bluuebunny/crossref_metadata_2025 huggingface dataset:
Examination of the Relationship Among Hearing Impairment, Linguistic Communication, Mood, and Social Engagement of Residents in Complex Continuing-Care Facilities
Authors: Brink Peter , Stones Michael
Published: April 2011

Earlier evidence was not conclusive about whether hearing loss is associated with mood (i.e., depressive symptoms and anhedonia) and social engagement (i.e., reduced psychosocial involvement and reduced activity levels) in elderly residents living in complex continuing-care facilities. If hearing impairment results in poor mood and lower levels of social engagement, then remedying hearing impairment might result in a higher quality of life. Purpose: The purpose of this study was to determine if functional hearing impairment in continuing-care residents is associated with mood and social engagement. Design and Methods: This study included all residents in Ontario who were admitted to complex continuing-care facilities between April 2000 and March 2001. Through the Canadian Institute of Health Information, we gathered health information by using the Minimum Data Set 2.0 questionnaire.  Results: The results were consistent with our hypothesized direct effect of functional hearing impairment on mood. Path analyses showed that hearing impairment impairs linguistic communication and that impaired linguistic communication is related to lower levels of mood and social engagement. Implications: This study adds to the literature supporting an association between hearing impairment and mood. It suggests that remedying hearing impairment may lower levels of poor mood in residents of complex continuing-care facilities. This, in turn, may reduce the negative effects of hearing impairment on social engagement and increase the quality of life for residents of these facilities. This study also suggests that questionnaires used to assess hearing, such as the Minimum Data Set 2.0, are suitable for early identification of hearing problems and may be used to refer residents to audiological services.
What the Resident Meant to Say: Use of Cognitive Interviewing Techniques to Develop Questionnaires for Nursing Home Residents
Authors: Housen Patricia , Shannon George R. , Simon Barbara , Edelen Maria Orlando , Cadogan Mary P. , Sohn Linda , Jones Malia , Buchanan Joan L. , Saliba Debra
Published: April 2011

Purpose:  Emphasis on consumer-centered care for frail and institutionalized older adults has increased the development and adaptation of surveys for this population. Conventional methods used to pretest survey items fail to investigate underlying sources of measurement error. However, the use of the cognitive interview (CI), a method for studying how respondents answer survey items, is not well established or documented in this population. This study demonstrates how CIs can be used to improve questionnaires intended for nursing home residents. Design and Methods: CIs were conducted with 29 nursing home residents in order to identify potential problems with prospective survey items. We used scripted probes to standardize the interviews and adapted the Question Appraisal System to enumerate and classify the problems discovered. Results: We fielded between one and five versions of each item in an iterative process that identified 61 item-specific problems. Additionally, residents' cognitive responses suggested that some screened their answers on the basis of perceived physical and environmental limitations, and some had difficulty answering items about preferences that fluctuate day to day. These findings led us to modify the items and response set to simplify the respondents' cognitive task. Implications: This study illustrates how CI techniques can be used to understand residents' comprehension of and response to survey items.
Fall-Related Hospitalization and Facility Costs Among Residents of Institutions Providing Long-Term Care
Authors: Carroll Norman V. , Delafuente Jeffrey C. , Cox Fred M. , Narayanan Siva
Published: April 2011

Purpose:  The purpose of this study was to estimate hospital and long-term-care costs resulting from falls in long-term-care facilities (LTCFs). Design and Methods: The study used a retrospective, pre/post with comparison group design. We used matching, based on propensity scores, to control for baseline differences between fallers and non-fallers. We estimated residents' propensity to fall from demographics, comorbidities, and reimbursement in the pre-period. The matched sample included 1,130 fallers and 1,130 non-fallers who were residents of a large, multifacility long-term-care chain. Cost estimates were based on information in the Minimum Data Set and were defined as hospital and LTCF reimbursements. We estimated fall-related costs as the difference between changes in costs for fallers and non-fallers from the pre- to post-period. Results: Fallers were substantially more likely to suffer fractures and hospitalizations in the post-period than were non-fallers. Fall-related LTCF and hospital costs were $6,259 (95% confidence interval = $2,034–$10,484) per resident per year. About 60% of this amount was attributable to higher hospitalization costs. Fallers were more likely to be discharged to hospitals or to die. Implications: Falls in LTCFs are associated with costs of about $6,200 per resident per year. These results provide baseline estimates that one may use to estimate the cost-effectiveness of interventions to reduce fall rates.
Effect of Rifampicin on S-ketamine and S-norketamine Plasma Concentrations in Healthy Volunteers after Intravenous S-ketamine Administration
Authors: Noppers Ingeborg , Olofsen Erik , Niesters Marieke , Aarts Leon , Mooren René , Dahan Albert , Kharasch Evan , Sarton Elise
Published: April 2011

Background

Low-dose ketamine is used as analgesic for acute and chronic pain. It is metabolized in the liver to norketamine via cytochrome P450 (CYP) enzymes. There are few human data on the involvement of CYP enzymes on the elimination of norketamine and its possible contribution to analgesic effect. The aim of this study was to investigate the effect of CYP enzyme induction by rifampicin on the pharmacokinetics of S-ketamine and its major metabolite, S-norketamine, in healthy volunteers.

Methods

Twenty healthy male subjects received 20 mg/70 kg/h (n = 10) or 40 mg/70 kg/h (n = 10) intravenous S-ketamine for 2 h after either 5 days oral rifampicin (once daily 600 mg) or placebo treatment. During and 3 h after drug infusion, arterial plasma concentrations of S-ketamine and S-norketamine were obtained at regular intervals. The data were analyzed with a compartmental pharmacokinetic model consisting of three compartments for S-ketamine, three sequential metabolism compartments, and two S-norketamine compartments using the statistical package NONMEM® 7 (ICON Development Solutions, Ellicott City, MD).

Results

Rifampicin caused a 10% and 50% reduction in the area-under-the-curve of the plasma concentrations of S-ketamine and S-norketamine, respectively. The compartmental analysis indicated a 13% and 200% increase in S-ketamine and S-norketamine elimination from their respective central compartments by rifampicin.

Conclusions

: A novel observation is the large effect of rifampicin on S-norketamine concentrations and indicates that rifampicin induces the elimination of S-ketamine's metabolite, S-norketamine, probably via induction of the CYP3A4 and/or CYP2B6 enzymes.
Mechanism of birth in chimpanzees: humans are not unique among primates
Authors: Hirata Satoshi , Fuwa Koki , Sugama Keiko , Kusunoki Kiyo , Takeshita Hideko
Published: April 2011

Researchers have argued that the process of human birth is unique among primates and mammals in that the infant emerges with its face oriented in the opposite direction from its mother (occiput anterior) and head rotation occurs in the birth canal. However, this notion of human uniqueness has not been substantiated, because there are few comparative studies of birth in non-human primates. This paper reports the mechanism of birth in chimpanzees (
Pan troglodytes
) based on the first clear, close-up video recordings of three chimpanzee births in captivity. In all three cases, the foetus emerged with an occiput anterior orientation, and the head and body rotated after the head had emerged. Therefore, these characteristics are not uniquely human. Furthermore, in two of the three cases, the chimpanzee newborns landed on the ground without being guided from the birth canal by the mother. The fact that the human newborn emerges with an occiput anterior orientation has thus far been taken as evidence for the necessity of midwifery in modern humans, but this view also needs revision. Our observations raise the need to reconsider the evolutionary scenario of human birth.
Climate change impact on Balearic shearwater through a trophic cascade
Authors: Luczak C. , Beaugrand G. , Jaffré M. , Lenoir S.
Published: April 2011

A recent study showed that a critically endangered migratory predator species, the Balearic shearwater
Puffinus mauretanicus
, rapidly expanded northwards in northeast Atlantic waters after the mid-1990s. As a significant positive correlation was found between the long-term changes in the abundance of this seabird and sea temperature around the British Isles, it was hypothesized that the link between the biogeographic shift and temperature occurred through the food web. Here, we test this conjecture and reveal concomitant changes in a regional index of sea temperature, plankton (total calanoid copepod), fish prey (anchovy and sardine) and the Balearic shearwater for the period 1980–2003. All three trophic levels exhibit a significant shift detected between 1994 and 1996. Our findings therefore support the assertion of both a direct and an indirect effect of climate change on the spatial distribution of post-breeding Balearic shearwater through a trophic cascade.
A golden orb-weaver spider (Araneae: Nephilidae:
Nephila
) from the Middle Jurassic of China
Authors: Selden Paul A. , Shih ChungKun , Ren Dong
Published: April 2011

Nephila
are large, conspicuous weavers of orb webs composed of golden silk, in tropical and subtropical regions. Nephilids have a sparse fossil record, the oldest described hitherto being
Cretaraneus vilaltae
from the Cretaceous of Spain. Five species from Neogene Dominican amber and one from the Eocene of Florissant, CO, USA, have been referred to the extant genus
Nephila
. Here, we report the largest known fossil spider,
Nephila jurassica
sp. nov., from Middle Jurassic (approx. 165 Ma) strata of Daohugou, Inner Mongolia, China. The new species extends the fossil record of the family by approximately 35 Ma and of the genus
Nephila
by approximately 130 Ma, making it the longest ranging spider genus known. Nephilidae originated somewhere on Pangaea, possibly the North China block, followed by dispersal almost worldwide before the break-up of the supercontinent later in the Mesozoic. The find suggests that the palaeoclimate was warm and humid at this time. This giant fossil orb-weaver provides evidence of predation on medium to large insects, well known from the Daohugou beds, and would have played an important role in the evolution of these insects.
Tactic-dependent plasticity in ejaculate traits in the swordtail
Xiphophorus nigrensis
Authors: Smith Chad C. , Ryan Michael J.
Published: April 2011

In species with alternative reproductive tactics, males that sneak copulations often have larger, higher quality ejaculates relative to males that defend females or nest sites. Ejaculate traits can, however, exhibit substantial phenotypic plasticity depending on a male's mating role in sperm competition, which may depend on the tactic of his competitor. We tested whether exposure to males of different tactics affected sperm number and quality in the swordtail
Xipophorus nigrensis
, a species with small males that sneak copulations and large males that court females. Sperm swimming speed was higher when the perceived competitor was small than when the competitor was large. Plasticity, however, was only exhibited by small males. Sperm number and viability were invariant between social environments. Our results suggest sperm quality is role-dependent and that plastic responses to the social environment can differ between male reproductive tactics.
Exploring the possibility of early cataract diagnostics based on tryptophan fluorescence
Authors: Gakamsky Dmitry M. , Dhillon Bal , Babraj John , Shelton Matthew , Smith S. Desmond
Published: April 2011

A novel route for early cataract diagnostics is investigated based on the excitation of tryptophan fluorescence (TF) at the red edge of its absorption band at 317 nm. This allows penetration through the cornea and aqueous humour to provide excitation of the ocular lens. The steepness of the red edge gives the potential of depth control of the lens excitation. Such wavelength selection targets the population of tryptophan residues, side chains of which are exposed to the polar aqueous environment. The TF emissions around 350 nm of a series of UV-irradiated as well as control lenses were observed. TF spectra of the UV cases were red-shifted and the intensity decreased with the radiation dose. In contrast, intensity of non-tryptophan emission with maximum at 435 nm exhibited an increase suggesting photochemical conversion of the tryptophan population to 435 nm emitting molecules. We demonstrate that the ratio of intensities at 435 nm to that around 350 nm can be used as a measure of early structural changes caused by UV irradiation in the lens by comparison with images from a conventional slit-lamp, which can only detect defects of optical wavelength size. Such diagnostics at a molecular level could aid research on cataract risk investigation and possible pharmacological research as well as assisting surgical lens replacement decisions.
Modelling planar polarity of epithelia: the role of signal relay in collective cell polarization
Authors: Viktorinová Ivana , Pismen Len M. , Aigouy Benoît , Dahmann Christian
Published: April 2011

Collective cell polarization is an important characteristic of tissues. Epithelia commonly display cellular structures that are polarized within the plane of the tissue. Establishment of this planar cell polarity requires mechanisms that locally align polarized structures between neighbouring cells, as well as cues that provide global information about alignment relative to an axis of a tissue. In theDrosophilaovary, the cadherin Fat2 is required to orient actin filaments located at the basal side of follicle cells perpendicular to the long axis of the egg chamber. The mechanisms directing this orientation of actin filaments, however, remain unknown. Here we show, using genetic mosaic analysis, thatfat2is not essential for the local alignment of actin filaments between neighbouring cells. Moreover, we provide evidence that Fat2 is involved in the propagation of a cue specifying the orientation of actin filaments relative to the tissue axis. Monte Carlo simulations of actin filament orientation resemble the results of the genetic mosaic analysis, if it is assumed that a polarity signal can propagate from a signal source only through a connected chain of wild-type cells. Our results suggest that Fat2 is required for propagating global polarity information within the follicle epithelium through direct cell–cell contact. Our computational model might be more generally applicable to study collective cell polarization in tissues.
Evolution of social learning when high expected payoffs are associated with high risk of failure
Authors: Arbilly Michal , Motro Uzi , Feldman Marcus W. , Lotem Arnon
Published: April 2011

In an environment where the availability of resources sought by a forager varies greatly, individual foraging is likely to be associated with a high risk of failure. Foragers that learn where the best sources of food are located are likely to develop risk aversion, causing them to avoid the patches that are in fact the best; the result is sub-optimal behaviour. Yet, foragers living in a group may not only learn by themselves, but also by observing others. Using evolutionary agent-based computer simulations of a social foraging game, we show that in an environment where the most productive resources occur with the lowest probability, socially acquired information is strongly favoured over individual experience. While social learning is usually regarded as beneficial because it filters out maladaptive behaviours, the advantage of social learning in a risky environment stems from the fact that it allows risk aversion to be circumvented and the best food source to be revisited despite repeated failures. Our results demonstrate that the consequences of individual risk aversion may be better understood within a social context and suggest one possible explanation for the strong preference for social information over individual experience often observed in both humans and animals.
Modelling the performance of isoniazid preventive therapy for reducing tuberculosis in HIV endemic settings: the effects of network structure
Authors: Mills H. L. , Cohen T. , Colijn C.
Published: April 2011

Individuals living with HIV experience a much higher risk of progression from latent
M. tuberculosis
infection to active tuberculosis (TB) disease relative to individuals with intact immune systems. A several-month daily course of a single drug during latent infection (i.e. isoniazid preventive therapy (IPT)) has proved in clinical trials to substantially reduce an HIV-infected individual's risk of TB disease. As a result of these findings and ongoing studies, the World Health Organization has produced strong guidelines for implementing IPT on a community-wide scale for individuals with HIV at risk of TB disease. To date, there has been limited use of IPT at a community-wide level. In this paper, we present a new co-network model for HIV and TB co-epidemics to address questions about how the population-level impact of community-wide IPT may differ from the individual-level impact of IPT offered to selected individuals. In particular, we examine how the effect of clustering of contacts within high-TB incidence communities may affect the rates of re-infection with TB and how this clustering modifies the expected population-level effects of IPT. We find that populations with clustering of respiratory contacts experience aggregation of TB cases and high numbers of re-infection events. While, encouragingly, the overall population-level effects of community-wide IPT appear to be sustained regardless of network structure, we find that in populations where these contacts are highly clustered, there is dramatic heterogeneity in the impact of IPT: in some sub-regions of these populations, TB is nearly eliminated, while in others, repeated re-infection almost completely undermines the effect of IPT. Our findings imply that as IPT programmes are brought to scale, we should expect local heterogeneity of effectiveness as a result of the complex patterns of disease transmission within communities.
Female choice for male motor skills
Authors: Barske Julia , Schlinger Barney A. , Wikelski Martin , Fusani Leonida
Published: April 2011

Sexual selection was proposed by Darwin to explain the evolution of male sexual traits such as ornaments and elaborate courtship displays. Empirical and theoretical studies have traditionally focused on ornaments; the reasons for the evolution of elaborate, acrobatic courtship displays remain unclear. We addressed the hypothesis that females choose males on the basis of subtle differences in display performance, indicating motor skills that facilitate survival. Male golden-collared manakins (
Manacus vitellinus
) perform elaborate, acrobatic courtship displays. We used high-speed cameras to record the displays of wild males and analysed them in relation to male reproductive success. Females preferred males that performed specific display moves at greater speed, with differences of tens of milliseconds strongly impacting female preference. In additional males, we recorded telemetrically the heart rate during courtship using miniature transmitters and found that courtship is associated with profoundly elevated heart rates, revealing a large metabolic investment. Our study provides evidence that females choose their mates on the basis of subtle differences in motor performance during courtship. We propose that elaborate, acrobatic courtship dances evolve because they reflect motor skills and cardiovascular function of males.
Digit ratio (2D:4D) predicts facial, but not voice or body odour, attractiveness in men
Authors: Ferdenzi Camille , Lemaître Jean-François , Leongómez Juan David , Roberts S. Craig
Published: April 2011

There is growing evidence that human second-to-fourth digit ratio (or 2D:4D) is related to facial features involved in attractiveness, mediated by
in utero
hormonal effects. The present study extends the investigation to other phenotypic, hormone-related determinants of human attractiveness: voice and body odour. Pictures of faces with a neutral expression, recordings of voices pronouncing vowels and axillary odour samples captured on cotton pads worn for 24 h were provided by 49 adult male donors. These stimuli were rated on attractiveness and masculinity scales by two groups of 49 and 35 females, approximately half of these in each sample using hormonal contraception. Multivariate regression analyses showed that males' lower (more masculine) right 2D:4D and lower right-minus-left 2D:4D (Dr−l) were associated with a more attractive (and in some cases more symmetrical), but not more masculine, face. However, 2D:4D and Dr−l did not predict voice and body odour masculinity or attractiveness. The results were interpreted in terms of differential effects of prenatal and circulating testosterone, male facial shape being supposedly more dependent on foetal levels (reflected by 2D:4D ratio), whereas body odour and vocal characteristics could be more dependent on variation in adult circulating testosterone levels.
Internal brooding favours pre-metamorphic chimerism in a non-colonial cnidarian, the sea anemone
Urticina felina
Authors: Mercier Annie , Sun Zhao , Hamel Jean-François
Published: April 2011

The concept of intraorganismal genetic heterogeneity resulting from allogeneic fusion (i.e. chimerism) has almost exclusively been explored in modular organisms that have the capacity to reproduce asexually, such as colonial ascidians and corals. Apart from medical conditions in mammals, the natural development of chimeras across ontogenetic stages has not been investigated in any unitary organism incapable of asexual propagation. Furthermore, chimerism was mainly studied among gregarious settlers to show that clustering of genetically similar individuals upon settlement promotes the occurrence of multi-chimeras exhibiting greater fitness. The possible occurrence of chimeric embryos and larvae prior to settlement has not received any attention. Here we document for the first time the presence of natural chimeras in brooded embryos and larvae of a unitary cnidarian, the sea anemone
Urticina felina
. Rates of visible bi- and multi-chimerism of up to 3.13 per cent were measured in the broods of 16 females. Apart from these sectorial chimeras, monitored fusion events also yielded homogeneous chimeric entities (mega-larvae) suggesting that the actual rates of natural chimerism in
U. felina
are greater than predicted by visual assessment. In support of this assumption, the broods of certain individuals comprised a dominant proportion (to 90%) of inexplicably large embryos and larvae (relative to oocyte size). Findings of fusion and chimerism in a unitary organism add a novel dimension to the framework within which the mechanisms and evolutionary significance of genetic heterogeneity in animal taxa can be explored.
Deep congenic analysis identifies many strong, context-dependent QTLs, one of which, Slc35b4, regulates obesity and glucose homeostasis
Authors: Yazbek Soha N. , Buchner David A. , Geisinger Jonathan M. , Burrage Lindsay C. , Spiezio Sabrina H. , Zentner Gabriel E. , Hsieh Chang-Wen , Scacheri Peter C. , Croniger Colleen M. , Nadeau Joseph H.
Published: April 2011

Although central to many studies of phenotypic variation and disease susceptibility, characterizing the genetic architecture of complex traits has been unexpectedly difficult. For example, most of the susceptibility genes that contribute to highly heritable conditions such as obesity and type 2 diabetes (T2D) remain to be identified despite intensive study. We took advantage of mouse models of diet-induced metabolic disease in chromosome substitution strains (CSSs) both to characterize the genetic architecture of diet-induced obesity and glucose homeostasis and to test the feasibility of gene discovery. Beginning with a survey of CSSs, followed with genetic and phenotypic analysis of congenic, subcongenic, and subsubcongenic strains, we identified a remarkable number of closely linked, phenotypically heterogeneous quantitative trait loci (QTLs) on mouse chromosome 6 that have unexpectedly large phenotypic effects. Although fine-mapping reduced the genomic intervals and gene content of these QTLs over 3000-fold, the average phenotypic effect on body weight was reduced less than threefold, highlighting the “fractal” nature of genetic architecture in mice. Despite this genetic complexity, we found evidence for 14 QTLs in only 32 recombination events in less than 3000 mice, and with an average of four genes located within the three body weight QTLs in the subsubcongenic strains. For Obrq2a1, genetic and functional studies collectively identified the solute receptor Slc35b4 as a regulator of obesity, insulin resistance, and gluconeogenesis. This work demonstrated the unique power of CSSs as a platform for studying complex genetic traits and identifying QTLs.
An Src Homology 3 Domain-Like Fold Protein Forms a Ferredoxin Binding Site for the Chloroplast NADH Dehydrogenase-Like Complex in Arabidopsis
Authors: Yamamoto Hiroshi , Peng Lianwei , Fukao Yoichiro , Shikanai Toshiharu
Published: April 2011

Some subunits of chloroplast NAD(P)H dehydrogenase (NDH) are related to those of the respiratory complex I, and NDH mediates photosystem I (PSI) cyclic electron flow. Despite extensive surveys, the electron donor and its binding subunits have not been identified. Here, we identified three novel components required for NDH activity. CRRJ and CRRL are J- and J-like proteins, respectively, and are components of NDH subcomplex A. CRR31 is an Src homology 3 domain-like fold protein, and its C-terminal region may form a tertiary structure similar to that of PsaE, a ferredoxin (Fd) binding subunit of PSI, although the sequences are not conserved between CRR31 and PsaE. Although CRR31 can accumulate in thylakoids independently of NDH, its accumulation requires CRRJ, and CRRL accumulation depends on CRRJ and NDH. CRR31 was essential for the efficient operation of Fd-dependent plastoquinone reduction in vitro. The phenotype of crr31 pgr5 suggested that CRR31 is required for NDH activity in vivo. We propose that NDH functions as a PGR5-PGRL1 complex-independent Fd:plastoquinone oxidoreductase in chloroplasts and rename it the NADH dehydrogenase-like complex.
d-myo-Inositol-3-Phosphate Affects Phosphatidylinositol-Mediated Endomembrane Function inArabidopsisand Is Essential for Auxin-Regulated Embryogenesis
Authors: Luo Yu , Qin Genji , Zhang Jun , Liang Yuan , Song Yingqi , Zhao Meiping , Tsuge Tomohiko , Aoyama Takashi , Liu Jingjing , Gu Hongya , Qu Li-Jia
Published: April 2011

In animal cells, myo-inositol is an important regulatory molecule in several physiological and biochemical processes, including signal transduction and membrane biogenesis. However, the fundamental biological functions of myo-inositol are still far from clear in plants. Here, we report the genetic characterization of three Arabidopsis thaliana genes encoding d-myo-inositol-3-phosphate synthase (MIPS), which catalyzes the rate-limiting step in de novo synthesis of myo-inositol. Each of the three MIPS genes rescued the yeast ino1 mutant, which is defective in yeast MIPS gene INO1, and they had different dynamic expression patterns during Arabidopsis embryo development. Although single mips mutants showed no obvious phenotypes, the mips1 mips2 double mutant and the mips1 mips2 mips3 triple mutant were embryo lethal, whereas the mips1 mips3 and mips1 mips2+/− double mutants had abnormal embryos. The mips phenotypes resembled those of auxin mutants. Indeed, the double and triple mips mutants displayed abnormal expression patterns of DR5:green fluorescent protein, an auxin-responsive fusion protein, and they had altered PIN1 subcellular localization. Also, membrane trafficking was affected in mips1 mips3. Interestingly, overexpression of PHOSPHATIDYLINOSITOL SYNTHASE2, which converts myo-inositol to membrane phosphatidylinositol (PtdIns), largely rescued the cotyledon and endomembrane defects in mips1 mips3. We conclude that myo-inositol serves as the main substrate for synthesizing PtdIns and phosphatidylinositides, which are essential for endomembrane structure and trafficking and thus for auxin-regulated embryogenesis.
Pituitary apoplexy in non‐functioning pituitary adenomas: long term follow up is important because of significant numbers of tumour recurrences
Authors: Pal A. , Capatina C. , Tenreiro A.P. , Guardiola P.D. , Byrne J.V. , Cudlip S. , Karavitaki N. , Wass J.A.H.
Published: April 2011

Objectives  The frequency of pituitary tumour regrowth after an episode of classical pituitary apoplexy is unknown. It is thus unclear whether regrowth, if it occurs, does so less frequently than with non‐apoplectic non‐functioning pituitary macroadenomas that have undergone surgery without postoperative irradiation. This has important repercussions on follow up protocols for these patients.

Design  Retrospective cohort study of patients diagnosed with classical pituitary apoplexy in Oxford in the last 24 years.

Measurements  MRI/CT scans of the pituitary were performed post‐operatively and in those patients who did not receive pituitary irradiation, this was repeated yearly for 5 years and 2 yearly thereafter.

Results  Thirty‐two patients with non‐functioning pituitary adenomas who presented with classical pituitary apoplexy were studied. There were 23 men and the mean age was 56·6 years (range 29–85). The mean follow up period was 81 months (range 6–248). Five patients received adjuvant radiotherapy within 6 months of surgery and were excluded from further analysis. In this group, there were no recurrences during a mean follow up of 83 months (range 20–150). In the remaining 27 cases there were 3 recurrences, with a mean of 79 months follow up (range 6–248) occurring 12, 51 and 86 months after surgery. This gives a recurrence rate of 11·1% at a mean follow up of 6·6 years post surgery. All recurrences had residual tumour on the post operative scan.

Conclusions  Patients with classical pituitary apoplexy may show recurrent pituitary tumour growth and therefore these patients need continued post‐operative surveillance if they have not had post‐operative radiotherapy.
Association of AGER gene G82S polymorphism with the severity of coronary artery disease in Chinese Han population
Authors: Lu Weixin , Feng Bo , Xie Guangping , Liu Fengjing
Published: April 2011

Background and objective  Advanced glycosylation end‐product receptor (AGER) plays an important role in the development and progression of atherosclerosis. The G82S polymorphism (rs2070600) is located in the ligand‐binding V‐domain of AGER suggesting a possible influence of this variant on AGER function. The aim of this study is to evaluate the association of the G82S polymorphism with the severity of coronary artery disease (CAD) in patients with or without type 2 diabetes mellitus (T2DM).

Design and methods  The AGER gene G82S polymorphism was analysed in 270 nondiabetic and 270 type 2 diabetic Chinese Han patients with angiographically proven CAD (luminal stenosis ≥50%). The number of diseased vessels and Gensini score were used to determine the severity of CAD. Genotyping for the G82S polymorphism was performed by PCR‐RFLP using restriction enzymes AluI.

Results  The frequency of 82S allele was significantly lower in the diabetic CAD patients with multi‐vessel disease than in those with single‐vessel disease (P = 0·015). When controlled for confounding variables, the 82S allele was associated with decreased risk of multi‐vessel disease [P = 0·038, adjusted OR = 0·565 (0·329–0·972)]. The protective effect of the 82S allele against the severity of CAD was not observed in patients with nondiabetic CAD.

Conclusions  AGER 82S allele showed a protective effect on CAD severity in the presence of T2DM in Chinese Han population.
Geostatistical prediction of nitrous oxide emissions from soil using data, process models and expert opinion
Authors: Orton T. G. , Goulding K. W. T. , Lark R. M.
Published: April 2011

Geostatistical techniques can be used to predict spatially correlated variables at unsampled locations. We can incorporate information from soil process models in the geostatistical methodology via regression kriging (RK), which we consider in a Bayesian statistical framework (BRK). The resulting predictions are better than those obtained from the process model alone or by ordinary kriging. We consider approaches to predict the nitrous oxide emissions from soil along a transect in Bedfordshire in the UK. In this case study, there exists uncertainty about the most appropriate model to represent the denitrification process. We account for this uncertainty by model averaging (MA); the MA predictions are a weighted average of the BRK predictions based on the individual models. We consider several approaches to calculate weights for MA. We use Bayesian model averaging (BMA) to investigate whether the local data from the neighbourhood of a prediction location can provide useful information for calculating the model weights. We use the opinions of an expert on the relevant soil processes to define probabilities for the candidate models, and investigate how this information benefits the MA and BMA predictions. If we would prefer not to base analysis on the opinions of a single expert, we could use a linear opinion pool to merge the opinions of multiple experts, which we demonstrate through a simple example. We show the conditions under which MA and BMA improve predictions in this case study, and suggest reasons for these improvements. We use the BMA model weights, which are calculated from local data, to provide information about the ability of the models to represent the spatial variability of the data along the transect.
Effect of nitrogen and phosphorus availability on the emergence, growth and over‐wintering of Rumex crispus and Rumex obtusifolius
Authors: Křišťálová V. , Hejcman M. , Červená K. , Pavlů V.
Published: April 2011

Rumex crispus and R. obtusifolius are known to be nitrophilous but it is not known whether either or both species require a high N supply at all developmental stages. Furthermore, it is not clear whether both species require a high P supply, attain flowering in the seeding year, or have similar levels of winter resistance. The effect of nutrient availability on the emergence, growth and over‐wintering of both Rumex species was investigated in a pot experiment (ten N, P and K fertilizer treatments) in Prague, Czech Republic. In both species, emergence of seedlings was negatively affected by very high N, but positively affected by increased P availability in the soil. No effect of K supply on the emergence, or subsequent growth, was recorded. High flowering in the seeding season and high winter mortality of R. obtusifolius contrasted with no flowering and no mortality of R. crispus. Over‐wintering was not markedly affected by N, P or K supply. Both Rumex species are sensitive to a very high N supply in early developmental stages but tend to require a high N supply from the fully developed rosette‐stage onwards. In addition to high N requirements during stem growth, flowering and seed ripening, both species also require a high P supply. At least some Central European populations of R. crispus, in contrast to R. obtusifolius, do not flower in the seeding year. In Central Europe, the frequently reported high field winter mortality of R. obtusifolius can be caused by its low frost resistance.
Making a difference: towards a method for weighing the evidence in a qualitative synthesis
Authors: Boeije Hennie R. , van Wesel Floryt , Alisic Eva
Published: April 2011

Objectives  In a qualitative synthesis, primary qualitative studies are integrated to develop a theory or evidence‐based interventions. Until now, the strength of the evidence in the primary studies has not been taken into account in the outcome of the qualitative synthesis. In this paper, a method is developed and evaluated to assign weights to the findings of the qualitative studies using both the frequency and the quality of the reported results.

Method  Seventeen qualitative studies were retrieved in an illustrative example project on children and trauma. Findings were extracted from the primary studies with the use of coding which resulted in 14 themes. The quality of the studies was appraised using both expert judgement and a quality checklist. These outcomes are used to calculate the weights.

Results  When the outcomes of the checklist appraisal are compared with those of the expert judgement, the effect on the strength of the evidence is virtually always in the same direction. We found that as the frequency with which a concept is studied is low, the strength of the evidence oftentimes decreases even further when using the quality of the results in the weighing process.

Conclusions  In the end, the outcomes of a critical appraisal affect the weight that is placed on particular studies. The use of a checklist is recommended because of its more distinguishing ability. The method that was developed for assigning weights to the evidence is discussed in light of both the quality appraisal in qualitative research and the objectives of qualitative synthesis.
Attitude towards Evidence‐Based Nursing Questionnaire: development and psychometric testing in Spanish community nurses
Authors: Ruzafa‐Martínez María , López‐Iborra Lidón , Madrigal‐Torres Manuel
Published: April 2011

Background  A readiness assessment for identifying and measuring variables that can facilitate evidence‐based nursing (EBN) is important. Attitude towards EBN is one of its components. However, questionnaires that exclusively measure attitude to EBN do not exist in Spanish‐speaking contexts.

Aim  This paper is a report of the development and psychometric testing of a Spanish‐language assessment tool: the Evidence‐Based Nursing Attitude Questionnaire (EBNAQ).

Methods  The questionnaire was developed in three phases: item generation through a review of scientific literature and focus groups; item selection through an expert review; content and construct validity testing, and internal consistency reliability testing. The instrument was validated in terms of construct validity by a factorial analysis and content validity by grouping the items into the three categories of attitude: cognitive, affective and behavioural. Data were collected from May to November of 2008.

Results  The questionnaire was validated in a sample of 219 Spanish community nurses, who had a mean age of 43.21 (SD 10.3) years, and 64.5% (141) were women. A total of 54.3% (121) had been working in the community for more than 10 years. The questionnaire consisted of 15 items grouped into the three factors that make up the concept of attitude. Cronbach's alpha was 0.853 for the entire questionnaire. The factor solution explained 54.70% of the variance.

Conclusions  The EBNAQ is brief, making it a user‐friendly tool. It is the first Spanish‐language questionnaire that exclusively measures attitude towards EBN in nurses who work in the community. The EBNAQ can be used efficiently in research and practice settings to better understand nurses' attitudes towards evidence‐based practice.
Integrated medicines management – can routine implementation improve quality?
Authors: Scullin Claire , Hogg Anita , Luo Ruoyin , Scott Michael G. , McElnay James C.
Published: April 2011

Rationale, aims and objectives  Previous service development work in the area of integrated medicines management (IMM) has demonstrated clear quality improvements in a targeted group of patients within a hospital in Northern Ireland. In order to determine whether this programme could be transferable to routine practice and thereby assess its generalizability, research has been carried out to quantify the health care benefits of incorporating the concept of IMM as routine clinical practice.

Method  The IMM programme of care was delivered to all eligible patients (subject to inclusion criteria) across two hospital sites in Northern Ireland during normal pharmacy opening hours. All patients were followed up for a period of 12 months from their time of hospital admission. All patient data were collected using the custom‐designed Electronic Pharmacist Intervention Clinical System at each stage of their hospital journey, that is, admission, inpatient stay and discharge.

Results  Patients who received the IMM service benefited from a reduced length of hospital stay on their reference admission (1.42 days; P = 0.020) as well as a reduced length of stay during the first rehospitalization (5.86 days; P = 0.013). There was also a trend of a reduced number of readmissions and a longer time to readmission during the 12‐month follow‐up period. Potential significant opportunity cost savings were demonstrated as well as a significant improvement in medication appropriateness (discharge vs. reference admission).

Conclusions  The IMM programme of care has proven to be transferable to routine hospital care within two hospitals in Northern Ireland. It is anticipated that this current research will further inform the development of IMM as routine clinical practice across Northern Ireland and beyond.
Technology and everyday functioning in people with intellectual disabilities: a Rasch analysis of the Everyday Technology Use Questionnaire (ETUQ)
Authors: Hällgren M. , Nygård L. , Kottorp A.
Published: April 2011

Background As people with intellectual disabilities (ID) today live integrated in society and use different technological artefacts and services in their everyday life, more in‐depth evaluation methods are crucial to detect strengths and limitations of their everyday technology use. The Everyday Technology Use Questionnaire (ETUQ) was originally designed to investigate the extent to which older adults with cognitive limitations can use the everyday technology that is of relevance to them. The purpose of this study was to explore and evaluate evidence of the validity of ETUQ among adult persons with ID.

Methods The original 93‐item ETUQ was used to interview 120 adult participants with ID, recruited from a region in northern Sweden. A Rasch model was used to analyse the psychometric properties of the rating scale, scale validity, person response validity and person separation.

Results The ETUQ rating scale displayed sound psychometric properties when used with this sample. The goodness‐of‐fit statistics showed that 15 (16%) of the 93 items demonstrated higher values than expected. A step‐by‐step removal process of items not demonstrating fit to the model resulted in an ETUQ version with 46 items (49%) that met all the criteria for scale validity. Fifteen participants (12%), primarily with mild ID, still demonstrated a higher number of unexpected responses included in ETUQ.

Conclusions The results of this study indicate that the ETUQ generates a valid measure of perceived difficulty in using everyday technology including adult persons with ID.
Changes in the Maternal Hypothalamic‐Pituitary‐Adrenal Axis During the Early Puerperium may be Related to the Postpartum ‘Blues’
Authors: O’Keane V. , Lightman S. , Patrick K. , Marsh M. , Papadopoulos A. S. , Pawlby S. , Seneviratne G. , Taylor A. , Moore R.
Published: April 2011

Most women experience time‐limited and specific mood changes in the days after birth known as the maternity blues (Blues). The maternal hypothalamic‐pituitary‐adrenal (HPA) axis undergoes gradual changes during pregnancy because of an increasing production of placental corticotrophin‐releasing hormone (CRH). The abrupt withdrawal of placental CRH at birth results in a re‐equilibration of the maternal HPA axis in the days post‐delivery. These changes may be involved in the aetiology of the Blues given the central role of the HPA axis in the aetiology of mood disorders in general, and in perinatal depression in particular. We aimed to test the novel hypothesis that the experience of the Blues may be related to increased secretion of hypothalamic adrenocorticotrophic hormone (ACTH) secretagogue peptides, after the reduction in negative‐feedback inhibition on the maternal hypothalamus caused by withdrawal of placental CRH. We therefore examined hormonal changes in the HPA axis in the days after delivery in relation to daily mood changes: our specific prediction was that mood changes would parallel ACTH levels, reflecting increased hypothalamic peptide secretion. Blood concentrations of CRH, ACTH, cortisol, progesterone and oestriol were measured in 70 healthy women during the third trimester of pregnancy, and on days 1–6 post‐delivery. Blues scores were evaluated during the postpartum days. Oestriol, progesterone and CRH levels fell rapidly from pregnancy up to day 6, whereas cortisol levels fell modestly. ACTH concentrations declined from pregnancy to day 3 post‐delivery and thereafter increased up to day 6. Blues scores increased, peaking on day 5, and were positively correlated with ACTH; and negatively correlated with oestriol levels during the postpartum days, and with the reduction in CRH concentrations from pregnancy. These findings give indirect support to the hypothesis that the ‘reactivation’ of hypothalamic ACTH secretagogue peptides may be involved in the aetiology of the Blues.
Recent Findings on Neuroprotection Against Excitotoxicity in the Hippocampus of Female Rats
Authors: Morales T.
Published: April 2011

Newborn mammals are totally dependent on maternal milk and care for survival. The mother’s brain undergoes different behavioural, physiological and emotional adaptations that make the mother more likely to satisfy the demands of the offspring. Recent reports from our group show that, compared to nulliparous rats, lactation diminishes cell damage induced by excitotoxicity in the dorsal hippocampus of the dam after systemic or i.c. administration of kainic acid (KA) and the resulting motor seizures. Elevated levels of prolactin (PRL), oxytocin, progesterone and glucocorticoids are characteristics of lactation, and the pronounced fluctuation of these hormones occurring in this phase may play a role protecting the hippocampus. Indeed, PRL administration to ovariectomised rats significantly diminishes the deleterious effects of KA in the dorsal hippocampus and reduces the progression of KA‐induced seizures. Thus, lactation is a natural model for neuroprotection because it effectively prevents acute and chronic cell damage of the hippocampus induced by excitotoxicity.