bluuebunny/crossref_metadata_2025 huggingface dataset:
Rose bitterling (Rhodeus ocellatus) embryos parasitize freshwater mussels by competing for nutrients and oxygen
Authors: Spence Rowena , Smith Carl
Published: November 2011

Spence, R. and Smith, C. 2011. Rose bitterling (Rhodeus ocellatus) embryos parasitize freshwater mussels by competing for nutrients and oxygen. —Acta Zoologica (Stockholm) 00: 1–6.

Understanding how parasites inflict fitness costs on their hosts is a key question in host–parasite biology. Rose bitterling (Rhodeus ocellatus) are small cyprinid fish that place their eggs in the gills of living freshwater mussels. The embryos complete their development inside the mussel gill and emerge as free‐swimming larvae after approximately 4 weeks. Bitterling show a range of specialized adaptations for using mussels as a spawning substrate, and the presence of bitterling embryos has been shown to retard the growth of mussels. We compared the development and survival of embryos incubated in either mussels or Petri dishes and exposed to either nutrient‐rich or nutrient‐poor pond water. Embryonic development rate was significantly faster in Petri dishes, probably as a result of oxygen limitation in mussel gills. Embryo survival rate was significantly higher in nutrient‐rich than filtered water, suggesting that the embryos obtained a nutritional benefit prior to emergence from the host. The results imply that bitterling embryos compete for oxygen and nutrients with their host mussel, as well as each other, and in this way, impose a growth cost on mussels.
Challenges and opportunities for sustainable livestock production in the UK
Authors: Pullar D. , Allen N. , Sloyan M.
Published: November 2011

Meat and milk production generally gets a bad press when it comes to discussions around climate change and food production. However, with a rising population, a balance has to be found between the environmental cost of producing and the benefits in terms of food security. Consequently, sustainable production is the byword. The beef, sheep meat, pig meat and dairy industries all have specific challenges in work to reduce their environmental impact. This paper examines some of these challenges, the research which has been undertaken into their scale, routes being exploited to improve efficiency and what gains have already been achieved. It also looks at some of the mitigating factors of dairy and livestock production that help mitigate any environmental costs and ensure we are making the most efficient use of available land.
Food and drink waste from households in the UK
Authors: Quested T. E. , Parry A. D. , Easteal S. , Swannell R.
Published: November 2011

Reducing the amount of food and drink that is wasted is a key element in developing a sustainable food system. In the UK, the largest contribution to food waste is from homes: 8.3 million tonnes per year, costing consumers £12 billion and contributing 3% of UK greenhouse gas emissions. This paper describes recent insights gained from research by the Waste and Resources Action Programme (WRAP) and others into the types of food wasted, why it is wasted and what can be done to minimise it. The research methods used – which have parallels with dietary research – are described and findings of interest to the field of nutrition are highlighted, including the impact of waste on intake (e.g. 0.8 portions of fruit and vegetables are wasted per person per day). The activities undertaken by WRAP and its partners to minimise household food waste are described: consumer engagement and working with retailers and food manufacturers to help consumers to buy the right amount, keep what they buy at its best and use what they buy. Between 2006–2007 and 2009, the amount of household food waste reduced, this is discussed in light of the work of WRAP and its partners, and other influences such as food prices. Areas for future research and engagement to further reduce the quantity and impact of food waste are outlined.
Making sustainable choices easier
Authors: Davies Sue
Published: November 2011

As policy makers grapple with the challenge of producing more food sustainably, consumers will increasingly be affected in terms of the food on offer and the choices they are encouraged to make. Which? research shows little awareness among consumers of the environmental impact of what they eat, but many would be open to making more sustainable choices if it was easy to do so. Simpler, user‐friendly information and advice about how to make more sustainable choices is necessary. Much can be learned from efforts to enable healthier choices, including the lack of consistent, user‐friendly labelling. But consumers' choices are determined by many factors and conflicting demands as well as synergies need to be made more explicit. Many of our choices are determined before food reaches the supermarket and so it is essential that consumers' views and expectations are also taken into account when decisions are made about the future direction of food policy and production.
Inter‐temporal changes in analysts’ forecast properties under the Australian continuous disclosure regime
Authors: Hsu Grace C.‐M. , Lindsay Steven , Tutticci Irene
Published: November 2011

Corporate disclosure regulations are important mechanisms for investor protection. This study examines the inter‐temporal changes in analysts’ forecast properties over the period 1988–2001 as Australia’s continuous disclosure regulation and enforcement intensity changed. The effectiveness of the continuous disclosure regime has been a question of interest since its inception, but research in this area is limited. Our results suggest that analysts’ forecast accuracy and dispersion improved for sample firms in response to the proposal and introduction of continuous disclosure regulations. However, following increased enforcement from 1998, analysts’ forecast dispersion deteriorated for small firms, possibly due to a decrease in private information received by financial analysts as regulators became more proactive in enforcing the ban on selective disclosure.
Recent advances towards development and commercialization of plant cell culture processes for the synthesis of biomolecules
Authors: Wilson Sarah A. , Roberts Susan C.
Published: November 2011

Plant cell culture systems were initially explored for use in commercial synthesis of several high‐value secondary metabolites, allowing for sustainable production that was not limited by the low yields associated with natural harvest or the high cost associated with complex chemical synthesis. Although there have been some commercial successes, most notably paclitaxel production from Taxus sp., process limitations exist with regards to low product yields and inherent production variability. A variety of strategies are being developed to overcome these limitations including elicitation, in situ product removal and metabolic engineering with single genes and transcription factors. Recently, the plant cell culture production platform has been extended to pharmaceutically active heterologous proteins. Plant systems are beneficial because they are able to produce complex proteins that are properly glycosylated, folded and assembled without the risk of contamination by toxins that are associated with mammalian or microbial production systems. Additionally, plant cell culture isolates transgenic material from the environment, allows for more controllable conditions over field‐grown crops and promotes secretion of proteins to the medium, reducing downstream purification costs. Despite these benefits, the increase in cost of heterologous protein synthesis in plant cell culture as opposed to field‐grown crops is significant and therefore processes must be optimized with regard to maximizing secretion and enhancing protein stability in the cell culture media. This review discusses recent advancements in plant cell culture processing technology, focusing on progress towards overcoming the problems associated with commercialization of these production systems and highlighting recent commercial successes.
Substance use among populations displaced by conflict: a literature review
Authors: Ezard Nadine
Published: November 2011

This paper reviews the literature on substance use among populations displaced by conflict. Of the 17 publications presenting primary data retained for review, all consider populations in or recovering from protracted conflict, the majority (10) in non‐camp settings. Most studies (10) offer prevalence estimates, suggesting that substance use (such as of alcohol, opiates, or minor tranquilizers) is common in some displaced settings. Five describe harmful consequences of substance use among displaced populations (such as HIV transmission, tuberculosis treatment failure, gender‐based violence, and economic problems). Three studies suggest risk factors for substance use problems (such as gender, trauma‐related conditions, pre‐displacement substance use, and socio‐economic factors); two examine qualitatively the gendered nature of alcohol‐related harm and its links with gender‐based violence. One study examines an intervention. The evidence base is weak. Findings are used to develop a conceptual framework emphasizing the risk environment to inform further research, to encourage debate among researchers and practitioners, and to enable the development of interventions.
An analysis of seismic risk from a tourism point of view
Authors: Mäntyniemi Päivi
Published: November 2011

Global awareness of natural calamities increased after the destructive Indian Ocean tsunami of December 2004, largely because many foreigners lost their lives, especially in Thailand. This paper explores how best to communicate the seismic risk posed by different travel destinations to crisis management personnel in tourists' home countries. The analysis of seismic risk should be straightforward enough for non‐specialists, yet powerful enough to identify the travel destinations that are most at risk. The output for each location is a point in 3D space composed of the natural and built‐up environment and local tourism. The tourism‐specific factors can be tailored according to the tourists' nationality. The necessary information can be collected from various directories and statistics, much of it available over the Internet. The output helps to illustrate the overall seismic risk conditions of different travel destinations, allows for comparison across destinations, and identifies the places that are most at risk.
“A World Class City of Your Own!”: Civic Governmentality in Chennai, India
Authors: Ellis Rowan
Published: November 2011

Abstract:  This paper utilizes a critical governmentality approach to theorize the processes through which urban elites become stakeholders in the “world‐class city”. Through a case study of public consultations for urban development plans in Chennai, India, the paper explores the technologies that produce urban actors who “participate” in urban governance. Key to these technologies is a discourse of participation that privileges and normalizes citizens as urban stakeholders. The paper contributes to current explorations into the technologies of inclusion that are central to an emerging civic governmentality in South Asia. In Chennai this civic governmentality engages various segments of civil society in processes of urban governance through the mechanism of public consultation. It is through these public consultations that elites come to exert influence over urban plans and consolidate a vision and desire for the world‐class city.
Turnover‐induced Forgetting and its Impact on Productivity
Authors: López Luis , Sune Albert
Published: November 2011

In this paper we investigate organizational forgetting, the notion that a firm's knowledge does not persist over time, exploring knowledge depreciation caused by changes in human capital. We first conduct an in‐depth exploratory case study to identify organizational forgetting. The empirical evidence suggests that organizational forgetting occurs when abrupt personnel turnover takes place. The data reveal a forgetting pattern that is entirely episodic in nature. Thereupon we conduct a confirmatory piece, using multiple regression models, to measure the impact of organizational forgetting on overall productivity. We find that, as a result of repeated forgetting processes, productivity falls in spite of continued output accumulation because of changes in the characteristics of the resource where experience resides.
Modeling of Tension Stiffening Behavior in FRP‐Strengthened RC Members Based on Rigid Body Spring Networks
Authors: Dai Jian‐Guo , Ueda Tamon , Sato Yasuhiko , Nagai Kohei
Published: November 2011

Abstract:  Allowing for the tension stiffening effects resulting from the bond between steel reinforcement and surrounding concrete leads to effective deformation analysis of reinforced concrete (RC) members when using a nonlinear finite element analysis modeled on the smeared crack concept. Nowadays, externally bonded fiber reinforced polymer (FRP) composites are widely used for strengthening existing RC structures. However, it remains unclear to what extent the tension stiffening of postcracking concrete is quantitatively influenced by the addition of FRP composites, as a result of the bond between the FRP and the concrete substrate. This article presents a discrete model, which is based on rigid body spring networks (RBSN), for investigating the tension stiffening behavior of concrete in FRP‐strengthened RC tensile members. A two‐parameter fracture energy‐based model was deployed to represent the bond‐slip behavior of the FRP‐to‐concrete interface. The reliability of the RBSN model was verified through comparisons with previous test results. Further parametric analysis indicates that the tension stiffening of concrete is hardly influenced by the addition of FRP composites before the yield of steel reinforcement has occurred although concrete crack patterns and crack widths may be influenced by the bond‐slip behavior of the FRP‐to‐concrete interface.
eHEALTH IN THE PUBLIC SECTOR: AN EMPIRICAL ANALYSIS OF THE ACCEPTANCE OF GERMANY'S ELECTRONIC HEALTH CARD
Authors: WIRTZ BERND W. , MORY LINDA , ULLRICH SEBASTIAN
Published: November 2011

Given the increasing importance of eHealth as an integral part of eGovernment, this contribution concentrates on the issue of acceptance regarding the introduction of the German electronic health card (eHC). A brief introduction highlights the relevance of the subject and the differing acceptance rates of patients and service providers, i.e. physicians. Based on both the technology acceptance model and the relevant literature, important factors influencing the attitude towards and the potential use of the eHC are conceptualized and integrated in a research model. The empirical examination was conducted throughout Germany through an online survey of physicians. Overall, 502 responses were collected and included in the analysis, which was carried out with structural equation modelling using EQS. The empirical results show that the relevant determinants of the acceptance of the eHC in Germany, such as efficiency and usability of the system and the cost–benefit ratio, were properly identified.
The Opportunity Cost of Climate Policy: A Question of Reference*
Authors: Rezai Armon
Published: November 2011

The cost of climate policy depends on the no‐policy alternative without which the “opportunity cost” of climate action cannot be determined. This baseline path has to reflect the current failure in the market for carbon emissions. Because of a negative externality, private investment decisions are made without considering the climate damage they entail. Agents overinvest in conventional capital and underinvest in climate capital. Internalization of climate damage lowers the private return to capital, and agents reduce investment in favor of mitigation and consumption. Optimal climate policy increases the welfare of both the present and the future. A simulation of the inefficient no‐policy scenario in the Dynamic Integrated Climate–Economy model (DICE‐07) confirms this numerically.
Organizational Form as a Mechanism to Involve Staff, Public and Users in Public Services: A Study of the Governance of NHS Foundation Trusts
Authors: Allen Pauline , Townsend Jean , Dempster Paul , Wright John , Hutchings Andrew , Keen Justin
Published: November 2011

In addition to introducing markets and market‐like structures into public services, New Labour wished to promote the involvement of users and the public in decision‐making in other ways than as individual consumers. One way was to involve the public in the governance of organizations. This could be done by removing public services from state control, and transferring them to mutual ownership; or by increasing public involvement in the governance of public bodies. NHS foundation trusts (FTs) were presented as mutuals. Our study shows FTs are not mutuals, as they continue to be owned by the state. Moreover, staff of FTs were generally not engaging with the new governance structures. In general, there was mixed experience of the new structures enabling governors to increase accountability of the hospitals to the public. On the other hand, having a membership did enhance the legitimacy of FTs, as opposed to other NHS organizations. The findings of the study are of current interest as the coalition government is continuing with the policy of FTs, and also encouraging mutuals and other forms of public involvement.
Time‐Varying Spillover Effects on Sectoral Equity Returns
Authors: Balli Hatice Ozer , Balli Faruk , Louis Rosmy Jean
Published: November 2011

In this paper, we investigate the integration of the Euro‐ and US‐wide sector equity indices by focusing on the return, volatility, and trend spillover effects of local and global shocks. We explore that unlike volatility spillovers, return spillovers are not significant enough to explain sector equity returns. Moreover, we are able to show that when the trend is incorporated into the volatility spillover analysis, a number of sector equity indices tend to react similarly to local and global shocks. Following this path, we arrive at four major sector groups: production and industry; consumer goods and services; financial; and technology, media, and telecommunication across Euro‐ and US‐wide sector equity indices.
Europe and Its Empires: From Rome to the European Union*
Authors: MARKS GARY
Published: November 2011

This article claims that the territorial structure of government results from a tension between scale and community. The benefits of scale arise from the nature of public goods, and include economic exchange, political power and protection against external shocks. Communities are double‐edged in that they are characterized by parochial altruism. Altruism and social solidarity facilitate government within communities, but parochial attachments constrain government among communities. Scale and community, as theorized here, provide a setting for strategic choice. Both are in flux as patterns of human interaction change, and government itself shapes those patterns. Evidence is drawn from the five largest polities in the history of western Europe: the Roman Empire, the Frankish Empire, Napoleonic France, the Third Reich and the European Union.
Aiming for the bull's eye: Preparing for throwing investigated with event‐related brain potentials
Authors: Frömer Romy , Hafner Verena , Sommer Werner
Published: November 2011

We explored the feasibility of investigating complex goal‐directed actions with event‐related brain potentials by studying the aiming phase of throwing. A virtual reality environment was set up, allowing aimed throws at distant targets, with participants standing upright and moving relatively unrestrained. After a separate practice session, the contingent negative variation (CNV) was measured during preparation for a simple button release, unaimed throws, and aimed throws at targets of two levels of difficulty. Consistent with expectations, CNV amplitude was larger for all throwing conditions compared to button release. It further increased with task difficulty in the aimed throwing conditions, reflecting the increasing motor programming demands for more difficult goal‐directed actions. Therefore, investigating throwing as an instance of complex goal‐directed action with ERPs is feasible, opening interesting perspectives for future research.
Effects of body size on sex‐related migration vary between two closely related gull species with similar size dimorphism
Authors: BOSMAN DAVY S. , VERCRUIJSSE HARRY J. P. , STIENEN ERIC W. M. , VINCX MAGDA , DE NEVE LIESBETH , LENS LUC
Published: November 2011

Studies of migration have revealed multiple trade‐offs with other life‐history traits that may underlie observed variation in migratory properties among ages and sexes. To assess whether, and to what extent, body size and/or sex‐specific differences in competition for resources (e.g. breeding territories or winter food) may shape variation in migration distance and timing of arrival in ecologically and phylogenetically related species, we combined over 30 000 sightings of individually marked, sexually mature males and females of Herring GullsLarus argentatusand Lesser Black‐Backed GullsLarus fuscuswith biometric measurements and phenological observations at a mixed breeding colony. InL. argentatus, larger males migrated further from the breeding colony, whereas migration distance was independent of body size in adult females. InL. fuscus, no relationship between body size and migration distance was apparent in either sex. Mean arrival dates at the breeding colony did not vary with migration distances but differed between males and females ofL. argentatus(but notL. fuscus). As allometry at least partly explains sexual segregation in migration behaviour inL. argentatus, but not inL. fuscus, we conclude that the effect of body size on sex‐related migratory strategies may vary between closely related, sympatric species despite similar size dimorphism.
The Productivity and Cost‐Efficiency of Models for Involving Nurse Practitioners in Primary Care: A Perspective from Queueing Analysis
Authors: Liu Nan , D'Aunno Thomas
Published: November 2011

Objective

To develop simple stylized models for evaluating the productivity and cost‐efficiencies of different practice models to involve nurse practitioners (NPs) in primary care, and in particular to generate insights on what affects the performance of these models and how.

Data Sources and Study Design

The productivity of a practice model is defined as the maximum number of patients that can be accounted for by the model under a given timeliness‐to‐care requirement; cost‐efficiency is measured by the corresponding annual cost per patient in that model. Appropriate queueing analysis is conducted to generate formulas and values for these two performance measures. Model parameters for the analysis are extracted from the previous literature and survey reports. Sensitivity analysis is conducted to investigate the model performance under different scenarios and to verify the robustness of findings.

Principal Findings

Employing an NP, whose salary is usually lower than a primary care physician, may not be cost‐efficient, in particular when the NP's capacity is underutilized. Besides provider service rates, workload allocation among providers is one of the most important determinants for the cost‐efficiency of a practice model involving NPs. Capacity pooling among providers could be a helpful strategy to improve efficiency in care delivery.

Conclusions

The productivity and cost‐efficiency of a practice model depend heavily on how providers organize their work and a variety of other factors related to the practice environment. Queueing theory provides useful tools to take into account these factors in making strategic decisions on staffing and panel size selection for a practice model.
State‐Level Variations in Racial Disparities in Life Expectancy
Authors: Bharmal Nazleen , Tseng Chi‐Hong , Kaplan Robert , Wong Mitchell D.
Published: November 2011

Objective

To explore state patterns in the racial life expectancy gap.

Data Sources

The 1997–2004 Multiple Cause of Death PUF, 2000 U.S. Census.

Study Design

We calculated life expectancy at birth for black and white men and women.

Data Extraction Methods

Data were obtained by the NCHS and U.S. Census Bureau.

Principal Findings

States with small racial differences are due to higher‐than‐expected life expectancy for blacks or lower‐than‐expected for whites. States with large disparity are explained by higher‐than‐average life expectancy among whites or lower‐than‐average life expectancy among blacks.

Conclusions

Heterogeneous state patterns in racial disparity in life expectancy exist. Eliminating disparity in states with large black populations would make the greatest impact nationally.
Agminated, Eruptive Pyogenic Granuloma‐Like Lesions Developing over Congenital Vascular Stains
Authors: Baselga Eulalia , Wassef Michel , Lopez Susana , Hoffman William , Cordisco Maria , Frieden Ilona J.
Published: November 2011

Abstract:  We report three infants who developed agminated pyogenic granulomas over congenital vascular malformations, all of which had an aggressive growth pattern. There were no precipitating events such as laser therapy or surgery. Lesions were excised.
Testing the Effect of Function‐Focused Care in Assisted Living
Authors: Resnick Barbara , Galik Elizabeth , Gruber‐Baldini Ann , Zimmerman Sheryl
Published: November 2011

Objectives

To develop and test the Function‐Focused Care in Assisted Living (FFC‐AL) intervention so as to alter the decline that older adults in AL experience.

Design

Cluster‐randomized controlled trial using repeated measures to test the effect of FFC‐AL.

Setting

Four AL facilities with at least 100 beds.

Participants

One hundred seventy‐one residents and 96 direct care workers (DCWs) were recruited. Ninety‐five of the DCWs were female (99%), and 59 were black (62%), with a mean age of 41.7 ± 13.8. The residents were mostly female (80%), white (93%), and widowed (80%), with a mean age of 87.7 ± 5.7.

Intervention

FFC‐AL included four components implemented by a research‐supported function focused‐care nurse (FFCN) and a site‐identified champion over a 12‐month period. Control sites were exposed to FFC education only.

Measurements

Outcomes for residents included psychosocial domains (mood, resilience, self‐efficacy, and outcome expectations for function and physical activity), function, gait and balance, and actigraphy. Outcomes for DCWs included knowledge, performance, and beliefs associated with FFC.

Results

DCWs in treatment sites provided more FFC by 12 months than those in control sites. Residents in treatment sites demonstrated less decline in function, a greater percentage returned to ambulatory status, and there were positive trends demonstrating more time in moderate‐level physical activity at 4 months and more overall counts of activity at 12 months than for residents in control sites.

Conclusion

Using a function‐focused approach in AL may help prevent some of the functional decline commonly noted in these settings.
Language Concordance and Patient–Physician Communication Regarding Mental Health Needs
Authors: August Kristin J. , Nguyen Hannah , Ngo‐Metzger Quyen , Sorkin Dara H.
Published: November 2011

Language‐related communication barriers between minority patients and their physicians may contribute to racial and ethnic disparities in mental health care. Accordingly, the current study sought to examine whether perceived mental health needs and discussion of these needs differed as a function of race or ethnicity and language concordance in older Latinos and Asian and Pacific Islanders (APIs). Using the 2007 California Health Interview Survey, the analytical sample included Latinos and APIs aged 55 and older (N = 2,960) who reported having seen a primary care provider within the past 2 years. Multivariable logistic regression was used to examine differences according to race or ethnicity and language concordance status (three groups: English‐language concordant, other‐language concordant, language discordant) in perceived mental health needs and discussion of those needs with a physician, adjusting for respondents’ sociodemographic characteristics and mental health status. There were no significant differences in respondents’ perceptions of their mental health needs across race or ethnicity or level of language concordance status (Ps > .41), although there were significant differences in whether respondents had discussed their mental health needs with their physicians according to participant race or ethnicity and language concordance status (adjusted odds ratio = 0.47, P = .04). Specifically, Spanish language‐concordant Latinos were just as likely to discuss their mental health needs with their physicians as English language‐concordant Latinos. In contrast, Asian language‐concordant APIs were less likely to discuss their mental health needs with their physicians than English language‐concordant APIs. There were no significant differences between language‐discordant and English language‐concordant older adults in predicting discussion of mental health concerns. These findings underscore the importance of overcoming language‐related and cultural barriers to improve patient‐provider discussions of older adults’ mental health needs.
Acquisition of Nonadjacent Phonological Dependencies in the Native Language During the First Year of Life
Authors: Gonzalez‐Gomez Nayeli , Nazzi Thierry
Published: November 2011

Languages instantiate many different kinds of dependencies, some holding between adjacent elements and others holding between nonadjacent elements. In the domain of phonology–phonotactics, sensitivity to adjacent dependencies has been found to appear between 6 and 10 months. However, no study has directly established the emergence of sensitivity to nonadjacent phonological dependencies in the native language. The present study focuses on the emergence of a perceptual Labial‐Coronal (LC) bias, a dependency involving two nonadjacent consonants. First, Experiment 1 shows that a preference for monosyllabic consonant‐vowel‐consonant LC words over CL (Coronal‐Labial) words emerges between 7 and 10 months in French‐learning infants. Second, two experiments, presenting only the first or last two phonemes of the original stimuli, establish that the LC bias at 10 months cannot be explained by adjacent dependencies or by a preference for more frequent coronal consonants (Experiment 2a & b). At 7 months, by contrast, infants appear to react to the higher frequency of coronal consonants (Experiment 3a & b). The present study thus demonstrates that infants become sensitive to nonadjacent phonological dependencies between 7 and 10 months. It further establishes a change between these two ages from sensitivity to local properties to nonadjacent dependencies in the phonological domain.
Conversion to low transfusion‐related acute lung injury (TRALI)‐risk plasma significantly reduces TRALI
Authors: Arinsburg Suzanne A. , Skerrett Donna L. , Karp Julie K. , Ness Paul M. , Jhang Jeffrey , Padmanabhan Anand , Gibble Joan , Schwartz Joseph , King Karen E. , Cushing Melissa M.
Published: November 2011

BACKGROUND: Transfusion‐related acute lung injury (TRALI) is an uncommon but serious transfusion reaction. Studies have shown that the transfusion of HLA and HNA antibodies in donor plasma can lead to TRALI. Female donors are more likely to have such antibodies due to alloantigen exposure during pregnancy. Many blood suppliers have now implemented various TRALI risk reduction strategies to unknown effect. A retrospective analysis of TRALI reactions in plasma recipients before and after the conversion to low‐TRALI‐risk plasma (all‐male donor plasma, male‐predominant plasma, nulliparous female plasma, and HLA antibody–tested plasma) is reported.

STUDY DESIGN AND METHODS: Transfusion reaction reports at three large hospitals 16 months before and 16 months after the conversion to low‐TRALI‐risk plasma were analyzed. Respiratory reactions were categorized as TRALI, possible TRALI, or other (e.g., transfusion‐associated circulatory overload or allergic reactions). Reactions were reported as a percentage of total units transfused and rates for the two time periods were compared. Trends in reaction rates for other components were also compared.

RESULTS: A total of 2156 transfusion reactions in association with 461,598 transfused blood components were reviewed. The incidence of combined TRALI or possible TRALI reactions, due to the transfusion of plasma, decreased from 0.0084% to zero (p = 0.052). The rate of TRALI or possible TRALI reactions in red blood cell and platelet recipients did not change significantly.

CONCLUSION: The conversion to low‐TRALI‐risk plasma has reduced the incidence of TRALI reactions in plasma recipients.
Transthoracic Echocardiographic Features of Cardiac Pheochromocytoma: A Single‐Institution Experience
Authors: Li Ling , Zhu Wenling , Fang Ligang , Zeng Zhengpei , Miao Qi , Zhang Chaoji , Fang Quan
Published: November 2011

Background: Cardiac pheochromocytoma is extremely rare. Previous papers usually are reports of a single case. Transthoracic echocardiography (TTE) offers a useful option, but the features of cardiac pheochromocytoma on TTE have not been favorably reported. In this study, the findings of cardiac pheochromocytoma on TTE in nine cases were presented. Methods: TTE images (especially two‐dimensional ultrasound) of nine patients with cardiac pheochromocytomas were analyzed retrospectively and compared with the findings from surgery. Results: Among the nine patients with cardiac pheochromocytomas identified in Peking Union Medical College Hospital (PUMCH) clinical and echocardiographic database, TTE identified one cardiac tumor in seven cases (77.8%), two cardiac tumors in one case (11.1%), and a false‐negative result in another (11.1%). Cardiac pheochromocytomas were usually located on the base of the heart, near the origin of great arteries. The tumors were usually round or ovoid, ranging from 1.4 cm to 7.7 cm in diameter, with homogeneous and moderate echoes and low activity. They could press or invade surrounding cardiac structures and influence hemodynamics. In this study the majority of cardiac pheochromocytoma seemed marginated and appeared to be encapsulated on TTE. Apical four‐chamber view and parasternal short‐axis view of the aortic valve were most effective in identifying cardiac pheochromocytomas. The findings on TTE were similar to those from surgical procedures. Conclusion: Cardiac pheochromocytomas presented characteristic TTE appearances in aspect of location, size, texture, and shape of tumors. Understanding of these characteristics on TTE can help correctly recognize this extremely rare disease. (Echocardiography 2012;29:153‐157)
Fast Track Echo of Abdominal Aortic Aneurysm Using a Real Pocket‐Ultrasound Device at Bedside
Authors: Dijos Marina , Pucheux Yann , Lafitte Marianne , Réant Patricia , Prevot Alain , Mignot Aude , Barandon Laurent , Roques Xavier , Roudaut Raymond , Pilois Xavier , Lafitte Stéphane
Published: November 2011

Background: Ultraminiaturization of echographic systems extraordinarily provides the image “within” the clinical examination. Abdominal aorta aneurysm (AAA) diagnosis based on conventional evaluation with a dedicated operator and ultrasound machine is still controversial due to the lack of evidence of the proposed management and guidelines’ cost‐effectiveness. We hypothesized that less expensive ultraportable devices could identify AAA with the same level of accuracy as conventional approaches. Methods: A first step of this study was to validate the VSCAN's image capabilities in patients referred to the vascular Doppler laboratory. Abdominal aorta measurements were performed by an experienced physician using conventional equipment followed by a second blinded physician using the ultraportable device VSCAN. Then, 204 patients hospitalized in our cardiology institute were prospectively included for a systematic screening of AAA at bedside using the VSCAN in order to determine the feasibility and impact of fast track evaluation compared to clinical examination. Results: A strong correlation was obtained between measurements of abdominal aorta diameters using the two ultrasound systems (r = 0.98, CI: 0.97–0.99, P < 0.001) with 100% of agreement for AAA diagnosis. In the second part of the study, visualization and measurement of the transverse diameter of the abdominal aorta was obtained in 199 patients, resulting in a feasibility of 97.5%. Among these patients, 18 AAAs were detected, which corresponds to a prevalence of 9%, whereas clinical evaluation did not detect any of them. Patients with AAA were more likely men (77.77% vs. 57.45%, P < 0.05) and hypertensive (88.8% vs. 56.9%, P < 0.05) as compared to those without AAA. Two patients with large AAA were quickly referred to the surgery department. Conclusion: Considering its low cost, diagnostic accuracy, and widespread availability, screening for AAA using an ultraportable ultrasound device such as VSCAN by an experienced physician is promising and should be used as an extension of routine physical examination in vascular patients. (Echocardiography 2012;29:285‐290)
Extrinsic Mechanism Obstructing the Opening of a Prosthetic Mitral Valve: An Unusual Case of Suture Entrapment
Authors: Ozkan Mehmet , Astarcioglu Mehmet Ali , Karakoyun Suleyman , Balkanay Mehmet
Published: November 2011

Obstruction to a prosthetic cardiac valve is a well‐recognized complication of cardiac valve replacement. Malfunction of the mobile component of a prosthetic valve to open or close correctly may occur in consequence of intrinsic or extrinsic causes (thrombus, vegetation, entrapment of left ventricular myocardium, suture entanglement, and pannus formation) that may result prosthetic valve stenosis and/or insufficiency. In the case we report a 48‐year‐old female with valve dysfunction occurred early after surgery, as one valve leaflet was only able to partially open due to suture entrapment. (Echocardiography 2012;29:E28‐E29)
Intraoperative Transesophageal Echocardiographic Imaging of Double Valve Repair for Aortic and Mitral Stenosis
Authors: Sung Tae‐Yun , Kim Ju‐Deok , Muhammad Hasmizy Bin , Kang Woon‐Seok , Kim Seong‐Hyop , Yun Tae‐Gyoon , Kim Jun‐Seok , Kim Tae‐Yop
Published: November 2011

An intraoperative echocardiographic evaluation to determine the feasibility and adequacy of the valve repair procedure is crucial for a successful repair. However, aortic valve repair in severe aortic stenosis (AS) is very limited and, consequently, its intraoperative echocardiographic evaluation has not been described well. Here, we describe an intraoperative transesophageal echocardiographic evaluation of a double‐valve repair procedure for a patient with severe AS, moderate aortic insufficiency, and severe mitral stenosis. (Echocardiography 2012;29:187‐191)
Strategies for Partner Management when Treating Sexually Transmitted Infection
Authors: FitzMaurice Emilie , Keller Elaine , Trebbin Jennifer , Wilson Jessica
Published: November 2011

Chlamydia trachomatis and Neisseria gonorrhea are the most commonly reported bacterial sexually transmitted infections (STIs) in the United States, and reinfection accounts for 14% to 30% of all reported cases of these STIs. Treatment of both the woman and her partner is imperative to prevent long‐term sequelae. This report examines the clinical course of a woman diagnosed with Chlamydia during pregnancy, and reviews various approaches to treating partners, including patient referral, provider referral, patient‐delivered partner therapy, and accelerated partner therapy.
Regulation of Prescriptive Authority for Certified Nurse‐Midwives and Certified Midwives: A National Overview
Authors: Osborne Kathryn
Published: November 2011

Introduction: Certified nurse‐midwives (CNMs) and certified midwives (CMs) provide primary care to women across the lifespan. Yet these primary care providers face barriers to practice that include restrictive state laws and regulations regarding prescriptive authority. The purpose of this review is to critically examine and report the regulatory requirements relative to prescriptive authority for CNMs/CMs in the United States.

Methods: State statutes and rules relative to midwifery practice were reviewed for all 50 United States and the District of Columbia.

Results: CNMs have been granted the authority to write prescriptions in all 50 United States and the District of Columbia, while CMs have been granted prescriptive authority only in the state of New York. Prescriptive authority for CNMs and CMs is regulated by individual state agencies and regulatory boards. Regulations regarding prescriptive authority for CNMs and CMs vary widely from state to state and are described, with a summary for each state presented.

Discussion: While CNMs are granted fully independent prescriptive authority in some states, the regulatory requirements relative to prescriptive authority for CNMs/CMs limit patients’ access to necessary services in most states.
Lapses in safety in end‐stage renal disease patients admitted to surgical services
Authors: Harel Ziv , Wald Ron , Liu Jessica J. , Bell Chaim M.
Published: November 2011

Chronic dialysis patients are a vulnerable population that may be highly susceptible to medical errors, particularly when they are hospitalized. We performed a chart review of chronic hemodialysis patients admitted to surgical services at a tertiary care center in order to characterize lapses in patient safety. We conducted a retrospective chart review of admissions of patients receiving chronic hemodialysis to various surgical services at St. Michael's Hospital from January 1, 2009 to December 31, 2010. For each hospitalization, we collected data on four process of care indicators of potential safety lapses. When these lapses were identified, we sought to determine whether: (i) the lapse was detected and remedied; and (ii) the lapse resulted in an adverse event. Among the 41 patients, 96 process of care lapses were identified. Multiple lapses were detected in 83% of the cohort. Failure to order a renal diet (72%) occurred most often. There was one adverse event. Process of care lapses were detected 39% of the time, usually within 1.5 days of their occurrence. Patients receiving chronic hemodialysis admitted to surgical services experience multiple lapses in patient safety, which often remain undetected. As such, it is imperative that these patients be closely monitored in order to mitigate against potential adverse events.
Effect of Atmospheric Water Vapor on the Thermally Induced Crystallization in Zirconia Gel
Authors: Tatsuoka Tomoyuki , Koga Nobuyoshi
Published: November 2011

Effect of water vapor on the thermally induced crystallization of tetragonal ZrO2 in hydrous gel precursor was investigated using TG‐DTA under controlled water vapor pressures, p(H2O). Existence of the temperature region for preliminary nucleation in the region lower than that of the crystallization exothermic peak was identified. The rate of preliminary nucleation was largely enhanced by the atmospheric water vapor, resulting in the increase of number of preexisting nuclei for the subsequent growth and the systematic shift of DTA exothermic peak of crystallization to the lower temperatures with increasing p(H2O). From a systematic shift of the DTA exothermic peak depending on the annealing time at a constant temperature, the rate behavior of preliminary nucleation under high p(H2O) was characterized as the constant rate nucleation. By the preannealing treatment in the temperature region of preliminary nucleation under high p(H2O), the number of preexisting nuclei is nearly saturated without any partial crystallization. From a series of DTA exothermic peaks of crystallization recorded by heating the preannealed samples at different heating rates, the apparent activation energy, Ea, for the crystal growth of tetragonal ZrO2 from the preexisting nuclei was estimated to be Ea = 187.3 ± 3.8 kJ mol−1.
Oral health condition of French elderly and risk of dementia: a longitudinal cohort study
Authors: Arrivé E. , Letenneur L. , Matharan F. , Laporte C. , Helmer C. , Barberger‐Gateau P. , Miquel J. L. , Dartigues J. F.
Published: November 2011

Arrivé E, Letenneur L, Matharan F, Laporte C, Helmer C, Barberger‐Gateau P, Miquel JL, Dartigues JF. Oral health condition of French elderly and risk of dementia: a longitudinal cohort study. Community Dent Oral Epidemiol 2011. © 2011 John Wiley & Sons A/S

Abstract –  Objectives:  Oral condition could be associated with cognitive impairment, but this is not yet well documented. We therefore hypothesized that people with poor oral condition would be more at risk to develop dementia. The objective of this study thus was to describe the oral condition of French community‐dwelling elderly persons and to assess its relationship with the occurrence of dementia.

Methods:  Oral examination was conducted on a sample of individuals aged 66–80 years followed‐up prospectively for screening of dementia over 15 years in Gironde, France. Univariate and multivariate analyses of the risk of dementia were performed using a Cox proportional hazard model with delayed entry.

Results:  Data from 405 individuals were analyzed; 45.4% men; median age at baseline: 70 years [interquartile range (IQR): 68–75]. The median number of decayed, missing, and filled teeth was 18 (IQR: 13–24) and was higher in women (median: 20 versus 17, P = 0.004) and in persons with lower school level (median: 21 versus 17, P = 0.003). Among 348 persons with sextant eligible for periodontal assessment, 2/3 required periodontal care: 5.2% had bleeding observed, 44.8% calculus, 17.8% 4–5 mm pockets, and 2.9%≥6 mm pockets. The incidence of dementia during a median follow‐up of 10 years (IQR: 6.5–13.7) was 19 per 1000 person‐years. The adjusted hazard ratio for a number of missing teeth≥11 (median) on the risk of dementia was 1.13 (95% confidence interval, CI = [0.60–2.12]) in people with higher education (n = 312) and 0.30 (CI = 0.11–0.79) in persons with lower school level (n = 93) (P for modification effect = 0.0002).

Conclusions:  Having eleven or more missing teeth seemed to be associated with a lower risk of dementia in people with lower education possibly owing to the suppression of source of chronic inflammation.