bluuebunny/crossref_metadata_2025 huggingface dataset:
Oncology patients’ perceptions of the good nurse: an explorative study on the psychometric properties of the Flemish adaptation of the Care‐Q instrument
Authors: Rchaidia Leila , Dierckx de Casterlé Bernadette , Verbeke Geert , Gastmans Chris
Published: September 2011

Aims and objectives.  The aims of this study were to translate the Care‐Q into Dutch, adapt it for use in oncological care settings in Flanders and explore its psychometric properties in oncology patients.

Background.  The ‘good nurse’ is a difficult concept to measure. Patients’ experiences are essential for understanding what characterises good nurses in the oncology setting. Although the Care‐Q is one of the most widely used instruments to measure cancer patients’ perceptions of good nurses, no translated, validated instrument has been developed for Flanders.

Design.  A quantitative, descriptive, non‐experimental research design was used.

Method.  We translated the Care‐Q into Dutch, adapted it and assessed its face and content validity. Its psychometric properties were examined in 100 oncology patients. Internal consistency was assessed using Cronbach’s alpha coefficient, and test‐retest reliability was assessed using Wilcoxon matched pairs test and Spearman’s rho coefficient. Factor structure was studied using explorative factor analysis derived from principal component analysis with varimax rotation, and the user‐friendliness was examined using descriptive statistics.

Results.  Several items from the original Care‐Q were removed or adapted, and new items were added. The content validity index was 0·83. Five reliable, consistent and meaningful subscales were identified that explained 49·7% of the total variance: good nurses are empathic (towards patients and family), professional, patient‐centred, respectful and communicative. Cronbach’s alpha was 0·92 for the whole instrument and 0·65–0·81 for the subscales. User‐friendliness was deemed favourable.

Conclusions.  The Flemish adaptation of the Care‐Q has favourable psychometric properties. It appears to be a useful instrument for studying cancer patients’ perceptions of good nurses in Flanders.

Relevance to clinical practice.  The Flemish adaptation of the Care‐Q is useful for helping nurses to reflect critically on the care they offer and to adapt and improve care to the real needs and expectations of patients with cancer.
Challenges in handling elder abuse in community care. An exploratory study among nurses and care coordinators in Norway and Australia
Authors: Sandmoe Astrid , Kirkevold Marit , Ballantyne Alison
Published: September 2011

Aim and objective.  The aim of this study was to explore how nurses and care coordinators in community care in Norway and Australia experienced and handled cases of abused older clients, including the support they received in clinical interventions.

Background.  Norway and Australia base their approaches to elder abuse problems on similar philosophies. The Australian Government, however, has taken a more active position on this issue by focusing on structures and policies that might influence professionals’ handling of abuse cases. The organisation and funding of community care services in the two countries are different, although common concerns are client‐centeredness, equal access to services and enabling the client to live at home as long as possible.

Design.  Explorative design with a qualitative hermeneutic approach.

Method.  Twenty participants, nurses, auxiliary nurses and care workers in Norway and Australia, were recruited by purposeful sampling. They participated in in‐depth interviews.

Results.  The similarity of the information given in the two countries was striking. The interventions differed based on the type and seriousness of the abuse and the client’s cognitive capacity. Financial abuse was a more prominent issue in Australia than in Norway. The handling of neglect cases in both countries followed much the same pathway and the intervention usually involved long‐lasting processes. The managers’ support and the elder protective services were of great importance to the nurses.

Conclusions.  Community care agencies in both countries struggle with similar problems in handling cases of abuse. The participants’ concerns were securing and supporting the older victim by individualising the intervention.

Relevance to clinical practice.  Community care agencies in both countries need to be aware of the huge impact of the managers’ involvement and the services’ responsibility and capacity to support professionals in the handling of elder abuse.
Analytical electron microscopy of black carbon and microaggregated mineral matter in Amazonian dark Earth
Authors: CHIA C.H. , MUNROE P. , JOSEPH S.D. , LIN Y. , LEHMANN J. , MULLER D.A. , XIN H.L. , NEVES E.
Published: September 2011

Black carbon (BC) is one of the most stable forms of soil organic matter. Its surface functional groups and structure have been well characterized by a range of analytical methods. However, little is known about the mechanisms of interactions between the BC particles and the surrounding mineral matter. In this paper a range of microscopy techniques, such as transmission electron microscopy and scanning transmission electron microscopy, were used to investigate the possible reactions of BC particles within microaggregates (<2 mm) found in Amazonian dark Earth. Attention is given to the interactions that occur at the interfacial regions between the organic and inorganic phases. Examination of Amazonian dark Earth showed that the carbon‐rich phase detected within the BC particles has a significant calcium concentration and a high density of micropores was found at the BC–mineral interface. These observations provide evidence to support suggested mechanisms of interaction between these phases.
Sex Steroids and the Control of the Kiss1 System: Developmental Roles and Major Regulatory Actions
Authors: García‐Galiano D. , Pinilla L. , Tena‐Sempere M.
Published: September 2011

Kisspeptins, encoded by the Kiss1 gene, and their canonical receptor, GPR54 (also termed Kiss1R), are unanimously recognised as essential regulators of puberty onset and gonadotrophin secretion. These key reproductive functions stem from the capacity of kisspeptins to stimulate gonadotrophin‐releasing hormone (GnRH) secretion in the hypothalamus, where discrete populations of Kiss1 neurones have been identified. In rodents, two major groups of hypothalamic Kiss1 neurones exist: one present in the arcuate nucleus (ARC) and the other located in the anteroventral periventricular area (AVPV/RP3V). In recent years, numerous signals have been identified as putative modulators of the hypothalamic Kiss1 system. Among them, the prominent role of sex steroids as being important regulators of Kiss1 neurones has been documented in different species and developmental stages, such as early brain sex differentiation, puberty, adulthood and senescence. These regulatory actions are (mainly) conducted via oestrogen receptor (ER)α, which is expressed in almost all Kiss1 neurones, and likely involve both classical and nonclassical pathways. The regulatory effects of sex steroids are nucleus‐specific. Thus, sex steroids inhibit the expression of Kiss1/kisspeptin at the ARC, as a mechanism to conduct their negative‐feedback actions on gonadotrophin secretion. By contrast, oestrogens enhance Kiss1 expression at the AVPV/RP3V in rodents, suggesting the involvement of this population in the positive‐feedback actions of oestradiol to generate the preovulatory surge of gonadotrophins. In addition, sex steroids have been shown to act post‐transcriptionally, modulating GnRH/gonadotrophin responsiveness to kisspeptin. Finally, sex steroids also regulate the expression of co‐transmitters of Kiss1 neurones, such as neurokinin B, whose mRNA content in the ARC fluctuates in parallel to that of Kiss1 in response to changes in the circulating levels of sex steroids, therefore suggesting the contribution of this neuropeptide in the feedback control of gonadotrophin secretion. In sum, compelling experimental evidence obtained in different mammalian (and non‐mammalian) species, including primates, demonstrates that sex steroids are essential regulators of hypothalamic Kiss1 neurones, which in turn operate as conduits for their effects on GnRH neurones. The physiological relevance of such regulatory phenomena is thoroughly discussed.
Adolescent client views towards the treatment of anorexia nervosa: a review of the literature
Authors: WESTWOOD L. M. , KENDAL S. E.
Published: September 2011

Accessible summary

Anorexia nervosa (AN) affects many young people but they can be reluctant to accept treatment. If we understood the views of young people with AN we might be able to develop more acceptable treatments. At the moment, most of what we know about their views is taken from studies of girls and young women.

For some young people, having AN means being able to control something, but AN can also be an illness that controls the person. Confusion about control is one of the things that make AN hard to treat.

It is difficult to find the right combination of treatments for the physical and psychological symptoms of AN. The research evidence we have does not offer enough guidance for clinicians.

Good relationships with clinicians can be difficult to achieve. Young people with AN want clinicians to look after them but at the same time they may resent it when clinicians tell them what to do. However, once they have recovered they often say that they needed firm treatment in order to get better.

This paper reviews current literature in which adolescents with anorexia nervosa (AN) were consulted about their views of their treatment. Published research was systematically retrieved and interrogated during 2009–2010 and analysed using a four‐stage model. Eleven studies met the inclusion criteria. Three core themes were identified. AN was perceived as a means of taking control and also something that controlled the individual. Tensions were recognized between client preferences for psychological interventions and treatments that prioritized physical care. Therapeutic alliance emerged as a strategy for overcoming these difficulties but was challenged by client ambivalence towards treatment. Most included studies were qualitative. Young males and individuals who dropped out of treatment were underrepresented in the studies. Adolescents' perspectives on treatment for AN were characterized by paradoxes and tensions. Egosyntonic theory was used as a theoretical construct to interpret findings.
Probabilistic sleep architecture models in patients with and without sleep apnea
Authors: BIANCHI MATT T. , EISEMAN NATHANIEL A. , CASH SYDNEY S. , MIETUS JOSEPH , PENG CHUNG‐KANG , THOMAS ROBERT J.
Published: September 2011

Sleep fragmentation of any cause is disruptive to the rejuvenating value of sleep. However, methods to quantify sleep architecture remain limited. We have previously shown that human sleep–wake stage distributions exhibit multi‐exponential dynamics, which are fragmented by obstructive sleep apnea (OSA), suggesting that Markov models may be a useful method to quantify architecture in health and disease. Sleep stage data were obtained from two subsets of the Sleep Heart Health Study database: control subjects with no medications, no OSA, no medical co‐morbidities and no sleepiness (n = 374); and subjects with severe OSA (n = 338). Sleep architecture was simplified into three stages: wake after sleep onset (WASO); non‐rapid eye movement (NREM) sleep; and rapid eye movement (REM) sleep. The connectivity and transition rates among eight ‘generator’ states of a first‐order continuous‐time Markov model were inferred from the observed (‘phenotypic’) distributions: three exponentials each of NREM sleep and WASO; and two exponentials of REM sleep. Ultradian REM cycling was accomplished by imposing time‐variation to REM state entry rates. Fragmentation in subjects with severe OSA involved faster transition probabilities as well as additional state transition paths within the model. The Markov models exhibit two important features of human sleep architecture: multi‐exponential stage dynamics (accounting for observed bout distributions); and probabilistic transitions (an inherent source of variability). In addition, the model quantifies the fragmentation associated with severe OSA. Markov sleep models may prove important for quantifying sleep disruption to provide objective metrics to correlate with endpoints ranging from sleepiness to cardiovascular morbidity.
Kinship of long‐term associates in the highly social sperm whale
Authors: ORTEGA‐ORTIZ JOEL G. , ENGELHAUPT DANIEL , WINSOR MARTHA , MATE BRUCE R. , RUS HOELZEL A.
Published: September 2011

The evolution of stable social groups can be promoted by both indirect and direct fitness benefits. Sperm whales (Physeter macrocephalus) are highly social, with a hierarchical social structure based around core groups of adult females and subadults, a rare level of complexity among mammals. We combined long‐term satellite tracking (ranging from 11 to 607 days) of 51 individual sperm whales with genetic kinship analysis to assess the pattern of kin associations within and among coherent social units. Unlike findings for other species with similar social structure, we find no consistent correlation between kinship and association apart from close associations between two pairs of first‐order relatives. A third pair of first‐order relatives did not associate, and overall, the mean relatedness was the same within as among social groups. However, social behaviour can also be promoted by ecological factors such as resource dispersion. We assessed putative foraging behaviour during travel from the satellite‐tracking data, which suggested that prey resources were dispersed and unpredictable, a condition that could promote living in groups.
Cerebral subcortical small vessel disease and its relation to cognition in elderly subjects: a pathological study in the Oxford Project to Investigate Memory and Ageing (OPTIMA) cohort
Authors: Smallwood A. , Oulhaj A. , Joachim C. , Christie S. , Sloan C. , Smith A. D. , Esiri M.
Published: September 2011

A. Smallwood, A. Oulhaj, C. Joachim, S. Christie, C. Sloan, A. D. Smith and M. Esiri (2012) Neuropathology and Applied Neurobiology38, 337–343

Cerebral subcortical small vessel disease and its relation to cognition in elderly subjects: a pathological study in the Oxford Project to Investigate Memory and Ageing (OPTIMA) cohort

Background: Subcortical small vessel disease (SVD) is known to contribute to vascular cognitive impairment and vascular dementia, but understanding about the extent of its influence is limited because there is a lack of consensus about how this pathology should be assessed. Methods: In this study we have made use of a simple, novel, image‐matching scoring system to assess the extent of SVD in a group of 70 cases from the prospectively assessed Oxford Project to Investigate Memory and Ageing (OPTIMA) cohort. These cases were found at autopsy to have cerebrovascular disease and no other pathology except Braak stage 4 or less tau pathology, and insufficient amyloid plaque pathology to meet Consortium to Establish a Registry for Alzheimer's Disease (CERAD) criteria for the diagnosis of Alzheimer's disease. Pathology scores for SVD were correlated with cognitive scores [Mini‐Mental State Examination (MMSE) and cognitive section of the Cambridge Examination for Mental Disorders in the Elderly (CAMDEX) (CAMCOG)] at the last clinical assessment before death. Results: The severity of SVD pathology was inversely related to cognitive score before death (P < 0.008 for MMSE and P < 0.024 for CAMCOG). Thirty‐one per cent and 33% of cases were rated as demented by MMSE or CAMCOG respectively. The degree of dementia was generally mild. Age did not influence severity of SVD. Conclusions: An image‐based scoring system for SVD in a group of 70 elderly subjects enabled the severity of SVD pathology to be assessed with results that showed a significant correlation between SVD pathology severity and cognitive impairment.
Effect of individual suppression of RBCS multigene family on Rubisco contents in rice leaves
Authors: OGAWA SHUN , SUZUKI YUJI , YOSHIZAWA RYUICHI , KANNO KEIICHI , MAKINO AMANE
Published: September 2011

In higher plants, a small subunit of Rubisco is encoded for by an RBCS multigene family in the nuclear genome. However, it is unknown how each multigene member contributes to the accumulation of Rubisco holoenzyme. Here, four RBCS genes that are highly expressed in leaf blaedes of rice (Oryza sativa L.) were individually suppressed by RNAi, and the effects on leaf Rubisco content were examined at seedling, vegetative and reproductive stages. Rubisco contents in each transgenic line declined irrespective of growth stage, and the ratios of Rubisco‐N to total N were 66–96% of wild‐type levels. The mRNA levels of the suppressed RBCS genes declined significantly, whereas those of the unsuppressed ones did not change drastically. These results indicate that four RBCS genes all contribute to accumulation of Rubisco holoenzyme irrespective of growth stage and that suppression of one RBCS gene is not fully compensated by other RBCS genes. Additionally, the mRNA levels of the large subunit of Rubisco showed a change similar to that of total RBCS mRNA level irrespective of genotype and growth stage. These results suggest that gene expression of RBCS and RBCL is regulated in a coordinated manner at the transcript level in rice.
Characterization and Comparison of ‘Standard’ and ‘Young’ Tumour‐Infiltrating Lymphocytes for Adoptive Cell Therapy at a Danish Translational Research Institution
Authors: Donia M. , Junker N. , Ellebaek E. , Andersen M. H. , Straten P. T. , Svane I. M.
Published: September 2011

Adoptive cell therapy (ACT) with ex vivo expanded tumour‐infiltrating lymphocytes (TILs) in combination with IL‐2 is an effective treatment for metastatic melanoma. Modified protocols of cell expansion may allow the treatment of most enrolled patients and improve the efficacy of adoptively transferred cells. The aims of this study were to establish and validate the novel ‘Young TIL’ method at our institution and perform a head‐to‐head comparison of clinical‐grade products generated with this protocol opposed to the conventional ‘Standard TIL’, which we are currently using in a pilot ACT trial for patients with melanoma. Our results confirm that ‘Young TILs’ display an earlier differentiation state, with higher CD27 and lower CD56 expression. In addition, CD8+ TILs expressing CD27 had longer telomeres compared with the CD27−. A recently described subset of NK cells, endowed with a high expression of CD56 (CD56bright), was detected for the first time in both types of cultures but at a higher frequency on Young TILs. Young and Standard TILs’ reactivity against autologous tumours was similar, with significant expression of TNF‐α/IFN‐γ/CD107a by CD8+ TILs detected in all cultures analysed. However, either slow expansion with high‐dose IL‐2 only or large numerical expansion with a rapid expansion protocol, which is required for current therapeutic protocols, significantly modified TIL phenotype by reducing the frequency of less differentiated, cancer‐specific TILs. These studies further support the adoption of the Young TIL method in our current ACT trial and highlight the importance of continuous quality control of expansion protocols.
Raa4 is a trans‐splicing factor that specifically binds chloroplast tscA intron RNA
Authors: Glanz Stephanie , Jacobs Jessica , Kock Vera , Mishra Arti , Kück Ulrich
Published: September 2011

During trans‐splicing of discontinuous organellar introns, independently transcribed coding sequences are joined together to generate a continuous mRNA. The chloroplast psaA gene from Chlamydomonas reinhardtii encoding the P700 core protein of photosystem I (PSI) is split into three exons and two group IIB introns, which are both spliced in trans. Using forward genetics, we isolated a novel PSI mutant, raa4, with a defect in trans‐splicing of the first intron. Complementation analysis identified the affected gene encoding the 112.4 kDa Raa4 protein, which shares no strong sequence identity with other known proteins. The chloroplast localization of the protein was confirmed by confocal fluorescence microscopy, using a GFP‐tagged Raa4 fusion protein. RNA‐binding studies showed that Raa4 binds specifically to domains D2 and D3, but not to other conserved domains of the tripartite group II intron. Raa4 may play a role in stabilizing folding intermediates or functionally active structures of the split intron RNA.
Protracted abstinence from distinct drugs of abuse shows regulation of a common gene network
Authors: Le Merrer Julie , Befort Katia , Gardon Olivier , Filliol Dominique , Darcq Emmanuel , Dembele Doulaye , Becker Jerome A. J. , Kieffer Brigitte L.
Published: September 2011

Addiction is a chronic brain disorder. Prolonged abstinence from drugs of abuse involves dysphoria, high stress responsiveness and craving. The neurobiology of drug abstinence, however, is poorly understood. We previously identified a unique set of hundred mu‐opioid receptor‐dependent genes in the extended amygdala, a key site for hedonic and stress processing in the brain. Here we examined these candidate genes either immediately after chronic morphine, nicotine, Δ9‐tetrahydrocannabinol or alcohol, or following 4 weeks of abstinence. Regulation patterns strongly differed among chronic groups. In contrast, gene regulations strikingly converged in the abstinent groups and revealed unforeseen common adaptations within a novel huntingtin‐centered molecular network previously unreported in addiction research. This study demonstrates that, regardless the drug, a specific set of transcriptional regulations develops in the abstinent brain, which possibly contributes to the negative affect characterizing protracted abstinence. This transcriptional signature may represent a hallmark of drug abstinence and a unitary adaptive molecular mechanism in substance abuse disorders.
The endogenous opioid system in human alcoholics: molecular adaptations in brain areas involved in cognitive control of addiction
Authors: Bazov Igor , Kononenko Olga , Watanabe Hiroyuki , Kuntić Vesna , Sarkisyan Daniil , Taqi Malik M. , Hussain Muhammad Z. , Nyberg Fred , Yakovleva Tatjana , Bakalkin Georgy
Published: September 2011

The endogenous opioid system (EOS) plays a critical role in addictive processes. Molecular dysregulations in this system may be specific for different stages of addiction cycle and neurocircuitries involved and therefore may differentially contribute to the initiation and maintenance of addiction. Here we evaluated whether the EOS is altered in brain areas involved in cognitive control of addiction including the dorsolateral prefrontal cortex (dl‐PFC), orbitofrontal cortex (OFC) and hippocampus in human alcohol‐dependent subjects. Levels of EOS mRNAs were measured by quantitative reverse transcription‐polymerase chain reaction (qRT‐PCR), and levels of dynorphins by radioimmunoassay (RIA) in post‐mortem specimens obtained from 14 alcoholics and 14 controls. Prodynorphin mRNA and dynorphins in dl‐PFC, κ‐opioid receptor mRNA in OFC and dynorphins in hippocampus were up‐regulated in alcoholics. No significant changes in expression of proenkephalin, and µ‐ and δ‐opioid receptors were evident; pro‐opiomelanocortin mRNA levels were below the detection limit. Activation of the κ‐opioid receptor by up‐regulated dynorphins in alcoholics may underlie in part neurocognitive dysfunctions relevant for addiction and disrupted inhibitory control.
Neuromuscular blocking agents for electroconvulsive therapy: a systematic review
Authors: MIRZAKHANI H. , WELCH C. A. , EIKERMANN M. , NOZARI A.
Published: September 2011

Electroconvulsive therapy (ECT) is the transcutaneous application of small electrical stimuli to the brain to induce generalised seizures for the treatment of selected psychiatric disorders. The clinical indications for ECT as an effective therapeutic modality have been considerably expanded since its introduction. Anaesthesia and neuromuscular blocking agents (NMBAs) are required to ensure patients’ safety during ECT. The optimal dose of muscle relaxant for ECT reduces muscle contractions without inducing complete paralysis. Slight residual motor convulsive activity is helpful in ascertaining that a seizure has occurred, while total paralysis prolongs the procedure unnecessarily. Suxamethonium is commonly used, but nondepolarising NMBAs are indicated in patients with certain comorbidities. In this review, we summarise current concepts of NMBA management for ECT.
Dexmedetomidine attenuates remote lung injury induced by renal ischemia‐reperfusion in mice
Authors: GU J. , CHEN J. , XIA P. , TAO G. , ZHAO H. , MA D.
Published: September 2011

Background

Renal ischemia–reperfusion (I/R) may cause acute lung injury (ALI). The mortality of combined acute kidney injury and ALI is extremely high. Dexmedetomidine, an α2 adrenergic agonist, exerts potent anti‐inflammatory and organoprotective effects in addition to its sedative and analgesic properties. We sought to elucidate whether dexmedetomidine can attenuate lung injury following renal I/R in a murine model of renal I/R.

Methods

Adult C57BL/6J male mice were randomized to five groups: sham‐operated control (Sham); renal I/R (I/R); intraperitoneal injection of dexmedetomidine 25 μg/kg before ischemia (pre‐dex) and after perfusion (post‐dex); combination of α2 adrenergic antagonist atipamezole 250 μg/kg prior to dexmedetomidine pre‐treatment (atip‐dex). Kidney I/R was induced by bilateral renal pedicle clamping for 45 min and followed by 6 h reperfusion. The pulmonary tissues were harvested for histopathological evaluation, wet/dry ratio measurement, biochemical analysis of myeloperoxidase (MPO), Polymerase chain reaction (PCR) determination of Inter‐cellular adhesion molecule (ICAM‐1) and Tumor necrosis factor – alpha (TNF‐α) mRNA.

Results

Renal IR induced significant pulmonary injuries, increased wet/dry ratio together with the enhanced of MPO activities and increased ICAM‐1 and TNF‐α mRNA level. Both pre‐ and post‐treatment with dexmedetomidine markedly reduced lung edema and inflammatory response and lowered MPO activity and ICAM‐1 and TNF‐α mRNA expression. The protective effects of dexmedetomidine in the lung were partially reversed by atipamezole, but there were no effect on ICAM‐1 and TNF‐α mRNA expression level.

Conclusions

Dexmedetomidine is capable of attenuating remote lung injury induced by renal IR via both α2 adrenoceptors dependent and independent mechanisms.
Photoplethysmographic and pulse pressure variations during abdominal surgery
Authors: HØISETH L. Ø. , HOFF I. E. , SKARE Ø. , KIRKEBØEN K. A. , LANDSVERK S. A.
Published: September 2011

Background

Respiratory variations in pulse pressure (ΔPP) predict fluid responsiveness during mechanical ventilation. Variations in pulse oximetry plethysmography amplitude (ΔPOP) are proposed as a non‐invasive alternative. Large variations in ΔPOP and poor agreement between ΔPP and ΔPOP are found in intensive care unit patients. General anaesthesia is suggested to reduce variability of ΔPOP and improve agreement between the variables. We evaluated the variability of the agreement between and the diagnostic values of ΔPP and ΔPOP during ongoing open abdominal surgery. The variability of diagnostic methods in specific clinical conditions is important, as this reflects the stability over time during which clinical decisions are made.

Methods

Observational study during open abdominal surgery in general anaesthesia. ΔPP and ΔPOP were calculated semi‐automatically from recording periods of approximately 5 min both before and after fluid challenges. Fluid responsiveness was evaluated by changes in stroke volume (oesophageal Doppler) after 250 ml colloid.

Results

Thirty‐four fluid challenges were performed in 25 patients. Variance both within registration periods and between patients were significantly larger for ΔPOP than for ΔPP (54.1% vs. 22.1% and 69.6% vs. 22.6%, respectively, both P < 0.001). Limits of agreement with a regression‐based correction were ± 13.9%. Areas under receiver operating characteristics curves for fluid responsiveness were 0.67 for ΔPP and 0.72 for ΔPOP.

Conclusions

Analysis of raw signals during open abdominal surgery documents that the variance of ΔPOP is larger than of ΔPP, with wide limits of agreement between ΔPP and ΔPOP. The diagnostic values of ΔPP and ΔPOP are relatively poor.
Hospital and long‐term outcomes of ICU‐treated severe community‐ and hospital‐acquired, and ventilator‐associated pneumonia patients
Authors: KARHU J. , ALA‐KOKKO T. I. , YLIPALOSAARI P. , OHTONEN P. , LAURILA J. J. , SYRJÄLÄ H.
Published: September 2011

Background

Our purpose was to analyse the association of pneumonia types with hospital and long‐term outcomes of intensive care unit (ICU)‐treated pneumonia patients.

Methods

The occurrence of pneumonia was retrospectively evaluated among prospectively registered patients admitted into a mixed university‐level ICU during a 14‐month period. Their age, severity of underlying disease, malignancy, immunosuppressive therapy and organ dysfunctions were recorded, as well as the length of hospital stay and short‐ and long‐term mortalities.

Results

There were 117 severe community‐acquired pneumonia (SCAP), 66 hospital‐acquired pneumonia (HAP) and 25 ventilator‐associated pneumonia (VAP) cases among the 817 patients admitted. ICU and hospital mortality did not differ between pneumonia groups. VAP and HAP patients had more malignant underlying diseases than SCAP patients (P < 0.001). HAP patients were older than SCAP and VAP patients (P = 0.023). The admission Acute Physiology and Chronic Health Evaluation II scores did not differ between the groups (P > 0.90). The patients with VAP had higher Sequential Organ Failure Assessment maximum scores compared with patients with SCAP and HAP (P < 0.001). In an adjusted multivariate logistic regression model, there were no significant differences in odds ratios for hospital mortality between the three pneumonia types. Mortality among the hospital survivors during the 12‐month follow‐up period was 18% (16/89) in the SCAP group, 35% (18/51) in the HAP group and 41% (7/17) in the VAP group (P = 0.023).

Conclusion

The type of pneumonia (i.e. SCAP, HAP or VAP) had no significant association with hospital mortality, whereas the SCAP patients had the lowest 1‐year mortality.
Characterization of Magnaporthe grisea (Pyricularia grisea) from Black Oat in Brazil
Authors: Urashima Alfredo Seiiti , Silva Cristina Perbelini
Published: September 2011

Blast caused by Magnaporthe grisea (Pyricularia grisea) is a disease that occurs in many important gramineous plants in Brazil such as rice, wheat, triticale and barley. In 2005, the presence of this disease was reported on black oat (Avena strigosa) at different locations of Parana state. Due to little information of M. grisea that is infecting this host, this work aimed to characterize it at molecular, sexual and pathogenic level. DNA analysis showed that M. grisea from black oat formed a homogenous and genetic distinct group of its own, different from other hosts, including rice, wheat, triticale and barley. Isolate 15720 was an exception, because it was similar to wheat isolate. There was no sexual compatibility between M. grisea from oat and other tested hosts. In pathogenic terms, isolates of M. grisea from oat infected triticale, wheat, rye, millet, barley, sorghum and rice; cross‐inoculation was positive with wheat, triticale, rice and barley.
Pelvic Dimensions in Phenotypically Double‐muscled Belgian Blue cows
Authors: Kolkman I , Hoflack G , Aerts S , Laevens H , Lips D , Opsomer G
Published: September 2011

Contents

Some anatomical characteristics of 507 Belgian Blue (BB) cattle, withers height (WH), heart girth (HG), the distance between the two tubera coxae (TcTc) and the distance between the two tubera ischiadica (TiTi), were compared with the internal pelvic measurements of width, height and area. Mean values were 58.9 ± 6.2 cm for TcTc, 14.6 ± 2.3 cm for TiTi, 15.2 ± 2.1 cm for pelvic width (PW), 18.8 ± 1.9 cm for pelvic height (PH) and 288.5 ± 60.9 cm2 for pelvic area (PA). Cows that calved per vaginam had larger WH (p < 0.05), TcTc (p < 0.05) and TiTi (p < 0.001) and internal pelvic measurements [PH and PA (p < 0.001)] compared with those whose parturition was managed by caesarean section (CS): Correlations between internal pelvic measurements and TcTc were higher (r = 0.58–0.63) than TiTi (r = 0.22–0.28). Correlations between other external body measures such as HG and WH with the internal pelvic measurements were even higher for HG (r = 0.69–0.74) and for WH (r = 0.67–0.74). HG and WH, together with internal pelvic measures, may be added to estimated breeding values (EBV’s) that should assist breeders in selecting cows that can calve per vaginam, thereby reducing the breed’s dependence on elective CS for maintaining its unique characteristics.
Determination of fluid status in haemodialysis patients with whole body and calf bioimpedance techniques
Authors: LIU LI , ZHU FANSAN , G RAIMANN JOCHEN , THIJSSEN STEPHAN , SIPAHIOGLU MURAT H , WYSTRYCHOWSKI GREGORY , KITZLER THOMAS , TETTA CIRO , WABEL PETER , KOTANKO PETER , LEVIN NATHAN W
Published: September 2011

Aim:  The aim of this study was to demonstrate the ability of widely used bioimpedance techniques to assess dry weight (DW) and to predict a state of normal hydration in haemodialysis patients whose post‐dialysis weight had been gradually reduced from baseline in successive treatments over time.

Methods:  Calf bioimpedance spectroscopy (cBIS) was employed to determine DW (DWcBIS) as defined by flattening of an intradialytic continuously measured resistance curve and by normalized resistivity (nRho) being in the gender‐specific normal range. The wECV/TBW ratio was determined by ‘classical’ wrist‐to‐ankle whole body bioimpedance spectroscopy (wBIS); in addition, a novel whole body model (WBM) based on wBIS was used to predict normal hydration weight (NHWWBM).

Results:  Twenty‐one haemodialysis patients were studied; 11 ± 6 measurements were performed per patient. Nine patients reached DWcBIS (DWcBIS group), while 12 patients remained fluid‐overloaded (non‐DWcBIS group). Change in wECV as measured by wBIS accounted for 46 ± 23% in DWcBIS group, which was higher than in non‐DWcBIS group (33 ± 48%, P < 0.05) of actual weight loss at the end of study. In both groups the wECV/TBW ratio did not change significantly between baseline and study end. Mean predicted NHWWBM at baseline was 3.55 ± 1.6 kg higher than DWcBIS. The difference in DWcBIS and NHWWBM was 1.97 ± 1.0 kg at study end.

Conclusion:  WBM could be useful to predict a target range of normal hydration weight particularly for patients with substantial fluid overload. The cBIS provides an accurate reference for the estimation of DW so that combined use of cBIS and WBM is promising and warrants further studies.
Pandemic (H1N1) 2009 in pregnant Japanese women in Hokkaido
Authors: Yamada Takahiro , Yamada Takashi , Morikawa Mamoru , Cho Kazutoshi , Endo Toshiaki , Sato Sawako Seto , Saito Tsuyoshi , Sengoku Kazuo , Minakami Hisanori
Published: September 2011

Aim:  No maternal mortality from pandemic (H1N1) 2009 occurred in Japan. However, the reasons for this lack of maternal deaths remain unknown. This study was performed to investigate how many pregnant women were infected, how many women took antiviral drugs for prophylaxis or treatment, and the rate of vaccination effectiveness.

Material and Methods:  A questionnaire study was given to 20 500 postpartum women before leaving obstetric facilities between December 2009 and May 2010 in Hokkaido, asking about antiviral drugs, vaccination, and infection with pandemic (H1N1) 2009.

Results:  Approximately one‐third (n = 7535) of women given the questionnaires responded. Of these, 268 women (3.5%) indicated that they had contracted influenza. 353 (4.7%) women took antiviral drugs for prophylaxis after close contact with an infected person and 140 (39.7%) of 353 women finally contracted influenza during or after prophylaxis with antiviral drugs, accounting for 52.2% (140/268) of all patients. 229 (85.4%) of 268 patients took antiviral drug for treatment and 6 (2.2%) needed hospitalization, but not mechanical ventilation or intensive care unit. 196 of 268 (73.1%) patients were already infected before the availability of a vaccine. Among 7328 candidates for vaccination, 4921 (67.2%) were vaccinated. Infection occurred in 0.22% (11/4921) and 2.1% (50/2407) of vaccinated and non‐vaccinated women, respectively.

Conclusion:  Frequent use of antiviral drugs for prophylaxis and treatment may partially explain the low infection rate and no maternal mortality from pandemic (H1N1) 2009 in Japan. Vaccination reduced infection by 89% in pregnant Japanese women.
Screening for urinary tract infection in women with hyperemesis gravidarum
Authors: Tan Peng Chiong , King Anthonia Siaw Jia , Omar Siti Zawiah
Published: September 2011

Aim:  The aim of this study was to evaluate urine microscopy, dipstick analysis and urinary symptoms in screening for urinary tract infection (UTI) in hyperemesis gravidarum (HG).

Materials and Methods:  A prospective cross‐sectional study was performed on women at first hospitalization for HG. A clean‐catch mid‐stream urine sample from each recruit was sent for microscopy (for bacteria, leucocytes and erythrocytes), dipstick analysis (for leukocyte esterase, nitrites, protein and hemoglobin) and microbiological culture. The presence of current urinary symptoms was elicited by questionnaire. UTI is defined as at least 105 colony‐forming units/mL of a single uropathogen on culture. Screening test parameters were analyzed against UTI.

Results:  UTI was diagnosed in 15/292 subjects (5.1%). Receiver–operator characteristic curve analysis of microscopic urine leucocytes revealed area under the curve = 0.64, 95% confidence interval (CI) 0.5–0.79, P = 0.063 and erythrocytes area under the curve = 0.53, 95%CI 0.39–0.67, P = 0.67 for UTI indicating the limited screening utility of these parameters. Microscopic bacteriuria (likelihood ratio [LR] 1.1, 95%CI 0.7–1.5) and urine dipstick leukocyte esterase (LR 1.4, 95%CI 1.1–1.8), nitrites (LR 2.3, 95%CI 0.3–17.2), protein (LR 1.0, 95%CI 0.7–1.6) and hemoglobin (LR 0.8, 95%CI 0.4–1.5) were not useful screening tests for UTI in HG. Elicited symptoms were also not predictive of UTI.

Conclusion:  Urine microscopy, dipstick analysis and urinary symptoms were not useful in screening for UTI in HG. UTI should be established by urine culture in HG before starting antibiotic treatment.
When do we need to perform laparotomy for benign uterine disease? Factors involved with conversion in vaginal hysterectomy
Authors: Cho Hye‐Yon , Kim Hong‐Bae , Kang Sung‐Won , Park Sung‐Ho
Published: September 2011

Aim:  To identify the preoperative risk factors affecting the conversion to laparotomy during vaginal hysterectomy (VH) for benign uterine conditions.

Material and Methods:  The charts were reviewed for all patients who underwent VH between 1 January 2003 and 31 December 2008 at Hallym University Hospital, Seoul.

Results:  The rate of conversion to laparotomy was 3.7% (32 cases). Factors that were independently associated with the risk of conversion to laparotomy were found to be low parity (conversion 1.43 vs VH 1.92, P = 0.021), previous abdominal surgery (conversion 0.71 vs, VH 0.26, P = 0.012), pelvic adhesion (conversion 1.25 vs VH 0.04, P = 0.000), and large uterine weight (conversion 345.15 g vs VH 222.38 g, P = 0.005). In the conversion group, the operative time was longer (conversion 144.84 min vs VH 77.67 min, P = 0.000), and estimated blood loss was also greater (conversion 656.25 mL vs VH 358.47 mL, P = 0.00). Postoperative hemoglobin change (conversion 1.65 g/dL vs VH 1.23 g/dL, P = 0.046) and transfusion rate were also greater in the conversion group (conversion 0.75 vs VH 0.01, P = 0.001).

Conclusion:  VH is the main procedure for benign uterine disease and is successfully performed in most cases. But several factors, including low parity, previous abdominal surgery, pelvic adhesion and large uterine weight can affect the risk of conversion to laparotomy.
Cardiac performance is impaired in morbidly obese pregnant females
Authors: Abdullah Arif , Hoq Sheikh , Choudhary Ronika , Laifer Steven , Zarich Stuart
Published: September 2011

Aim:  To evaluate the effect of pregnancy on ventricular function in morbidly obese as compared to lean controls.

Material and Methods:  We serially studied 33 obese and non‐obese pregnant females with echocardiography during each trimester of pregnancy and after delivery. Two well‐validated, relatively load‐independent indices of contractility (systolic shortening index and systolic velocity index) were assessed, along with more traditional echocardiographic parameters. ANOVA for repeated measures was used to compare data between sequential studies in the normal and obese pregnant groups.

Results:  In lean controls, stroke volume increased and contractility was maintained during pregnancy as compared to pre‐pregnancy levels. In contrast, both stroke volume and contractility declined significantly by the third trimester in morbidly obese females.

Conclusion:  There is a maladaptive left ventricular contractile response to pregnancy in morbidly obese patients.
Evaluation of air‐QTM intubating laryngeal airway as a conduit for tracheal intubation in infants – a pilot study
Authors: Sinha Renu , Chandralekha  , Ray Bikash Ranjan
Published: September 2011

Background:  Air‐QTM intubating laryngeal airway (ILA) has been used successfully as a conduit for tracheal intubation in pediatric difficult airway. However, its use as an airway device and conduit for intubation in infants is not yet evaluated.

Aims:  The primary objective was to evaluate ILA as a conduit for tracheal intubation in infants, and secondary objectives were to evaluate ILA in terms of ease of insertion and ventilation, oropharyngeal leak pressure (OLP), glottic view, and complications.

Methods:  Twenty infants with normal airway were included. After induction of general anesthesia and neuromuscular blockade, ILA (size 1.0/1.5) was inserted. Fiberoptic bronchoscope (FOB)–guided intubation and removal of ILA with the stabilizing stylet was attempted.

Results:  The mean age and weight of the infants were 7.5 ± 2.3 months and 7.3 ± 1.8 kg. The ILA sizes 1.0 and 1.5 were inserted in 10 infants each according to the weight of the infants. The mean OLP was 18.5 ± 1.8 cm H2O, and mean time for insertion of ILA was 13.3 ± 3.9 s. Glottic view was grade I in 6, grade II in 1, grade III in 4, and grade IV in nine infants. Tracheal intubation was successful in 19/20 infants. The mean endotracheal tube (ETT) insertion time and mean total time (ILA insertion to the confirmation of ETT placement) were 95.6 ± 32.3 s and 306.42 ± 120.2 s respectively.

Conclusion:  The ILA is a safe and easy‐to‐use supraglottic airway device for intubation with FOB in infants with normal airway. Insertion and removal of ILA are easy with satisfactory oropharyngeal seal and ventilation.
Manganese sulfide formation via concomitant microbial manganese oxide and thiosulfate reduction
Authors: Lee Ji‐Hoon , Kennedy David W. , Dohnalkova Alice , Moore Dean A. , Nachimuthu Ponnusamy , Reed Samantha B. , Fredrickson James K.
Published: September 2011

The dissimilatory metal‐reducing bacterium, Shewanella oneidensis MR‐1 produced γ‐MnS (rambergite) nanoparticles during the concurrent reduction of MnO2 and thiosulfate coupled to H2 oxidation. To investigate effect of direct microbial reduction of MnO2 on MnS formation, two MR‐1 mutants defective in outer membrane c‐type cytochromes (ΔmtrC/ΔomcA and ΔmtrC/ΔomcA/ΔmtrF) were also used and it was determined that direct reduction of MnO2 was dominant relative to chemical reduction by biogenic sulfide generated from thiosulfate reduction. Although bicarbonate was excluded from the medium, incubations of strain MR‐1 with lactate as the electron donor produced MnCO3 (rhodochrosite) as well as MnS in nearly equivalent amounts as estimated by micro X‐ray diffraction (micro‐XRD) analysis. It was concluded that carbonate released from lactate metabolism promoted MnCO3 formation and that Mn(II) mineralogy was strongly affected by carbonate ions even in the presence of abundant sulfide and weakly alkaline conditions expected to favour the precipitation of MnS. Formation of MnS, as determined by a combination of micro‐XRD, transmission electron microscopy, energy dispersive X‐ray spectroscopy, and selected area electron diffraction analyses was consistent with equilibrium speciation modelling predictions. Biogenic manganese sulfide may be a manganese sink in the Mn biogeochemical cycle in select environments such as deep anoxic marine basins within the Baltic Sea.
Genome of alkaliphilic Bacillus pseudofirmus OF4 reveals adaptations that support the ability to grow in an external pH range from 7.5 to 11.4
Authors: Janto Benjamin , Ahmed Azad , Ito Masahiro , Liu Jun , Hicks David B. , Pagni Sarah , Fackelmayer Oliver J. , Smith Terry‐Ann , Earl Joshua , Elbourne Liam D.H. , Hassan Karl , Paulsen Ian T. , Kolstø Anne‐Brit , Tourasse Nicolas J. , Ehrlich Garth D. , Boissy Robert , Ivey D. Mack , Li Gang , Xue Yanfen , Ma Yanhe , Hu Fen Z. , Krulwich Terry A.
Published: September 2011

Bacillus pseudofirmus OF4 is an extreme but facultative alkaliphile that grows non‐fermentatively in a pH range from 7.5 to above 11.4 and can withstand large sudden increases in external pH. It is a model organism for studies of bioenergetics at high pH, at which energy demands are higher than at neutral pH because both cytoplasmic pH homeostasis and ATP synthesis require more energy. The alkaliphile also tolerates a cytoplasmic pH > 9.0 at external pH values at which the pH homeostasis capacity is exceeded, and manages other stresses that are exacerbated at alkaline pH, e.g. sodium, oxidative and cell wall stresses. The genome of B. pseudofirmus OF4 includes two plasmids that are lost from some mutants without viability loss. The plasmids may provide a reservoir of mobile elements that promote adaptive chromosomal rearrangements under particular environmental conditions. The genome also reveals a more acidic pI profile for proteins exposed on the outer surface than found in neutralophiles. A large array of transporters and regulatory genes are predicted to protect the alkaliphile from its overlapping stresses. In addition, unanticipated metabolic versatility was observed, which could ensure requisite energy for alkaliphily under diverse conditions.