bluuebunny/crossref_metadata_2025 huggingface dataset:
Annual Research Review: Phenotypic and causal structure of conduct disorder in the broader context of prevalent forms of psychopathology
Authors: Lahey Benjamin B. , Waldman Irwin D.
Published: December 2011

Background:  A better understanding of the nature and etiology of conduct disorder (CD) can inform nosology and vice versa. We posit that any prevalent form of psychopathology, including CD, can be best understood if it is studied in the context of other correlated forms of child and adolescent psychopathology using formal models to guide inquiry.

Methods:  Review of both cross‐sectional and longitudinal studies of the place of CD in the phenotypic and causal structure of prevalent psychopathology, with an emphasis on similarities and differences between CD and oppositional defiant disorder (ODD). Papers were located using Web of Science by topic searches with no restriction on year of publication.

Results:  Although some important nosologic questions remain unanswered, the dimensional phenotype of CD is well defined. CD differs from other disorders in its correlates, associated impairment, and course. Nonetheless, it is robustly correlated with many other prevalent dimensions of psychopathology both concurrently and predictively, including both other ‘externalizing’ disorders and some ‘internalizing’ disorders. Based on emerging evidence, we hypothesize that these concurrent and predictive correlations result primarily from widespread genetic pleiotropy, with some genetic factors nonspecifically influencing risk for multiple correlated dimensions of psychopathology. In contrast, environmental influences mostly act to differentiate dimensions of psychopathology from one another both concurrently and over time. CD and ODD share half of their genetic influences, but their genetic etiologies are distinct in other ways. Unlike most other dimensions of psychopathology, half of the genetic influences on CD appear to be unique to CD. In contrast, ODD broadly shares nearly all of its genetic influences with other disorders and has little unique genetic variance.

Conclusions:  Conduct disorder is a relatively distinct syndrome at both phenotypic and etiologic levels, but much is revealed by studying CD in the context of its causal and phenotypic associations with other disorders over time. Advancing and refining formal causal models that specify the common and unique causes and biological mechanisms underlying each correlated dimension of psychopathology should facilitate research on the fundamental nature and nosology of CD.
The timing of maternal depressive symptoms and child cognitive development: a longitudinal study
Authors: Evans Jonathan , Melotti Roberto , Heron Jon , Ramchandani Paul , Wiles Nicola , Murray Lynne , Stein Alan
Published: December 2011

Background:  Maternal depression is known to be associated with impairments in child cognitive development, although the effect of timing of exposure to maternal depression is unclear.

Methods:  Data collected for the Avon Longitudinal Study of Parents and Children, a longitudinal study beginning in pregnancy, included self‐report measures of maternal depression the Edinburgh Postnatal Depression Scale, completed on 6 occasions up to 3 years of age, and IQ of the index child (WISC) measured at aged 8 years. We used these data to assign women to 8 groups according to whether depression occurred in the antenatal, postnatal, preschool period, any combination of these times, or not at all. We compared a model comprising all patterns of depression (saturated model) with models nested within this to test whether there is a relationship between depression and child cognitive development and, if so, whether there is a sensitive period. We then investigated the relationship with child IQ for each model, following adjustment for confounders.

Results:  Six thousand seven hundred and thirty‐five of 13,615 children from singleton births (49.5%, of eligible core sample) attended a research clinic at 8 years and completed a WISC with a score ≥ 70. A total of 5,029 mothers of these children had completed mood assessments over the 3 time periods. In unadjusted analyses, all three sensitive period models were as good as the saturated model, as was an accumulation model. Of the sensitive period models, only that for antenatal exposure was a consistently better fit than the accumulation model. After multiple imputation for missing data (to n = 6,735), there was no effect of postnatal depression on child IQ independent of depression at other times [−0.19 IQ points, 95% confidence interval (CI) −1.5 to 1.1 points]. There was an effect of antenatal depression (−3.19 IQ points, 95% CI: −4.33 to −2.06) which attenuated following adjustment (−0.64 IQ points, 95% CI: −1.68 to 0.40).

Conclusions:  The postnatal period is not a sensitive one for the effect of maternal depression on child cognitive development.
The physicochemical characteristics of nonfat set yoghurt containing some hydrocolloids
Authors: LUNARDELLO KAMILLA AVELINO , YAMASHITA FÁBIO , DE TOLEDO BENASSI MARTA , DE RENSIS CHRISTIANE MACIEL VASCONCELLOS BARROS
Published: December 2011

The effect of incorporating the hydrocolloids carrageenan (0.10%, 0.30%), xanthan gum (0.15%, 0.35%) and alginate (0.05%, 0.15%) in nonfat set yoghurt was examined in respect of instrumental texture profile and water‐holding capacity (WHC) of the yoghurt. The yoghurts which exhibited the similar behaviour of commercial yoghurts in terms of WHC, firmness and consistency, low adhesiveness and gumminess were analysed by difference‐from‐control sensory test. Carrageenan increased firmness, adhesiveness, gumminess and WHC at the highest concentration tested. The sensory tests did not show any significant difference between the formulations tested.
Evaluation of physicochemical, microbiological and sensorial characteristics of fermented milk beverages with buttermilk addition
Authors: DE BASSI LARISSA GUILHERME , FERREIRA GÉSSICA CAMILA CAETANO , DA SILVA ALISSON SANTANA , SIVIERI KÁTIA , ARAGON‐ALEGRO LINA CASALE , COSTA MARCELA DE REZENDE
Published: December 2011

This study evaluated three fermented milk beverages to which had been added sugar strawberry puree post‐fermentation. The base was composed of 70% of milk, with whey and buttermilk in the concentrations of 30% and 0%, 15% and 15%, and 0% and 30%, respectively. The starter culture developed well with all formulations reaching pH 4.7–4.9 in 180 min of fermentation. Lactic acid bacteria in the products were above 8 log cfu/mL throughout the study. The beverages presented similar pH, acidity and viscosity. Buttermilk and whey can be interesting ingredients to be added into fermented milk beverages, because the consumers liked all the products equally, which had an average acceptance score exceeding ‘liked moderately’.
Questions and Answers: Some Questions Discussed at One of the Round Tables Held at Chicago Institute with Public Health Nurses
Authors: Crandall Ella Phillips
Published: December 2011

There were a number of issues confronting public health nurses in 1919, including the differentiation of practice between visiting nurses and public health nurses, use of community partnerships when developing a new nursing service in a community, and standards of nursing work. Other issues included the focus of nursing work at the community/population versus individual level, how to balance the work load where there was only one nurse in a community, and educating the public about the value of public health nursing to the community. In this excerpt from the original publication, Ella Phillips Crandall responded to questions raised at a round table session held in Chicago in 1919 as a part of a Public Health Nursing Forum, and then published in the October 1919 issue of The Public Health Nurse. While the social context in which PHNs worked in 1919 were significantly different from those nurses face today, these insights are prescient to the issues faced by PHNs today as the profession continues to address issues related to standards of practice, role development, and educational preparation for both entry level and advanced practice.
Lessons Learned from Toulouse and Buncefield Disasters: From Risk Analysis Failures to the Identification of Atypical Scenarios Through a Better Knowledge Management
Authors: Paltrinieri Nicola , Dechy Nicolas , Salzano Ernesto , Wardman Mike , Cozzani Valerio
Published: December 2011

The recent occurrence of severe major accidents has brought to light flaws and limitations of hazard identification (HAZID) processes performed for safety reports, as in the accidents at Toulouse (France) and Buncefield (UK), where the accident scenarios that occurred were not captured by HAZID techniques. This study focuses on this type of atypical accident scenario deviating from normal expectations. The main purpose is to analyze the examples of atypical accidents mentioned and to attempt to identify them through the application of a well‐known methodology such as the bow‐tie analysis.

To these aims, the concept of atypical event is accurately defined. Early warnings, causes, consequences, and occurrence mechanisms of the specific events are widely studied and general failures of risk assessment, management, and governance isolated.

These activities contribute to outline a set of targeted recommendations, addressing transversal common deficiencies and also demonstrating how a better management of knowledge from the study of past events can support future risk assessment processes in the identification of atypical accident scenarios. Thus, a new methodology is not suggested; rather, a specific approach coordinating a more effective use of experience and available information is described, to suggest that lessons to be learned from past accidents can be effectively translated into actions of prevention.
V. THE NEUROBIOLOGICAL TOLL OF EARLY HUMAN DEPRIVATION
Authors: Nelson Charles A. , Bos Karen , Gunnar Megan R. , Sonuga‐Barke Edmund J. S.
Published: December 2011

Children raised in institutions frequently suffer from a variety of behavioral, emotional, and neuropsychological sequelae, including deficits in attention, executive functions, disorders of attachment, and in some cases a syndrome that mimics autism. The extent and severity of these disorders appear to be mediated, in part, by the age at which the child entered and, in some cases, left the institution. Here we review the neurobiological literature on early institutionalization that may account for the psychological and neurological sequelae discussed in other chapters in this volume.
VII. IDEAL COMPONENTS AND CURRENT CHARACTERISTICS OF ALTERNATIVE CARE OPTIONS FOR CHILDREN OUTSIDE OF PARENTAL CARE IN LOW‐RESOURCE COUNTRIES
Authors: Groza Victor K. , Bunkers Kelley McCreery , Gamer Gary N.
Published: December 2011

Utilizing the United Nations Convention on the Rights of the Child and the Guidelines for the Alternative Care of Children, this paper examines critical components and current characteristics of alternative care for children in low‐resource countries. It begins by exploring the role of values within policy and practice related to child welfare. Then a brief examination comparing alternative care in high‐ versus low‐resource countries is presented. Alternative care includes a continuum approach beginning with family support and reunification, kinship care, foster care, domestic adoption, and ending with intercountry adoption. Specific examples are provided from Eastern Europe, Latin America, and Africa. The paper concludes with the need for more research related to alternative care outcomes that could inform policy and practice.
Study of the Gelling Process in the La‐Co‐Citric Acid System
Authors: Predoana Luminita , Jitianu Andrei , Malic Barbara , Zaharescu Maria
Published: December 2011

The gelling process in the aqueous lanthanum‐cobalt‐citric acid system was studied using UV‐VIS and IR spectroscopic methods, as well as viscosity measurements, to establish the gelling mechanism of transition metal ions (La3+ and Co2+) in the presence of chelating agent.

Lanthanum and cobalt nitrates and lanthanum and cobalt acetates, respectively, were used as starting reagents, and the citric acid was used as chelating agent. The gelation process was investigated at room temperature and at 80°C. At elevated temperature, the gels were obtained after 30 h, whereas at room temperature, these were obtained in 1 month.

Complex gels were formed for the both studied systems. The Co2+ ions mainly present an octahedral symmetry during the whole gelation process, whereas the citric acid acts as monodentate or bridging ligand depending on the metal precursors used. The mechanism of formation of the La‐Co‐CA based gels with the coordinative structures was proposed.
Microstructures and Properties of Submicrometer Carbides Obtained by Conventional Sintering
Authors: Soares Eduardo , Malheiros Luis F. , Sacramento Joaquim , Valente Manuel A. , Oliveira Filipe J.
Published: December 2011

Submicrometer carbides (0.2–0.8 μm) are technologically important new materials because they can reach very high hardness with good mechanical resistance and excellent hardness/toughness combinations, making them especially effective for the wear tools market. Sintering of these engineering materials requires a careful process control to reach the maximum densification without damaging irreversibly the grain size, fundamental for reaching the expected properties. Especially for larger wear tools, which are more complex to produce, further know‐how regarding sintering optimization is required to improve their quality and consistency. In this work, grades from WC 0.6 μm and WC 0.4 μm powders, combined with varying contents of 0.7 μm Co powder (from 2 to 12 wt%), were prepared by water technology to reach high‐quality powder mixtures. Thermal analyses were performed to obtain the powders shrinkage profile and sintering temperatures. Pressed powder samples were vacuum‐ and sinterHIP‐sintered at different temperatures on industrial furnaces and their relevant properties were analyzed. Some practical aspects, like compaction pressures, carbon content influence on sintered properties were also addressed. Low Co (<6 wt%) grades presented exceptional high hardness levels (>2200HV30) and hardness/toughness ratios (2200HV30/8.7 MPa·m1/2) although requiring special sintering cycles at higher pressures. The data collected in this work will be further used to optimize the sintering and maximize densification of these special grades using HIP – Hot Isostatic Pressing technology.
Crystallization Mechanism of the Bioactive Glasses, 45S5 and S53P4
Authors: Massera Jonathan , Fagerlund Susanne , Hupa Leena , Hupa Mikko
Published: December 2011

The crystallization kinetics of the two commercial bioactive glasses, 45S5 and S53P4, was studied using differential thermal analysis (DTA), optical microscopy, and scanning electron microscopy (SEM). The thermal properties, the activation energy of crystallization, and the Johnson‐Mehl‐Avrami (JMA) exponent were determined for two glass fractions: fine powder (<45 μm) and coarse powder (300–500 μm). The crystallization behavior of 45S5 was significantly different for the two fractions, whereas the particle size did not affect the crystallization behavior of S53P4. The JMA exponent of S53P4 suggested surface crystallization for both size fractions. However, for 45S5, the JMA exponent suggested that, with increasing particle size, crystallization evolves from predominantly surface crystallization to predominantly bulk crystallization. Surprisingly, SEM imaging did not support this conclusion. A method based on the crystallization rate dα/dt showed that the JMA approach could not be employed for 45S5. The crystallization mechanism of 45S5 appears to be more complex than a simple nucleation and growth process. Nucleation‐like curves were measured for both fractions of the two glasses. The maximum nucleation rate occurred at 566 ± 4°C and 608 ± 4°C for the coarse powders of 45S5 and S53P4, respectively. The higher maximum nucleation temperature of S53P4 was attributed to the higher SiO2 content. The nucleation temperature range of these two glasses together with DTA data makes it possible to develop guidelines for tailoring thermal treatment parameters to achieve desired glass‐to‐crystal ratios.
Preparation of Porous, Hierarchically Organized Glass Monoliths via Combination of Sintering and Phase Separation
Authors: Reinhardt Bjoern , Enke Dirk , Syrowatka Frank
Published: December 2011

Hierarchically structured, porous materials have been successfully prepared via a combination of sintering and phase separation of a sodium borosilicate glass. The materials were characterized using N2‐adsorption, Hg‐intrusion, and scanning electron microscopy. Some hardness measurements were performed to investigate the mechanical stability. Secondary pore sizes were adjusted by the use of different grain fractions of the filler, different primary pore sizes could be obtained by a variation of the annealing conditions. Thus, both pore systems can be adjusted independently. The resulting monoliths consist of a system of secondary pores between 20 and 150 μm and primary pores within the walls of the open‐pored sintered material between 1 and 70 nm. The hierarchical porous materials exhibit surface areas up to 420 m2/g and total porosities up to 74%.
Rheological Studies of Nickel/Scandia‐Stabilized‐Zirconia Screen Printing Inks for Solid Oxide Fuel Cell Anode Fabrication
Authors: Somalu Mahendra R. , Brandon Nigel P.
Published: December 2011

Screen printing is widely used to fabricate thick film solid oxide fuel cell (SOFC) electrodes, followed by drying and high temperature sintering. This study focuses on the rheology of such screen printing inks for the fabrication of porous composite anodes of nickel and scandia‐ stabilized zirconia. Inks with 1–3 wt% binder were suitable for screen printing, but inks with higher binder content were tacky and difficult to print. The particle network strength, important to the production of films with good particle connectivity and mechanical strength, increased as the binder content increased. Inks having 3 wt% binder showed the best balance of thixotropic and viscoelastic properties, resulting in printable films with minimum numbers of film defects and are therefore recommended from this study, with the texanol ink appearing to be better than terpineol due its minimum number of film defects.
Color‐Tunable Blue to Green Ca4‐1.5xTa2O9: xTb3+ Phosphor: Cross‐Relaxation Mechanism and Thermal Stability
Authors: Fang Ying‐Chien , Huang Xiao‐Rong , Juang Yung‐Der , Chu Sheng‐Yuan
Published: December 2011

Color‐tunable Ca4‐1.5xTa2O9: xTb3+ phosphors are prepared via a convenient solid‐state reaction and the cross‐relaxation mechanism is investigated. The concentration of Tb3+ ions greatly affects blue‐green emission in Ca4Ta2O9 samples. The cross‐relaxation effect is explained with the use of Raman and emission spectra and the thermal stability of Ca4‐1.5xTa2O9: xTb3+ is evaluated under excitation at 254 nm. Using the theoretical fitting results, the cross‐relaxation between Tb3+ ions, via energy transfer from 5D3 to 5D4, was determined to be a multipolar interaction of the dipole–dipole mechanism. The critical distance was calculated to be 15.45 Å. The thermal quenching temperature (T50) is higher than 200°C. Results show that Ca4‐1.5xTa2O9: xTb3+ phosphors have good thermal stability and color tunability.
α‐Alumina Fiber with Platelet Morphology Through Wet Spinning
Authors: Mohanty Saralasrita , Rameshbabu Arun Prabhu , Dhara Santanu
Published: December 2011

Highly loaded Al(OH)3 slurries were prepared in a 2 vol% aqueous acetic acid medium up to 33.3 wt% powder loading. The slurries were blended with 4 wt% chitosan in 2 vol% acetic acid and formed into ceramic fibers through wet spinning in sodium tripolyphosphate (STPP) bath. A gelation kinetics study of the chitosan‐blended slurry also showed instantaneous gelation behavior under oscillatory mode rheological measurement. The slurries with moderate viscosities up to 150 Pa·s were spinnable in STPP bath due to ionotropic gelation. Low viscous slurries were formed into a lump during spinning due to low powder loading and less chitosan present in the blend. The green fibers crystallized into α‐alumina during sintering at ~950°C with an average diameter varying between 70 and 120 μm. α‐alumina platelets were formed at 1350°C and changed to hexagonal platelets at 1550°C. The crystallite size of α‐alumina varied between 26 and 112 nm which was measured from XRD data using Scherrer formula. The grain size of sintered fibers was ~4.5 μm at 1350°C. The fibers were assembled into a cylindrical scaffold and sintered to produce a crushing strength of 0.9 MPa with density 0.9 g/cm3.
Fabrication and Properties of High Curie Temperature xBiZn1/2Ti1/2O3–(1−x)PbTiO3 Piezoelectric Films by a Sol–Gel Process
Authors: Zhong Caifu , Guo Limin , Wang Xiaohui , Li Longtu
Published: December 2011

The xBiZn1/2Ti1/2O3–(1−x)PbTiO3 (BZT–PT, x = 0.1–0.3) thin films were fabricated on Pt(111)/Ti/SiO2/Si substrates via an aqueous sol–gel method. Highly (100) oriented BZT–PT films with thickness of 600 nm were obtained by introducing PbO seeding layers. Dense uniform microstructures with average grain size of about 50 nm were observed for these films. The dielectric, ferroelectric, and piezoelectric properties of the BZT–PT thin films were investigated. The curie temperature of the BZT–PT films was about 535°C for x = 0.2, and higher than 600°C for x = 0.3. The local effective piezoelectric coefficient of the (100) oriented BZT–PT films was approximately 40 pm/V for x = 0.3.
Voltage–Current Nonlinearity of CaCu3Ti4O12 Ceramics
Authors: Lu Zhen‐Ya , Li Xiao‐Ming , Wu Jian‐Qing
Published: December 2011

Ceramic samples of CaCu3Ti4O12 (CCTO) were prepared and the voltage–current characteristics were investigated. Extremely strong nonlinear behavior, similar to the reported results in literature [Nature Materials 3[11] 774–8 (2004); Appl. Phys. Lett., 89[19] 191907 (2006); Appl. Phys. Lett., 89[21] 212102 (2006); Appl. Phys. Lett., 91[9] 091912 (2007)] was observed. However, we found that this is a measurement artifact due to a thermionic emission current feedback amplification effect. Compared to that of ZnO varistor, the thermionic emission current of CCTO sample is about six orders of magnitude higher and it is feedback amplified due to strong negative temperature coefficient resistance behavior when the CCTO sample is tested with a voltage (or current) source. Eliminating the thermionic emission current feedback amplification effect, the true value of nonlinear coefficient of the CCTO sample is much lower.
Ferroelectric PbTiO3 Nanodots Shattered Using Atomic Force Microscopy
Authors: Son Jong Yeog , Jung Inhwa
Published: December 2011

A PbTiO3 (PTO) nanodot was formed on an Nb‐doped SrTiO3 substrate using dip‐pen nanolithography, using a PTO precursor sol. After drying and annealing to remove the solvent contained in the PTO nanodot, this dot had a diameter of about 40 nm. The nanodot was then shattered using an atomic force microscope, producing broken nanoparticles of various sizes, ranging from several nanometers to a few tens of nanometers. Finally, after the crystallization annealing process, ferroelectric PTO nanodots smaller than 10 nm in diameter were successfully fabricated. These small PTO nanodots exhibited good ferroelectric properties, as confirmed using a piezoelectric force microscope.
Improved Electrical Properties and Strong Red Emission of Pr3+‐Doped x K0.5Bi0.5TiO3–(1−x)Na0.5Bi0.5TiO3 Lead‐Free Ferroelectric Thin Films
Authors: Zhou Hong , Wu Guangheng , Qin Ni , Bao Dinghua
Published: December 2011

Structural, photoluminescence, dielectric, and ferroelectric properties of lead‐free perovskite Pr3+‐doped xK0.5Bi0.5TiO3–(1−x)Na0.5Bi0.5TiO3 (x = 0–1.0) thin films were studied. The thin films were prepared by a chemical solution deposition method combined with a rapid thermal annealing process at 700°C. We observed that the thin film with x = 0.15, corresponding to the morphotropic phase boundary in the solid solution ceramics or single crystal bulk counterparts, showed a very large dielectric constant and a high remanent polarization, as well as a strong red emission at 611 nm assigned to 1D2→3H4 transitions of the Pr3+ ions. In addition, this study also indicates that the morphotropic phase boundary in xK0.5Bi0.5TiO3–(1−x)Na0.5Bi0.5TiO3 thin films might be probed by photoluminescence probe of Pr3+ ions because the photoluminescence of Pr3+ ions is very sensitive to the phase structure changes.
More Patients Are Triaged Using the Emergency Severity Index Than Any Other Triage Acuity System in the United States
Authors: McHugh Megan , Tanabe Paula , McClelland Mark , Khare Rahul K.
Published: December 2011

ACADEMIC EMERGENCY MEDICINE 2012; 19:106–109 © 2011 by the Society for Academic Emergency Medicine

Objectives:  Patient acuity triage systems can play an important role in supporting patient safety and emergency department (ED) operations. In 2003, the boards of the American College of Emergency Physicians (ACEP) and the Emergency Nurses Association (ENA) approved a joint statement calling for hospitals to adopt a reliable, valid, five‐level triage scale such as the Emergency Severity Index (ESI). Still, there appears to be considerable variation in use of triage acuity systems in the United States, with many hospitals using three‐ and four‐level systems that have not been validated. The purpose of this effort was to measure the use of various triage acuity systems in U.S. hospitals.

Methods:  The authors conducted a cross‐sectional analysis of secondary data. Data were obtained from the 2009 American Hospital Association (AHA) Annual Survey—an intensive questionnaire mailed to all U.S. general medical and surgical hospitals. In 2009, a question was added to the survey about hospitals’ use of triage systems in EDs. Descriptive statistics were used to explore various triage acuity systems used by different types of hospitals.

Results:  Of the 4,897 hospitals surveyed, 82% responded, and 62% (3,024 hospitals) provided information on their ED triage system. The 2009 data revealed that the most commonly used triage system types were the five‐level ESI (56.9% of responding hospitals) and three‐level triage systems (25.2%). More than 70% of large hospitals and teaching hospitals use the ESI, and the unvalidated three‐level systems were more common in small hospitals, public hospitals, nonteaching hospitals, and hospitals in the Midwest. The majority (72.1%) of all ED patient visits to hospitals in our sample were assessed using ESI; only 13.1% of visits were assessed using a three‐level system.

Conclusions:  Among our sample of more than 3,000 hospitals, the ESI was the most commonly used triage system, and more patients were triaged using the ESI than any other triage acuity system. Still, there is an opportunity to further promote the adoption of validated, reliable triage systems.
The Technical Errors of Physicians Learning to Perform Focused Assessment With Sonography in Trauma
Authors: Jang Timothy , Kryder George , Sineff Sanford , Naunheim Rosanne , Aubin Chandra , Kaji Amy H.
Published: December 2011

ACADEMIC EMERGENCY MEDICINE 2012; 19:98–101 © 2011 by the Society for Academic Emergency Medicine

Objectives:  The objective was to assess the incidence of various technical errors committed by emergency physicians (EPs) learning to perform focused assessment with sonography in trauma (FAST).

Methods:  This was a retrospective review of the first 75 consecutive FAST exams for each EP from April 2000 to June 2005. Exams were assessed for noninterpretable views, misinterpretation of images, poor gain, suboptimal depth, an incomplete exam, or backward image orientation.

Results:  A total of 2,223 FAST exams done by 85 EPs were reviewed. Multiple noninterpretable views or misinterpreted images occurred in 24% of exams for those performing their first 10 exams, 3.6% for those performing their 41st to 50th exams, and 0% for those performing their 71st to 75th exams (Cochran‐Armitage trend test = 10.5, p < 0.0001). A single noninterpretable view, poor gain, suboptimal depth, incomplete exam, or backward image orientation occurred in 48% of exams for those performing their first 10 exams, 17% for those performing their 41st to 50th exams, and 5% for those performing their 71st to 75th exams (Cochran‐Armitage trend test = 11.6, p < 0.0001).

Conclusions:  The incidence of specific technical errors of EPs learning to perform FAST at our institution improved with hands‐on experience. Interpretive skills improved more rapidly than image acquisition skills.
Effect of Electronically Delivered Prescriptions on Compliance and Pharmacy Wait Time Among Emergency Department Patients
Authors: Fernando Tasha J. , Nguyen Duy D. , Baraff Larry J.
Published: December 2011

ACADEMIC EMERGENCY MEDICINE 2012; 19:102–105 © 2011 by the Society for Academic Emergency Medicine

Objectives:  The primary objectives were to assess whether electronically delivered prescriptions lead to reduced pharmacy wait time, improved patient satisfaction, and improved compliance with prescriptions. Secondary objectives included determining other reasons for noncompliance and if there was an association between prescription noncompliance and subsequent physician and emergency department (ED) visits.

Methods:  In this prospective study, patients discharged from the Ronald Reagan UCLA Medical Center ED with prescriptions for nonnarcotic medications were randomized to a control group who were discharged with standard written prescriptions or an intervention group who had their prescriptions electronically delivered to the pharmacy of their choice. All study participants were contacted 7 to 31 days after ED discharge for a structured telephone interview.

Results:  Of the 454 patients enrolled, follow‐up was successful for 224 patients (52.4%). Twenty‐eight patients did not fill their prescriptions (12.5% noncompliance rate). The top three reasons patients stated for not picking up their medications were perceiving their prescription as unnecessary (n = 11), medication affordability (n = 5), and lack of time (n = 4). There was no difference in primary prescription noncompliance between the two study groups (p = 0.58). However, electronically delivered prescriptions significantly reduced the median pharmacy wait time, from 15 to 0 minutes (p < 0.001), and improved patient satisfaction at the pharmacy (p = 0.034). Neither subsequent physician nor ED visits were increased by primary prescription noncompliance.

Conclusions:  Electronically delivered prescriptions significantly minimized pharmacy wait time and improved patient satisfaction at the pharmacy, but did not improve primary compliance with prescriptions.
Melatonin influences insulin secretion primarily via MT1 receptors in rat insulinoma cells (INS‐1) and mouse pancreatic islets
Authors: Mühlbauer Eckhard , Albrecht Elke , Bazwinsky‐Wutschke Ivonne , Peschke Elmar
Published: December 2011

Abstract:  Several studies have revealed that melatonin affects the insulin secretion via MT1 and MT2 receptor isoforms. Owing to the lack of selective MT1 receptor antagonists, we used RNA interference technology to generate an MT1 knockdown in a clonal β‐cell line to evaluate whether melatonin modulates insulin secretion specifically via the MT1 receptor. Incubation experiments were carried out, and the insulin concentration in supernatants was measured using a radioimmunoassay. Furthermore, the intracellular cAMP was determined using an enzyme‐linked immunosorbent assay. Real‐time RT‐PCR indicated that MT1 knockdown resulted in a significant increase in the rIns1 mRNA and a significantly elevated basal insulin secretion of INS‐1 cells. Incubation with melatonin decreased the amount of glucagon‐like peptide 1 or inhibited the glucagon‐stimulated insulin release of INS‐1 cells, while, in MT1‐knockdown cells, no melatonin‐induced reduction in insulin secretion could be found. No decrease in 3‐isobutyl‐1‐methylxanthine‐stimulated intracellular cAMP in rMT1‐knockdown cells was detectable after treatment with melatonin either, and immunocytochemistry proved that MT1 knockdown abolished phosphorylation of cAMP‐response‐element‐binding protein. In contrast to the INS‐1 cells, preincubation with melatonin did not sensitize the insulin secretion of rMT1‐knockdown cells. We also monitored insulin secretion from isolated islets of wild‐type and melatonin‐receptor knockout mice ex vivo. In islets of wild‐type mice, melatonin treatment resulted in a decrease in insulin release, whereas melatonin treatment of islets from MT1 knockout and MT1/2 double‐knockout mice did not show a significant effect. The data indicate that melatonin inhibits insulin secretion, primarily via the MT1 receptor in rat INS‐1 cells and isolated mouse islets.
Melatonin enhances endogenous heme oxygenase‐1 and represses immune responses to ameliorate experimental murine membranous nephropathy
Authors: Wu Chia‐Chao , Lu Kuo‐Cheng , Lin Gu‐Jiun , Hsieh Hsin‐Yi , Chu Pauling , Lin Shih‐Hua , Sytwu Huey‐Kang
Published: December 2011

Abstract:  Idiopathic membranous nephropathy (MN), an autoimmune‐mediated glomerulonephritis, is one of the most common causes of nephrotic syndrome in adults. Therapeutic agents for MN remain ill defined. We assessed the efficacy of melatonin therapy for MN. Experimental murine MN was induced with cationic bovine serum albumin, and the mice were immediately administered 20 mg/kg melatonin or phosphate‐buffered saline subcutaneously once a day. Disease severity was verified by examining serum and urine metabolic profiles and renal histopathology. The expression of cytokines and oxidative stress markers, cell apoptosis, and the associated mechanisms were also determined. Mice treated with melatonin displayed a significant reduction in proteinuria and a marked amelioration of glomerular lesions, with attenuated immunocomplex deposition. The subpopulations of T cells were not altered, but the CD19+ B‐cell subpopulation was significantly reduced in the MN mice treated with melatonin. The expression of cytokine mRNAs in splenocytes indicated that melatonin reduced the expression of proinflammatory cytokines and increased the expression of anti‐inflammatory cytokines (interleukin 10). The production of reactive oxygen species and TUNEL‐positive apoptotic cells in the kidney were also significantly reduced in the melatonin‐treated MN mice. Melatonin also upregulated heme oxygenase 1 (HO1) and ameliorated MN. The blockade of HO1 expression with SnPP, a HO1 inhibitor, attenuated HO1 induction by melatonin and thus mitigated its renoprotective effects during MN. Our results suggest that melatonin treatment ameliorates experimental MN via multiple pathways, including by its antioxidative, antiapoptotic, and immunomodulatory effects. Melatonin should be considered a potential therapeutic intervention for MN in the future.
In vitro and in vivo protection by melatonin against the decline of elongation factor‐2 caused by lipid peroxidation: preservation of protein synthesis
Authors: Argüelles Sandro , Muñoz Mario F. , Cano Mercedes , Machado Alberto , Ayala Antonio
Published: December 2011

Abstract:  As organisms age, a considerable decrease in protein synthesis takes place in all tissues. Among the possible causes of the decline of translation in old animals are the modifications of elongation factor‐2 (eEF‐2). eEF‐2 occupies an essential role in protein synthesis where it catalyzes the ribosomal translocation reaction. eEF‐2 is particularly sensitive to increased oxidative stress. However, all oxidants do not affect eEF‐2, only compounds that increase lipid peroxidation. As peroxides are unstable compounds, they decompose and generate a series of highly reactive compounds, including aldehydes malondialdehyde (MDA) and 4‐hydroxynoenal (HNE). We have previously reported that hepatic eEF‐2 forms adducts with low‐molecular weight aldehydes, MDA and HNE. Therefore, the protection of eEF‐2 must be specifically carried out by a compound with lipoperoxyl radical‐scavenging features such as melatonin. In this article, we show the ability of melatonin to protect against the changes that occur in the eEF‐2 under conditions of lipid peroxidation induced by cumene hydroperoxide (CH), a compound used experimentally to induce lipid breakdown. As experimental models, we used cultured cells and rats treated with this oxidant compound. eEF‐2 levels, adduct formation of this protein with MDA and HNE, and lipid peroxides were determined. In the cultured cells, protein synthesis rate was also measured. Our results show that melatonin prevented the molecular changes in eEF‐2 and the decline in protein synthesis rate secondary to lipid peroxidation. The results also show that serum levels of several hormones were affected by CH‐induced oxidative stress, which was partially or totally prevented by melatonin.
Toxin Pores Endocytosed During Plasma Membrane Repair Traffic into the Lumen of MVBs for Degradation
Authors: Corrotte Matthias , Fernandes Maria Cecilia , Tam Christina , Andrews Norma W.
Published: December 2011

Cells permeabilized by the bacterial pore‐forming toxin streptolysin O (SLO) reseal their plasma membrane in a Ca2+‐dependent manner. Resealing involves Ca2+‐dependent exocytosis of lysosomes, release of acid sphingomyelinase and rapid formation of endosomes that carry the transmembrane pores into the cell. The intracellular fate of the toxin‐carrying endocytic vesicles, however, is still unknown. Here, we show that SLO pores removed from the plasma membrane by endocytosis are sorted into the lumen of lysosomes, where they are degraded. SLO‐permeabilized cells contain elevated numbers of total endosomes, which increase gradually in size while transitioning from endosomes with flat clathrin coats to large multivesicular bodies (MVBs). Under conditions that allow endocytosis and plasma membrane repair, SLO is rapidly ubiquitinated and gradually degraded, in a process sensitive to inhibitors of lysosomal hydrolysis but not of proteasomes. The endosomes induced by SLO permeabilization become increasingly acidified and promote SLO degradation under normal conditions, but not in cells silenced for expression of Vps24, an ESCRT‐III complex component required for the release of intraluminal vesicles into MVBs. Thus, cells dispose of SLO transmembrane pores by ubiquitination/ESCRT‐dependent sorting into the lumen of late endosomes/lysosomes.
Peroxisome Formation Requires the Endoplasmic Reticulum Channel Protein Sec61
Authors: Thoms Sven , Harms Imke , Kalies Kai‐Uwe , Gärtner Jutta
Published: December 2011

In peroxisome formation, models of near‐autonomous peroxisome biogenesis with membrane protein integration directly from the cytosol into the peroxisomal membrane are in direct conflict with models whereby peroxisomes bud from the endoplasmic reticulum and receive their membrane proteins through a branch of the secretory pathway. We therefore reinvestigated the role of the Sec61 complex, the protein‐conducting channel of the endoplasmic reticulum (ER) in peroxisome formation. We found that depletion or partial inactivation of Sec61 in yeast disables peroxisome formation. The ER entry of the early peroxisomal membrane protein Pex3 engineered with a glycosylation tag is reduced in sec61 mutant cells. Moreover, we were able to reconstitute Pex3 import into ER membranes in vitro, and we identified a variant of a signal anchor sequence for ER translocation at the Pex3 N‐terminus. Our findings are consistent with a Sec61 requirement for peroxisome formation and a fundamental role of the ER in peroxisome biogenesis.
Urban legends: pemphigus vulgaris
Authors: Cirillo N , Cozzani E , Carrozzo M , Grando SA
Published: December 2011

Oral Diseases (2012) 18, 442–458

Pemphigus vulgaris (PV) is the most common type of pemphigus. PV pathogenesis is still debated, and treatment remains challenging. We investigated five controversial topics: (1) What are the target antigens in PV? (2) Do desmogleins adequately address PV pathophysiology? (3) How does acantholysis occur in PV? (4) Is PV still a lethal disease? (5) What is the role of rituximab (RTX) in PV treatment? Results from extensive literature searches suggested the following: (1) Target antigens of PV include a variety of molecules and receptors that are not physically compartmentalized within the epidermis. (2) PV is caused by a variety of autoantibodies to keratinocyte self‐antigens, which concur to cause blistering by acting synergistically. (3) The concept of apoptolysis distinguishes the unique mechanism of autoantibody‐induced keratinocyte damage in PV from other known forms of cell death. (4) PV remains potentially life‐threatening largely because of treatment side effects, but it is uncertain which therapies carry the highest likelihood of lethal risk. (5) RTX is a very promising treatment option in patients with widespread recalcitrant or life‐threatening PV. RTX’s cost is an issue, its long‐term side effects are still unknown, and randomized controlled trials are needed to establish the optimal dosing regimen.
Clinical evaluation of chlorhexidine and essential oils for adjunctive effects in ultrasonic instrumentation of furcation involvements: a randomized controlled clinical trial
Authors: Yilmaz H.G. , Bayindir H
Published: December 2011

To cite this article:
 
Int J Dent Hygiene 10, 2012; 113–117  DOI: 10.1111/j.1601‐5037.2011.00538.x

Yilmaz HG, Bayindir H. Clinical evaluation of chlorhexidine and essential oils for adjunctive effects in ultrasonic instrumentation of furcation involvements: a randomized controlled clinical trial.

Abstract:  Background:  The aim of this clinical study was to evaluate and compare the clinical efficacy of subgingival ultrasonic mechanical instrumentation (UMI) irrigated with essential oils (EOs) and chlorhexidine (CHX) at the furcation involvements (FI).

Methods:  Forty‐five patients (244 FI) who presented with Class II FI were recruited to the study. Patients were randomly assigned to CHX (UMI irrigated with 0.2% CHX), EO (UMI irrigated with EOs) or control (UMI irrigated with distilled water) groups. All treatments were performed in one session. For all groups, plaque index (PI), gingival index (GI), position of gingival margin (PGM), pocket depth (PD), bleeding on probing (BOP), clinical attachment level (CAL) and horizontal attachment level (HAL) scores were recorded at baseline and 1 and 3 months after therapy.

Results:  In all groups, there were significant reductions in PI, GI, PD and BOP, increase in PGM scores and gain in CAL and HAL scores, at 1 and 3 months compared to baseline. Except in BOP scores, there were no significance differences among the groups at any time point. At 1 and 3 months, there were significant reductions in the BOP scores of the EO group compared with the CHX and control groups.

Conclusion:  Within the limits of this study, the use of EOs as a cooling liquid of UMI may promote slight adjunctive effects at FI compared to CHX and water.
Subclinical hypothyroidism in in vitro fertilization babies
Authors: Onal Hasan , Ercan Oya , Adal Erdal , Ersen Atilla , Onal Zerrin
Published: December 2011

Aim:  Assisted reproduction technology is used widely all over the world. There is a great concern about the morbidity of in vitro fertilization (IVF) babies, but investigations are mostly related to mechanical conditions that are attributed to multiparity. This paper aimed to investigate the effect of IVF on thyroid functions in newborns.

Methods:  A total of 98 healthy, term IVF newborns were evaluated between postnatal 2–4 weeks of age by screening of thyroid functions between July 2006 and April 2008. Ten subjects were assessed as a study group whose thyroid‐stimulating hormone (TSH) levels were higher than 6.5 mU/L. Control group consisted of randomly selected 10 naturally conceived infants with hyperthyrotropinemia (whose TSH levels were higher than 6.5 mU/L but under 15 mU/L) with the same age. All children were thoroughly examined, and serum fT4, TSH, anti‐thyroid peroxidase and anti‐thyroglobulin antibodies were measured, and a thyrotropin‐releasing hormone (TRH) test was performed in all subjects in both groups.

Results:  Euthyroid hyperthyrotropinemia was diagnosed in approximately 10% of IVF babies. Exaggerated TSH levels to TRH were obtained in all IVF babies (subclinical hypothyroidism) but in none of the controls. A significant difference was noted in the concentration of TSH at the 20th min between the two groups (p < 0.001). Besides, sustained and delayed TSH responses were observed in IVF babies. Neonatal screening tests were negative in both of the groups.

Conclusion:  In IVF babies, despite normal neonatal screening tests, subclinical hypothyroidism might be observed that suggests the need for screening in this respect.
Disabilities and health of extremely low‐birthweight teenagers: a population‐based study
Authors: Georgsdottir Ingibjorg , Erlingsdottir Gigja , Hrafnkelsson Birgir , Haraldsson Asgeir , Dagbjartsson Atli
Published: December 2011

Aim:  Evaluation of long‐term outcome of extremely low‐birthweight (ELBW) teenagers born in Iceland in 1991–1995.

Method:  Participants, 30 of 35 ELBW survivors and 30 full term control teenagers (14–19 years), were assessed for disabilities, health problems and learning difficulties. Results of national standardized tests in mathematics and Icelandic language were compared with results of neurodevelopmental assessment at 5 years of age.

Results:  A quarter of the ELBW teenagers had disabilities. All were initially diagnosed with neurodevelopmental disorders early in life and neurosensory and/or intellectual disabilities were confirmed later in childhood. Chronic lung disorders, neurological problems and psychiatric disorders were most common health problems. Growth parameters were within normal limits for most of the ELBW teenagers. Learning difficulties affected 57% of the ELBW teenagers, 20% attended special education classes and 37% required special teaching. Results of national standardized tests were significantly lower for ELBW survivors and were significantly related to the results of neurodevelopmental assessment at 5 years of age.

Interpretation:  A quarter of ELBW teenagers have disabilities albeit most of them mild. Chronic health problems and learning difficulties affect many ELBW survivors. Changes with time emphasize need of long‐term follow‐up.
Cord blood interleukin‐6 as a predictor of early‐onset neonatal sepsis
Authors: Cernada María , Badía Natalia , Modesto Vicente , Alonso Ricardo , Mejías Asunción , Golombek Sergio , Vento Máximo
Published: December 2011

Aim:  To compare diagnostic accuracy in cord blood of interleukin‐6 (IL‐6) with C‐reactive protein (CRP) as predictors of early‐onset neonatal sepsis (EOS) in newborns with prenatal risk factors for infection.

Methods:  During 12 months, cord blood IL‐6 and CRP were measured immediately after birth in neonates with prenatal risk factors of infection. The odds of developing sepsis based on IL‐6 and CRP values were calculated using likelihood ratios (LR), and their accuracy as predictors was compared by binary logistic regression. Multivariable logistic regression analyses were performed to identify independent risk factors for sepsis.

Results:  Ten of 128 neonates (7.8%) were diagnosed with EOS confirmed with positive blood culture in five cases (3.9%). Cord blood IL‐6 was a greater predictor of sepsis than CRP [ROC for IL‐6 (0.88) vs. CRP (0.70)]. IL‐6‐positive and IL‐6‐negative LR [7.14 vs. −0.11] were superior to those calculated for CRP [2.86 vs. −0.51]. Chorioamnionitis and Apgar at 1 min were identified as independent risk factors for EOS.

Conclusions:  Cord blood IL‐6 showed superior LR than CRP; therefore, it is a better predictor to initiate treatment in neonates with prenatal infectious risk factors immediately after birth.