro- and macrovascular morbidity and mortality in patients with type 2 diabetes. The aims of this study were to (1) identify gaps between current medication management and evidence-based treatment targets in a rural cohort of Australian adults with type 2 diabetes and (2) determine patient factors associated with the prescribing of medications to patients with type 2 diabetes.

Methods

Two hundred and seventy-two medical records were randomly selected from a regional health service type 2 diabetes database. Demographic, biochemical, anthropometric, pharmacological, co-morbidity and lifestyle data during the initial 5 years post diagnosis were collected and analysed.

Key findings

Five years post type 2 diabetes diagnosis only 12% of the cohort were meeting optimal targets for glucose, blood pressure, low-density lipoprotein, high-density lipoprotein and triglyceride. Younger age (odds ratio, OR 0.96; 95% confidence interval, CI 0.94–0.99; P < 0.05) and elevated urinary microalbumin (OR 1.02; 95% CI 1.01–1.03; P < 0.05) were significantly associated with anti-diabetic medication treatment. The only independent factor associated with pharmacological treatment for hypertension was elevated HbA1c (OR 1.4; 95% CI 1.0–2.0; P < 0.05). Patient factors associated with prescription of lipid-lowering agents were a past history of cardiovascular disease (OR 5.0; 95% CI 2.0–12.5; P < 0.001), concurrent use of anti-hypertensive agents (OR 2.6; 95% CI 1.2–5.8; P < 0.05) and elevated triglyceride (OR 1.9; 95% CI 1.2–3.1; P < 0.01).

Conclusion

Treatment targets were not being translated into clinical practice in this cohort of patients with type 2 diabetes. Patients with acceptable HbA1c levels, with no history of cardiovascular disease and those taking few medications were at risk of being overlooked for the pharmacotherapy they required.
Consumer–pharmacist interactions around complementary medicines: agreement between pharmacist and consumer expectations, satisfaction and pharmacist influence
Authors: Tran Sophia , Calabretto Jean-Pierre , Sorich Michael
Published: March 2013

Objective

To explore pharmacist–consumer interactions around the use of complementary medicines (CMs), with specific focus on consumer expectations, perceptions and satisfaction.

Methods

Twenty pharmacists and 20 healthcare consumers were recruited across 16 metropolitan community pharmacies in Adelaide, Australia, from June to August 2011. Semi-structured interviews containing comparable questions for both study groups were used. Data was transcribed and analysed with the aid of AutoMap®.

Key findings

 There was high consumer satisfaction with pharmacists as CM providers, which was in agreement with pharmacist's perceptions of consumer satisfaction. However, this was against a background of low consumer expectations and pharmacists' dissatisfaction with their own role in the interaction. Consumers often perceived pharmacy-stocked CMs to be more effective and safer compared to those in supermarkets or health food shops, but this perception was not shared by pharmacists. Pharmacists believed they had significant influence around recommendation and use of CMs, whereas consumers perceived a more limited influence. Both pharmacists and consumers shared similar perceptions of CM safety and similar expectations regarding business influence and professional pressures on information provision.

Conclusion

Behind a perception of high satisfaction, consumers have low expectations of pharmacists around provision of CM-related information. Further work is required to improve pharmacists' knowledge and confidence around CM use and to address barriers such as the tension between potentially competing business pressures and professional responsibilities.
Opciones de cuidados alternativos y elección de políticas para apoyar a los huérfanos: el caso de Mozambique en el contexto de la Comunidad de Desarrollo del África Meridional
Authors: Shibuya Tomoko , Taylor Viviene
Published: March 2013

Contextualizando la situación de los huérfanos en la región del África Meridional y basándose en la investigación cuantitativa y cualitativa, el presente artículo analiza las opciones de cuidados y las políticas de protección social para los huérfanos en Mozambique, focalizándose en los niños que se encuentran en los centros de apoyo a los huérfanos. En la búsqueda orientada a brindar nuevas perspectivas y una mayor comprensión de las experiencias de los niños que reciben cuidados y de la protección social de que éstos disponen, la investigación pone de relieve la mayor probabilidad de que los niños huérfanos que viven en instituciones informales de cuidados experimenten abusos, abandono y malos tratos respecto de aquellos que viven en instituciones de cuidados no gubernamentales. La investigación pone el acento en que se requiere una selección más cuidadosa de las familias adoptivas que acogen a los niños. Las recomendaciones incluyen la necesidad de centrarse en el desarrollo de capacidades y en unas reformas institucionales dirigidas a implementar políticas de protección social para los niños huérfanos, como parte de un piso de protección social general. La supervisión y la evaluación de las organizaciones que brindan cuidados a los niños huérfanos se consideran una prioridad.
Early Discharge with Domiciliary Visits and Hospital Care
Authors: Waldenström Ulla
Published: March 2013

ABSTRACT. Parents' experiences of two modes of post‐partum care are described: hospital discharge 24–48 h after the birth followed by domiciliary visits by a midwife and traditional hospital care. Women interested in participating in an early discharge study were, in late pregnancy, randomly allocated to an experimental group (EG, n = 50) offered the first alternative, and a control group (CG, n = 54) offered the second. A random sample of the non‐participants (NP group, n = 240) was also collected. Ninety‐two per cent of the women and 83% of the men in the EG had only a positive experience of the early discharge programme, while only 40 and 30% of the CG women and men respectively, had only positive experience of the hospital post‐partum period. Parents with no interest in early discharge (NP group), however, had better experience of the hospital care: 78% of the women and 66% of the men were positive. EG and CG parents emphasised the home setting as more natural and calm, and the importance for the family to be together. They wanted early discharge in order to be close to the newborn both day and night, and not to be separated from the other children. Parents in the NP group emphasised the medical security and support, and the opportunity for the mother to rest in hospital.
Prediction of Pressure Sore Development
Authors: Ek Christina‐Anna
Published: March 2013

ABSTRACT. The condition of 515 consecutive patients newly admitted to the long‐term medical ward was followed weekly during a 26‐week maximum observation period. A modified Norton scale consisting of eight variables and constructed as an additive scale was used. Serum albumin level and skin test on admission supplemented the information about the nutritional state. Eighty‐three patients (16%) had skin lesions classified as pressure sores on admission and 39 patients (7.6%) developed pressure sores during the observation period. It could be shown that those who developed pressure sores during the observation period, had a lower functional level when they arrived and that this deteriorated up until the time that the pressure sore was recorded. It could also be demonstrated that low serum albumin and anergy, as indicators of poor nutritional status, had value as predictors for the development of pressure lesions. General physical condition, activity, mobility and nutritional status appear to be the most important factors in the development of pressure sores in this study. The systematic planning of care with special emphasis on the four above‐named risk factors, can probably decrease the risk for the development of pressure sores.
Patterns of Care for Patients with Cancer before and after the Establishment of a Hospice Ward
Authors: Andershed Birgitta , Ternestedt Britt‐Marie
Published: March 2013

A majority of people die in acute hospital care, in a culture of quickness primary aimed at curing. There are indications that hospice care in various forms will spread during the present decade in Sweden. The hospice philosophy contributes to a culture of slowness, where the patient is not only allowed but is encouraged to live at his own pace. As a first step in establishing for whom hospice inpatient care is the best alternative, patient flow to a newly started hospice ward was studied. All patients (n = 1464) who died at the Medical Centre Hospital with a primary diagnosis of cancer during the period of study were compared regarding place of death, diagnosis, gender, age and length of the last period of care. The year before the ward was established, 82% of patients died in acute hospital care compared with 59% during the hospice ward's third year of operation. A total of 315 patients (22%) died in the hospice ward during the study period. The percentage of these patients over the age of 80 was significantly higher (p = 0.0001), and they also had a longer continuous final period of care. More women (57%) than men (43%) were cared for at the hospice ward. The hospice ward has in this way influenced the pattern of care in the hospital.
The Effectiveness of the Mental Health Nursing Inverventions in a General Hospital
Authors: Priami Maria , Plati Chrysanthi
Published: March 2013

The purpose of the study was to investigate: a) how mental health nursing interventions were provided to general hospital patients, who during their hospitalization presented psychological/pyschiatric problems and b) how the patients actually evaluate the effectiveness of the care given to them. We interviewed 95 medical‐surgical patients, who were referred to the psychiatric consultation‐liaison service of a general hospital. During the interview, a nursing evaluation of the patients' psychological problems took place, followed by appropriate mental health nursing interventions which were taken from the NOSIE scale and the standards of the Psychiatric Mental Health Nursing Practice. Anxiety was the most common problem 41.1% in the referrals. The comparison of the mean value of the patients' problems before and those after the mental health nursing interventions, showed statistically significant reduction of the problems. Also, the comparison of the mean value in the fourth assessment of the patients' problems with the mean value of the patients' opinion, showed an achievement in facilitating the verbal expression and comforting the physical and psychological symptoms to a point statistically significant.
Descriptions of Suffering in Connection with Life Values
Authors: Graneheim Ulla H. , Lindahl Elisabeth , Kihlgren Mona
Published: March 2013

Nine semistructured interviews with attendant questions were conducted with the purpose of elucidating how healthy individuals describe suffering and life values in their reflections upon active euthanasia. In order to find the intended meaning in utterances, the interviews were interpreted step by step. The point of departure was the following question: What expressions of suffering and what expressions of life values can be found in the text? A connection was found between the interviewees' descriptions of suffering and life values in their reflections upon active euthanasia. The interviewees who considered close relations to be a value of life expressed suffering as dependence, compassion, violation, abandonment and feelings of guilt, while those to whom health was a value of life expressed suffering as torment, dependence, physical pain, feebleness, hopelessness and dying. Those who saw autonomy as a value of life expressed suffering as dependence and violation, and those to whom doing good was a value of life expressed suffering as compassion. When organizing health care and deciding about the response to suffering, it seems important to strive for a response built upon the individual patient's description of suffering and life values.
Laboratory Technologists' Attitudes Towards AIDS and AIDS Patients
Authors: Liikanen Eeva , Aavarinne Helena
Published: March 2013

The purpose of this study was to examine the attitudes of laboratory staff towards AIDS and AIDS patients and related factors. The population consisted of the working‐age laboratory technologists living in Finland (n = 5 973). A sample of 249 laboratory technologists was selected from the register of the National Research and Development Centre for Welfare and Health using systematic random selection. The material was collected with a questionnaire. The younger laboratory technologists had more knowledge about AIDS than the older ones, and those who had more knowledge about AIDS had a more positive attitude than those with less knowledge. The attitudes were connected with the way the disease was contracted: the most positive attitudes were expressed towards the patients who had contracted AIDS through blood transfusion and the most negative towards the patients who had contracted AIDS from non‐sterile needles. The factor analysis yielded six factors representing attitudes. The fear factor explained most (19%) of the laboratory technologists' attitudes towards AIDS and AIDS patients. The older laboratory technologists were more afraid of work‐related infections than the younger ones. The laboratory technologists with adequate knowledge of AIDS were less afraid of contracting the virus than those with little knowledge. They wanted information mainly on the care of AIDS patients, on how to respond to them and on the ways AIDS is transmitted.