bluuebunny/crossref_metadata_2025 huggingface dataset:
Plasma profile and haemodynamic tolerance to isosorbide‐5‐mononitrate in controlled‐release form.
Authors: Jahnchen E
Published: July 2012

1. Plasma concentrations and some haemodynamic parameters known to be affected by nitrates, were monitored in healthy volunteers who received three different dose regimens of isosorbide‐5‐mononitrate (5‐ISMN) over 5 day study periods. 2. No haemodynamic tolerance was found in the 60 mg once‐daily dose schedule which produced high plasma concentrations during the daytime but concentrations no greater than 100 ng ml‐1 at night. In contrast, a dose regimen of 60 mg followed by 30 mg 12 h later and thereafter every 8 h until the fifth day induced complete haemodynamic tolerance. With this dose regimen the minimum plasma concentrations were never below 300 ng ml‐1. A significant attenuation of haemodynamic effects was also found with the third dose regimen, 60 mg followed by 30 mg 6 h later for 5 days, which produced minimum plasma concentrations of between 100 ng ml‐1 to 300 ng ml‐1; the degree of attenuation rose as trough plasma concentrations increased. 3. In conclusion, 60 mg 5‐ISMN in a controlled‐release (Durules) preparation given once daily was the only dose regimen not inducing nitrate tolerance.
Endogenous and exogenous nitrates and their role in myocardial ischaemia.
Authors: Luscher TF
Published: July 2012

1. Although nitrates have been prescribed in patients with angina pectoris for more than a century, their mechanism of action has only been understood recently. 2. The discovery of the endogenous nitrovasodilator nitric oxide, which is formed in endothelial cells by the enzyme nitric oxide synthase, has greatly expanded our knowledge. Nitric oxide, if released from endothelial cells can interact with vascular smooth muscle as well as circulating blood cells such as platelets. Nitric oxide activates soluble guanylate cyclase, which in turn leads to an intracellular increase in cyclic GMP. In vascular smooth muscle, this causes vasorelaxation, in platelets dysaggregation and prevention of platelet adhesion. This protective pathway both reduces the effects of vasoconstrictor substances, can produce profound vasodilation, if activated appropriately and acts as a regulator of platelet‐vessel wall interaction. In addition, nitric oxide inhibits the production and action of endothelin, a 21 amino acid vasoconstrictor peptide formed by endothelial cells. 3. Exogenous nitrovasodilators also exert their action by releasing nitric oxide from the molecule. Their action is particularly pronounced in blood vessels with a low basal production of nitric oxide and is enhanced after removal of the endothelium. In coronary artery disease, the formation of endothelium‐derived nitric oxide is reduced, its breakdown is increased, but only at later stages, is the action of endogenous and therapeutic nitrates depressed. 4. Hence, nitrates are an appropriate therapeutic tool in patients with coronary artery disease to substitute the effects of the impaired activity of the endothelial L‐ arginine/nitric oxide pathway.
The efficacy of parecoxib on systemic inflammatory response associated with cardiopulmonary bypass during cardiac surgery
Authors: Wu Qingping , Purusram Gunsham , Wang Huiqing , Yuan Ruixia , Xie Wanli , Gui Ping , Dong Nianguo , Yao Shanglong
Published: July 2012

Aims

Cardiopulmonary bypass (CPB) during cardiac surgery is well known to be associated with the development of a systemic inflammatory response. The efficacy of parecoxib in attenuating this systemic inflammatory response is still unknown.

Methods

Patients undergoing elective mitral valve replacement with CPB were assessed, enrolled and randomly allocated to receive parecoxib (80 mg) or placebo. Blood samples were collected in EDTA vials for measuring serum cytokine concentrations, troponin T, creatinekinase myocardial‐brain isoenzyme CK‐MB concentrations and white cell counts.

Results

Compared with the control group, IL‐6 and IL‐8‐values in the parecoxib group increased to a lesser extent, peaking at 2 h after the end of CPB (IL‐6 31.8 pg ml−1 ± 4.7 vs. 77.0 pg ml−1 ± 14.1, 95% CI −47.6, −42.8, P < 0.001; IL‐8 53.6 pg ml−1 ± 12.6 vs. 105.7 pg ml−1 ± 10.8, 95% CI −54.8, −49.4, P < 0.001). Peak concentrations of anti‐inflammatory cytokine IL‐10 occurred immediately after termination of CPB and were higher in the parecoxib group (115.7 pg ml−1 ± 10.5 vs. 88.4 pg ml−1 ± 12.3, 95% CI 24.7, 29.9, P < 0.001). Furthermore, the increase in neutrophil counts caused by CPB during cardiac surgery was inhibited by parecoxib. The increases in serum troponin T and CK‐MB concentrations were also significantly attenuated by parecoxib in the early post‐operative days. Peak serum concentrations of CK‐MB in both groups occurred at 24 h post‐CPB (17.4 μg l−1 ± 5.2 vs. 26.9 μg l−1 ± 6.9, 95% CI −10.9, −8.1, P < 0.001). Peak troponin T concentrations occurred at 6 h post‐bypass (2 μg l−1 ± 0.62 vs. 3.5 μg l−1 ± 0.78, 95% CI −1.7, −1.3, P < 0.001).

Conclusion

Intra‐operative parecoxib attenuated the systemic inflammatory response associated with CPB during cardiac surgery and lowered the biochemical markers of myocardial injury.
High diagnostic accuracy of subcutaneous Triptorelin test compared with GnRH test for diagnosing central precocious puberty in girls
Authors: Freire Analía Verónica , Escobar María Eugenia , Gryngarten Mirta Graciela , Arcari Andrea Josefina , Ballerini María Gabriela , Bergadá Ignacio , Ropelato María Gabriela
Published: July 2012

Context

The GnRH test is the gold standard to confirm the diagnosis of central precocious puberty (CPP); however, this compound is not always readily available. Diagnostic accuracy of subcutaneous GnRH analogues tests compared to classical GnRH test has not been reported.

Objective

To evaluate the diagnostic accuracy of Triptorelin test (index test) compared to the GnRH test (reference test) in girls with suspicion of CPP.

Design

A prospective, case–control, randomized clinical trial was performed. CPP or precocious thelarche (PT) was diagnosed according to maximal LH response to GnRH test and clinical characteristics during follow‐up.

Patients and Interventions

Forty‐six girls with premature breast development randomly underwent two tests: (i) intravenous GnRH 100 μg, (ii) subcutaneous Triptorelin acetate (0·1 mg/m2, to a maximum of 0·1 mg) with blood sampling at 0, 3 and 24 h for LH, FSH and estradiol ascertainment.

Measurements

Gonadotrophins and estradiol responses to Triptorelin test were measured by ultrasensitive assays.

Results

Clinical features were similar between CPP (n = 33) and PT (n = 13) groups. Using receiver operating characteristic curves, maximal LH response (LH‐3 h) under Triptorelin test ≥7 IU/l by immunofluorometric assay (IFMA) or ≥8 IU/l by electrochemiluminescence immunoassay (ECLIA) confirmed the diagnosis of CPP with specificity of 1·00 (95% CI: 0·75–1·00) and sensitivity 0·76 (95% CI: 0·58–0·89). Considering either LH‐3 h or maximal estradiol response at 24 h (cut‐off value, 295 pm), maintaining the specificity at 1·00, the test sensitivity increased to 0·94 (95% CI: 0·80–0·99) and the diagnostic efficiency to 96%.

Conclusion

The Triptorelin test had high accuracy for the differential diagnosis of CPP vs PT in girls providing a valid alternative to the classical GnRH test. This test also allowed a comprehensive evaluation of the pituitary–ovarian axis.
Snapshots of ancient oceanic mantle captured in British and Irish ophiolites
Authors: O'Driscoll B. , Derbyshire E.J. , Gertisser R.
Published: July 2012

The mantle is not commonly exposed at Earth's surface. Hands‐on investigation is necessarily restricted to mantle xenoliths that have been transported upwards by deeply sourced volcanic activity, or to dredged samples of abyssal peridotites. But it is ophiolites, which represent partially‐to‐wholly preserved slivers of ‘obducted’ oceanic lithosphere, which are particularly valuable resources. Ophiolites allow an assessment of the timing, causes and extent of processes that operate in the mantle, facilitating the coupling of field‐based investigations with geochemical analysis of these otherwise inaccessible rocks. Furthermore, ophiolites may preserve a range of oceanic mantle lithologies (e.g. harzburgite, lherzolite and dunite) and such variation allows a detailed evaluation of the distribution and relative timing of events acting upon the convecting upper mantle.
Thyroid hormones and male sexual function
Authors: Corona G. , Wu F. C. W. , Forti G. , Lee D. M. , O’Connor D. B. , O’Neill T. W. , Pendleton N. , Bartfai G. , Boonen S. , Casanueva F. F. , Finn J. D. , Giwercman A. , Han T. S. , Huhtaniemi I. T. , Kula K. , Lean M. E. J. , Punab M. , Vanderschueren D. , Jannini E. A. , Mannucci E. , Maggi M. ,   the EMAS Study Group
Published: July 2012

The role of thyroid hormones in the control of erectile functioning has been only superficially investigated. The aim of the present study was to investigate the association between thyroid and erectile function in two different cohorts of subjects. The first one derives from the European Male Ageing Study (EMAS study), a multicentre survey performed on a sample of 3369 community‐dwelling men aged 40–79 years (mean 60 ± 11 years). The second cohort is a consecutive series of 3203 heterosexual male patients (mean age 51.8 ± 13.0 years) attending our Andrology and Sexual Medicine Outpatient Clinic for sexual dysfunction at the University of Florence (UNIFI study). In the EMAS study all subjects were tested for thyroid‐stimulating hormone (TSH) and free thyroxine (FT4). Similarly, TSH levels were checked in all patients in the UNIFI study, while FT4 only when TSH resulted outside the reference range. Overt primary hyperthyroidism (reduced TSH and elevated FT4, according to the reference range) was found in 0.3 and 0.2% of EMAS and UNIFI study respectively. In both study cohorts, suppressed TSH levels were associated with erectile dysfunction (ED). Overt hyperthyroidism was associated with an increased risk of severe erectile dysfunction (ED, hazard ratio = 14 and 16 in the EMAS and UNIFI study, respectively; both p < 0.05), after adjusting for confounding factors. These associations were confirmed in nested case‐control analyses, comparing subjects with overt hyperthyroidism to age, BMI, smoking status and testosterone‐matched controls. Conversely, no association between primary hypothyroidism and ED was observed. In conclusion, erectile function should be evaluated in all individuals with hyperthyroidism. Conversely, assessment of thyroid function cannot be recommended as routine practice in all ED patients.
Caseinophosphopeptide enrichment and identification
Authors: Zhu Yi‐Shen , FitzGerald Richard J.
Published: July 2012

Caseinophosphopeptides (CPPs) were generated via tryptic hydrolysis of sodium caseinate followed by heat treatment (75 °C) at pH 6.0, 7.0 and 8.0. Calcium aggregation, ethanol precipitation and gallium immobilised metal affinity chromatography (IMAC) were applied to enrich the CPPs. Nano‐liquid chromatography electrospray ionisation‐quadrupole time‐of‐flight tandem mass spectrometry was used for phosphopeptide separation and identification. The combination of gallium IMAC isolation with calcium and ethanol precipitation appears to be a useful tool in characterising the fate of CPPs in CN hydrolysates during thermal processing. CPPs appeared to be less susceptible to thermal modification when heat‐treated at pH 7.0 than at pH 6.0 and 8.0. Different extents of methionine oxidation occurred in the CPPs depending on heat‐treatment pH. The results herein may have important implications for the manufacture of CPPs and for the quality control of CPP products.
Dephytinisation of Sangak and Barbari bread made from different extraction rate flours increases iron and zinc bioaccessibility in Caco‐2 cells
Authors: Shockravi Soodeh , Almgren Annette , Carlsson Nils‐Gunnar , Sandberg Ann‐Sofie
Published: July 2012

Bread is a staple food in many countries and an important source of iron and zinc. The bioavailability of these minerals is generally low because of the content of phytic acid. Traditional Iranian breads were prepared with flours of different extraction rates, Sangak at 93% and Barbari at 82%. Breads were dephytinised by addition of Aspergillus niger phytase during in vitro digestion. The effect upon iron and zinc bioaccessibility in the Caco‐2 cell model was investigated. The cellular uptake of iron and zinc was lower from Sangak, compared to Barbari, despite higher mineral content in Sangak. Dephytinisation of both breads increased iron uptake in the Caco‐2 cells (0.65 vs. 1.64 in Sangak and 0.77 vs. 1.97 ng mg−1 protein in Barbari). Zinc uptake increased from 0.98 to 2.8 in Sangak and from 1.4 to 2.9 ng mg−1 protein in Barbari. Thus, dephytinisation substantially improves iron and zinc bioaccessibility.
Changes in aromatic profile of fresh and dried fig – the role of pre‐treatments in drying process
Authors: Mujić Ibrahim , Bavcon Kralj Mojca , Jokić Stela , Jarni Kristjan , Jug Tjaša , Prgomet Željko
Published: July 2012

The aromatic profile of volatiles in fresh figs (FF), fresh figs frozen in liquid nitrogen (NF) and dried figs (DF) (dark variety Petrovača Crna) was characterised by HS–SPME followed by GC–MS. Figs were dried in a pilot plant cabinet dryer using different pre‐treatments to preserve the dried fruit: sulphuring and immersion in a solution of citric acid and ascorbic acid (separately). The adaptability of thin‐layer drying models to whole figs was investigated. Fresh figs and fresh figs frozen in liquid nitrogen differed mainly in the amount of aldehydes. The highest abundance of volatile compounds in dried figs was found in figs pre‐treated with sulphur dioxide and the control, compared to samples immersed in the acid solutions. Preservation was the most successful for the group of terpenes and terpenic compounds, quite good for some esters and ketones, whereas aldehydes were not affected by the used pre‐treatment.
The identification of clinical and professional leadership activities of advanced practitioners: findings from the Specialist Clinical and Advanced Practitioner Evaluation study in Ireland
Authors: Elliott Naomi , Higgins Agnes , Begley Cecily , Lalor Joan , Sheerin Fintan , Coyne Imelda , Murphy Kathy
Published: July 2012

Aim

To report a case study that identifies how leadership is enacted by advanced practitioners in nursing and midwifery and differentiates between clinical and professional leadership in advanced practice.

Background

A national evaluation of advanced practitioners in nursing and midwifery was commissioned to inform policy makers' decision‐making about future developments in Ireland. Leadership is a key aspect of the advanced practitioner role. However, leadership in the advanced practice context is under researched and lacks empirical evidence on how advanced practitioners enact their clinical and professional leadership function in practice.

Design

A multiple case study methodology was used to identify the leadership activities of advanced practitioners.

Methods

Purposive sampling of advanced practitioners in nursing and midwifery across various specialities and health regions in Ireland was employed. Data sources included non‐participant observation of advanced practitioners, interviews with key stakeholders, and documentary evidence including audits, policies, and guidelines. Collectively these data were used to identify the leadership activities of advanced practitioners in practice. The study was conducted between December 2008–December 2010.

Results

Seven key activities that indicated clinical leadership and three key activities for professional leadership at advanced practice level were identified.

Conclusions

The leadership activities identified provide greater clarity in distinguishing between professional and clinical leadership and in specifying the nature and scope of leadership activities.
Mokken scaling of the Caring Dimensions Inventory (CDI‐25)
Authors: Akansel Neriman , Watson Roger , Aydin Nursel , Özdemir Aysel
Published: July 2012

Aims and objectives.  To validate a Turkish version of the Caring Dimensions Inventory in a group of Turkish nursing students.

Background.  There are no studies about how nurses or nursing students perceive caring in nursing in Turkey. There is also no valid and reliable instrument in Turkey for evaluating caring in nursing.

Design.  Descriptive study design.

Methods.  Using a convenience sample of nursing students (n = 266), standard forward‐back translation techniques were used with the Caring Dimensions Inventory. An expert panel considered the translations and provided content validation. A final version of the Caring Dimensions Inventory was tested with 10 nursing students, and we found no difficulties with the items in the instrument. Mokken Scaling analysis of the Caring Dimensions Inventory was used.

Results.  A range of psychosocial and professional/technical items was included in the Mokken scale with ‘Providing privacy for a patient’ as the most endorsed (mean = 4·66) item and ‘Being with a patient during a clinical procedure’ being the least endorsed (mean = 3·87). There is a tendency for the most endorsed items to be psychosocial with the professional/technical items being less endorsed, with the exception of the least endorsed item ‘Being with a patient during a clinical procedure’ which is a psychosocial item.

Conclusion.  The Turkish version of the Caring Dimensions Inventory is a reliable instrument for measuring nurses’ perceptions about caring.

Relevance to clinical practice.  The results using the Caring Dimensions Inventory will help to identify how caring in nursing is perceived by nursing students in Turkey. Repeating this study in different groups such as working nurses will help to determine nurses who work in clinical settings perceive caring in nursing.
The locus of pain control in patients with lower limb ulcerations
Authors: Cwajda‐Białasik Justyna , Szewczyk Maria T , Mościcka Paulina , Cierzniakowska Katarzyna
Published: July 2012

Aims and objectives.  (1) To analyse the distribution of pain control profiles of individuals suffering from the lower limb ulcerations. (2) To identify sociodemographic and clinical factors determine the locus of pain control in this group of patients.

Background.  The locus of pain control can play a critical role in determining the quality of life in patients with lower limb ulcerations, and identification of individuals with an unfavourable pain control profile would enable the opportunity of offering them dedicated psychological counselling.

Design.  Quantitative survey.

Methods.  This study included 298 patients with lower limb ulcerations resulting from chronic venous insufficiency (n = 101), lower limb atherosclerosis (n = 98), or having mixed arteriovenous aetiology (n = 99). The study included the completion of the Polish version of the Beliefs about Pain Control Questionnaire.

Results.  The most important role in the control of pain was assigned to the powerful others locus. This locus correlated directly with poorer educational level and higher professional activity. Additionally, the intensity of usual pain correlated inversely with the powerful others locus. Respondents’ age was the only sociodemographic variable decreasing the level of the internal locus. Moreover, the severity of usual and maximal pain and the area of ulceration correlated inversely with the internal locus of pain control. In contrast, the aetiology of lower limb ulceration did not affect significantly any of the dimensions of pain control.

Conclusion.  The control of pain in ulceration patients is mostly determined by the support of medical personnel, which generally should be considered a negative finding.

Relevance to clinical practice.  Determination of the locus of pain control should be included in the complex medical evaluation of individuals suffering from ulcerations.
Creep mechanisms of a new Ni‐Co‐base disc superalloy at an intermediate temperature
Authors: YUAN Y. , GU Y.F. , ZHONG Z.H. , OSADA T. , CUI C.Y. , TETSUI T. , YOKOKAWA T. , HARADA H.
Published: July 2012

The microstructures of a new Ni‐Co‐base disc superalloy, TMW‐4M3, before and after the creep test at 725 °C/630 MPa have been systematically investigated by transmission electron microscopy (TEM). The crept microstructures were marked as three different deformation stages (I, II and III) corresponding to the gradually increased strain. At stage I, stacking fault (SF) shearing was the main deformation mechanism. The SF was extrinsic and lay on {111} plane. However, deformation microtwinning became the dominant mode at stage II and III. The average spacing of deformation twins decreased from 109 ± 15 nm at stage II to 76 ± 12 nm at stage III, whereas the twin thickness did not change significantly. The influence of stacking fault energy (SFE) of γ matrix on the deformation mechanism is discussed. It is suggested that lower SFE in TMW‐4M3 is partly responsible for the enhanced creep resistance.
Moxidectin has a lower neurotoxic potential but comparable brain penetration in P‐glycoprotein‐deficient CF‐1 mice compared to ivermectin
Authors: JANKO C. , GEYER J.
Published: July 2012

The anti‐parasitic drugs ivermectin (IVM) and moxidectin (MOX) normally show limited brain penetration in vertebrates because of effective drug efflux at the blood–brain barrier by P‐glycoprotein, encoded by the multi‐drug resistance (MDR1) gene. However, dogs with homozygous nt230(del4) mutation in theMDR1gene do not express a functionally active P‐glycoprotein and show increased brain penetration of these drugs, resulting in neurological toxicity to different degrees. Thus, whereas IVM provokes neurological toxicity at 0.1 mg/kg, MOX is tolerated at this dosage. To investigate whether this difference is attributable to lower brain penetration of MOX in the absence of P‐glycoprotein or to their neurotoxic potential, we applied IVM and MOX to P‐glycoprotein‐deficient CF‐1 mice and comparatively analysed the absolute drug concentrations in the brain. Furthermore, we quantified drug‐induced neurotoxicity by measuring the walking performance of the mice on a rotarod setup. We found that at a dosage of 0.2 mg/kg, representing 0.23 μmol/kg IVM and 0.31 μmol/kg MOX, the absolute drug concentrations in the brain were comparable with 100.8 pmol/g and 140.2 pmol/g, respectively. However, MOX induced the same degree of neurotoxicosis at the higher dosage of 1.09 μmol/kg (0.7 mg/kg) compared with IVM at 0.40 μmol/kg (0.35 mg/kg), demonstrating the 2.7‐fold lower neurotoxic potential of MOX compared to IVM. This could be explained by a lower binding affinity or lower intrinsic activity of MOX at the relevant central nervous system receptors compared with IVM.
Asexual evolution: do intragenomic parasites maintain sex?
Authors: CRESPI BERNARD , SCHWANDER TANJA
Published: July 2012

Resolving the paradox of sex, with its twofold cost to genic transmission, remains one of the major unresolved questions in evolutionary biology. Counting this genetic cost has now gone genomic. In this issue of Molecular Ecology, Kraaijeveld et al. (2012) describe the first genome‐scale comparative study of related sexual and asexual animal lineages, to test the hypothesis that asexuals bear heavier loads of deleterious transposable elements. A much higher density of such parasites might be expected, due to the inability of asexual lineages to purge transposons via mechanisms exclusive to sexual reproduction. They find that the answer is yes—and no—depending upon the family of transposons considered. Like many such advances in testing theory, more questions are raised by this study than answered, but a door has been opened to molecular evolutionary analyses of how responses to selection from intragenomic parasites might mediate the costs of sex.
Selective and hyperactive uptake of foreign DNA by adaptive immune systems of an archaeon via two distinct mechanisms
Authors: Erdmann Susanne , Garrett Roger A.
Published: July 2012

Central to the disparate adaptive immune systems of archaea and bacteria are clustered regularly interspaced short palindromic repeats (CRISPR). The spacer regions derive from invading genetic elements and, via RNA intermediates and associated proteins, target and cleave nucleic acids of the invader. Here we demonstrate the hyperactive uptake of hundreds of unique spacers within CRISPR loci associated with type I and IIIB immune systems of a hyperthermophilic archaeon. Infection with an environmental virus mixture resulted in the exclusive uptake of protospacers from a co‐infecting putative conjugative plasmid. Spacer uptake occurred by two distinct mechanisms in only one of two CRISPR loci subfamilies present. In two loci, insertions, often multiple, occurred adjacent to the leader while in a third locus single spacers were incorporated throughout the array. Protospacer DNAs were excised from the invading genetic element immediately after CCN motifs, on either strand, with the secondary cut apparently produced by a ruler mechanism. Over a 10‐week period, there was a gradual decrease in the number of wild‐type cells present in the culture but the virus and putative conjugative plasmid were still propagating. The results underline the complex dynamics of CRISPR‐based immune systems within a population infected with genetic elements.
Two intercellular signals required for fruiting body formation in Myxococcus xanthus act sequentially but non‐hierarchically
Authors: Konovalova Anna , Wegener‐Feldbrügge Sigrun , Søgaard‐Andersen Lotte
Published: July 2012

Starvation‐induced fruiting body formation in Myxococcus xanthus depends on intercellular signalling. A‐signal functions after 2 h of starvation and its synthesis depends on the asg genes. C‐signal functions after 6 h of starvation and is generated by proteolytic cleavage of a precursor by the protease PopC. Previous gene expression studies suggested that the A‐ and C‐signal lie on a hierarchical pathway. Here we explored the causal relationship between the A‐ and C‐signal. The asgA and asgB mutants have reduced popC expression, PopC accumulation and C‐signal accumulation. popC expression was shown not to depend on A‐signal but on the AsgA and AsgB proteins. Restored popC expression in the two mutants rescued PopC and C‐signal accumulation as well as C‐signalling and the developmental defects of the two mutants without restoring A‐signalling. Based on these results we suggest that A‐ and C‐signal do not lie on a hierarchical, dependent pathway. Instead the A‐ and C‐signal act sequentially and without a causal relationship suggesting that they are linked by a shared timing mechanism, which ensures the early and late onset of A‐signalling and C‐signalling, respectively, during starvation. This pathway topology represents a novel architecture for bacterial intercellular signalling systems involving more than one signal.
Depositional processes beneath coastal multi‐year sea ice
Authors: MURRAY KATHERINE T. , MILLER MOLLY F. , BOWSER SAMUEL S.
Published: July 2012

The extent of multi‐year sea ice impacts climate processes worldwide, such as ocean–atmosphere carbon dioxide exchange and deep ocean current formation. Reconstructing these processes in the past, and assessing the distribution of ecologically and climatically significant features, such as polynas, requires recognition of sediments deposited under multi‐year sea ice, but little is known about their characteristics. Textural analysis of subaerial and sea floor sediment in Explorers Cove, McMurdo Sound, at the mouth of Taylor Valley, Antarctica, augmented with observations of sedimentary structures and faunal components, elucidates how sediment is transported to the sea floor and allows characterization of the deposits. Comparison of grain‐size characteristics of subaerial (moraine, delta and sea‐ice surface) sediment and sea floor sediment from short cores taken at depths of 7 to 25 m indicates that the likely source of the moderately to poorly sorted sea floor sand is deltaic sediment; small glacial meltwater streams have built deltas since Taylor Valley became ice‐freeca7000 years ago. Windblown sediment accumulating on the multi‐year sea ice close to the coast typically is coarser grained than sediment on the sea floor; this suggests that the transport of sediment through the ice to the sea floor is not the predominant mode of sediment transfer. However, supra‐sea‐ice sediment does move to the sea floor through local fractures. The rate of sedimentation under multi‐year sea ice is low because of limited stream flow and biogenic sedimentation; the ice cover inhibits primary productivity and dampens waves, precluding physical re‐suspension. The upper centimetres of sea floor sediment are churned by epifaunal scallops and brittle stars that leave no telltale biogenic structures and whose calcite ossicles and shells may be poorly preserved. The resulting deposits under multi‐year sea ice are poorly sorted, massive sand that provides little evidence of the bioturbators that have masked the indicators of the original physical depositional processes.
A comparative study of clinical characteristics, work‐up, treatment, and association to malignancy in dermatomyositis between two tertiary skin centers in the USA and Singapore
Authors: Yosipovitch Gil , Tan Audrey , LoSicco Katherine , Manabat Catherine G , Kannagra Ajith , Carroll Christie , Chan Yiong Huak , Ng Patricia , Jorizzo Joseph
Published: July 2012

Background  To date, no study has compared the clinical characteristics, malignancy associations, and treatment of dermatomyositis in predominantly Caucasian vs. Asian populations.

Materials and methods  This prospective study was conducted to compare clinical characteristics of dermatomyositis, its relationship to malignancy, and treatment between two tertiary medical centers in the USA and Singapore. A total of 19 newly‐diagnosed patients in the USA and 15 patients in Singapore were enrolled. Dermatomyositis or amyopathic dermatomyositis were diagnosed based on clinical assessment, skin and muscle biopsies, and muscle testing.

Results  Ninety‐five percent of patients in the USA group were of Caucasian descent, while 93% of patients in the Singapore group were of Chinese descent. Both groups were predominantly female. Pruritus was the most common initial symptom reported in both groups, while periungual erythema and Gottron’s papules were the most common skin presentations. Heliotrope eruption was more common in the Singapore group, occurring in 80% of patients vs. 32% of patients in the USA group (P = 0.007). Three patients in the Singapore group developed a malignancy, with two of these patients having nasopharyngeal carcinoma. None of the USA patients developed malignancies in a follow‐ up period of 2–5 years. Immunosuppressive steroid sparing therapy with hydroxychloroquine was more frequently used in Singapore, while topical tacrolimus was more frequently used in the USA.

Conclusion  The clinical presentations of dermatomyositis vary among different ethnic populations. Chinese patients with dermatomyositis have a significant risk for nasopharyngeal carcinoma.
Major histocompatibility complex class I chain related gene‐A microsatellite polymorphism shows secondary association with type 1 diabetes and celiac disease in North Indians
Authors: Kumar N. , Sharma G. , Kaur G. , Tandon N. , Bhatnagar S. , Mehra N.
Published: July 2012

Microsatellite polymorphism in exon 5 of major histocompatibility complex class I chain related gene‐A (MIC‐A) has been implicated in the etiology of autoimmune diseases including type 1 diabetes (T1D) and celiac disease (CD). In this study on North Indian population, the MIC‐A5.1 allele, carrying a premature termination codon in transmembrane region, was observed with increased frequency in T1D (29.6%, odds ratio OR = 2.1, P = 0.00017) and CD patients (40.3%, OR = 3.37, P = 1.67E‐05) than in controls (16.7%). When the MIC‐A5.1 association was adjusted for linkage with human leukocyte antigen (HLA)‐DR3, the statistical significance of the association was abolished. This implies that the observed association of MIC‐A5.1 is due to its linkage disequilibrium (D′ = 0.94) with HLA‐B8‐DR3‐DQ2 haplotype and is secondary to the overall association with DR3 positive MHC haplotypes.
New insights into the genetics of immune responses in rheumatoid arthritis
Authors: Ruyssen‐Witrand A. , Constantin A. , Cambon‐Thomsen A. , Thomsen M.
Published: July 2012

Rheumatoid arthritis (RA) is a common autoimmune disease with a strong genetic component. Numerous aberrant immune responses have been described during the evolution of the disease. In later years, the appearance of anti‐citrullinated protein antibodies (ACPAs) has become a hallmark for the diagnosis and prognosis of RA. The post‐translational transformation of arginine residues of proteins and peptides into citrulline (citrullination) is a natural process in the body, but for unknown reasons autoreactivity towards citrullinated residues may develop in disposed individuals. ACPAs are often found years before clinical manifestations. ACPAs are present in about 70% of RA patients and constitute an important disease marker, distinguishing patient groups with different prognoses and different responses to various treatments. Inside the human leukocyte antigen (HLA) region, some HLA‐DRB1 alleles are strongly associated with their production. Genome‐wide association studies in large patient cohorts have defined a great number of single nucleotide polymorphisms (SNPs) outside of the HLA region that are associated with ACPA positive (ACPA+) RA. The SNPs are generally located close to or within genes involved in the immune response or signal transduction in immune cells. Some environmental factors such as tobacco smoking are also positively correlated with ACPA production. In this review, we will describe the genes and loci associated with ACPA+ RA or ACPA− RA and attempt to clarify their potential role in the development of the disease.
Differential executive functioning performance by phase of bipolar disorder
Authors: Ryan Kelly A , Vederman Aaron C , McFadden E Michelle , Weldon Anne L , Kamali Masoud , Langenecker Scott A , McInnis Melvin G
Published: July 2012

Ryan KA, Vederman AC, McFadden EM, Weldon AL, Kamali M, Langenecker SA, McInnis MG. Differential executive functioning performance by phase of bipolar disorder. Bipolar Disord 2012: 14: 527–536. © 2012 The Authors. Journal compilation © 2012 John Wiley & Sons A/S.

Objective:  This study examined the influence of illness phase on executive functioning performance using factor‐derived cognitive scores in a cross‐sectional design.

Methods:  Healthy control (HC) subjects (n = 57), and euthymic (E‐BD) (n = 117), depressed (D‐BD) (n = 73), and hypomanic/mixed (HM/M‐BD) (n = 26) patients with bipolar disorder (BD) were evaluated using executive functioning measures (Wisconsin Card Sorting Test, Trail Making Test–Parts A and B, Verbal Fluency, Parametric Go/No‐Go, Stroop, and Digit Symbol) comprising Conceptual Reasoning and Set‐Shifting (CRSS), Processing Speed with Interference Resolution (PSIR), Verbal Fluency and Processing Speed (VFPS), and Inhibitory Control (IC) factor scores.

Results:  Two of the four executive functioning factors were significantly different between groups based upon phase of illness. The HM/M group was significantly worse than both of the other BD groups and the HC group in IC. The VFPS factor was sensitive to the active phase of BD, with the HM/M‐BD and D‐BD groups worse than HC. Extending our prior work, the PSIR factor, and now the CRSS factor were significantly worse in BD relative to HC, irrespective of phase of illness.

Conclusions:  Phase of illness had differential cognitive profiles in executive functioning factors, even after considering and excluding the impact of clinical features, illness characteristics, medications, and demographics. Consolidating executive functioning tasks into reliable factor scores provides unique information to measure and define cognitive deficiencies throughout phases of BD, and to measure intermediate phenotypes in BD, and may aid in tracking and clarifying treatment focus.
Forced fluid removal in critically ill patients with acute kidney injury
Authors: GANTER C. C. , HOCHULI R. , BOSSARD M. , ETTER R. , TAKALA J. , UEHLINGER D. E. , JAKOB S. M.
Published: July 2012

Purpose

The aim was to test the feasibility of protocol‐driven fluid removal with continuous renal replacement therapy (CRRT) in patients in whom standard fluid balance prescription did not result in substantial negative fluid balances.

Materials and Methods

In 10 mechanically ventilated patients with sepsis or signs of inflammation and acute kidney injury [age 65 (48–78 years; median, range), simplified acute physiology score II 66 (39–116)], fluid removal was guided by mean arterial pressure (MAP), cardiac index (CI), mixed venous oxygen saturation (SvO
2), lactate/base excess, peripheral circulation, and filling pressures, and adjusted hourly with the goal to maximize volume removal for up to 3 days.

Results

Fluid removal rates during the 3 days before and during the study period [66 (36–72) h] were 11 (−30 to +36) ml/kg/day and −59 (−85 to −31) ml/kg/day, respectively (P = 0.002). In 12% of a total of 594 fluid removal rate evaluations, fluid removal had to be decreased or stopped. Most frequent reasons leading to decreasing fluid removal were (n, % of all instances, median lowest value from all patients): SvO
2 (44, 28%, 59%), MAP (36, 23%, 57 mmHg), CI (26, 17%, 2.4 l/min/m2), low peripheral temperature (22, 14%, ‘cold’). Overall, systemic hemodynamics remained stable throughout the study period.

Conclusions

In these patients, protocolized fluid removal with CRRT was associated with large negative fluid balances.
Continuous evaluation of neurological prognosis after cardiac arrest
Authors: FRIBERG H. , RUNDGREN M. , WESTHALL E. , NIELSEN N. , CRONBERG T.
Published: July 2012

Post‐resuscitation care has changed in the last decade, and outcome after cardiac arrest has improved, thanks to several combined measures. Induced hypothermia has shown a treatment benefit in two randomized trials, but some doubts remain. General care has improved, including the use of emergency coronary intervention. Assessment of neurological function and prognosis in comatose cardiac arrest patient is challenging, especially when treated with hypothermia. In this review, we evaluate the recent literature and discuss the available evidence for prognostication after cardiac arrest in the era of temperature management. Relevant literature was identified searching PubMed and reading published papers in the field, but no standardized search strategy was used. The complexity of predicting outcome after cardiac arrest and induced hypothermia is recognized in the literature, and no single test can predict a poor prognosis with absolute certainty. A clinical neurological examination is still the gold standard, but the results need careful interpretation because many patients are affected by sedatives and by hypothermia. Common adjuncts include neurophysiology, brain imaging and biomarkers, and a multimodal strategy is generally recommended. Current guidelines for prediction of outcome after cardiac arrest and induced hypothermia are not sufficient. Based on our expert opinion, we suggest a multimodal approach with a continuous evaluation of prognosis based on repeated neurological examinations and electroencephalography. Somatosensory‐evoked potential is an established method to help determine a poor outcome and is recommended, whereas biomarkers and magnetic resonance imaging are promising adjuncts. We recommend that a decisive evaluation of prognosis is performed at 72 h after normothermia or later in a patient free of sedative and analgetic drugs.
Effect of adductor‐canal‐blockade on established, severe post‐operative pain after total knee arthroplasty: a randomised study
Authors: JÆGER P. , GREVSTAD U. , HENNINGSEN M. H. , GOTTSCHAU B. , MATHIESEN O. , DAHL J. B.
Published: July 2012

Background:

In this proof‐of‐concept study, we investigated the effect of the predominantly sensory adductor‐canal‐blockade on established pain in the early post‐operative period after total knee arthroplasty (TKA). We hypothesised that the adductor‐canal‐blockade would reduce pain during flexion of the knee (primary end point) and at rest, as well as reducing morphine consumption and morphine‐related side effects (secondary outcomes) compared with placebo.

Methods:

We enrolled patients scheduled for elective TKA into this double‐blind, placebo‐controlled, randomised study. During general anaesthesia, we placed a catheter in the adductor canal, and after obtaining pre‐block pain scores 30 min post‐operatively, we injected 30 ml of ropivacaine 0.75% (n = 21) or saline (n = 20) according to randomisation. Clinicaltrials.gov Identifier: NCT01261897.

Results:

Forty‐two patients were randomised, and 41 were analysed. Mean (standard deviation) pain scores during flexion of the knee at 1 h post‐operatively were 58 (22) mm and 67 (29) mm, ropivacaine and placebo group, respectively (P = 0.23) but was significantly reduced in the ropivacaine group when calculated as area under the curve for the interval 1–6 h (P = 0.02). There were no statistically significant differences regarding pain at rest (P = 0.08), morphine consumption (P = 0.06), nor morphine‐related side effects, apart from nausea (P = 0.04).

Conclusion:

This proof‐of‐concept study shows promising results regarding the analgesic efficacy of adductor‐canal‐blockade in post‐operative pain treatment after TKA, with a significant reduction in pain during flexion of the knee in the early post‐operative period compared with placebo. However, the study was not sufficiently powered to permit final conclusions.
Relationship between regional lung compliance and ventilation homogeneity in the supine and prone position
Authors: TANG R. , HUANG Y. , CHEN Q. , HUI X. , LI Y. , YU Q. , ZHAO H. , YANG Y. , QIU H.
Published: July 2012

Background

The prone position (PP) improves ventilation homogeneity in acute respiratory distress syndrome. The aim of this study was to investigate whether the alleviation of ventilation inhomogeneity in PP was due to changes in regional lung compliance.

Methods

Ten lung‐lavaged piglets were mechanically ventilated in supine position (SP) and in PP. In each position, positive end‐expiratory pressure (PEEP) was reduced from 20 to 6 cmH2O in steps of 2 cmH2O every 10 min after full lung recruitment. Respiratory mechanics, blood gas, haemodynamic data and whole‐lung computed tomography scans were recorded at each PEEP. The compliances of normally aerated (C
normal) and newly recruited (C
recruited) lung regions were calculated. Open lung PEEP (OL‐PEEP) was defined as the lowest PEEP to maintain full lung recruitment.

Results

At OL‐PEEP, PP significantly increased normally aerated lung regions, decreased poorly aerated and hyperinflated lung regions and decreased tidal recruitment and hyperinflation. C
normal was significantly reduced in PP compared with SP (12.8 ± 4.2 ml/cmH2O vs. 20.1 ± 6.2 ml/cmH2O, P < 0.001), whereas C
recruited was increased in PP (13.9 ± 3.9 ml/cmH2O vs. 9.4 ± 2.4 ml/cmH2O, P < 0.001). C
normal was correlated with hyperinflated lung regions at end‐expiration (rho = 0.67) and end‐inspiration (rho = 0.56) at OL‐PEEP. C
recruited was correlated with normally (r2 = 0.36) and poorly aerated lung regions (rho = –0.58) at OL‐PEEP.

Conclusion

This surfactant‐depleted model shows that the improvement of ventilation homogeneity in PP is related to an increase in C
recruited and a decrease in C
normal.
Scent‐Marking Behaviour in a Pack of Free‐Ranging Domestic Dogs
Authors: Cafazzo Simona , Natoli Eugenia , Valsecchi Paola
Published: July 2012

Most mammals scent‐mark, and a variety of hypotheses have been put forward to explain this behaviour. Most of our knowledge about scent marking in domestic dogs comes from studies carried out on laboratory or companion dogs, while few studies have been carried out on free‐ranging dogs. Here, we explored the functional significance of different scent‐marking behavioural patterns in a pack of free‐ranging domestic dogs by testing two non‐exclusive hypotheses: the indirect territorial defence and the dominance/threat hypotheses. Through direct observation, we recorded the locations of dog scent marks (urination, defecation and ground scratching) and information regarding the identity and posture of the marking animal. We found evidence that markings are used by dogs to form a ‘property line’ and to threaten rivals during agonistic conflicts. Both males and females utilized scent marking to assert dominance and probably to relocate food or maintain possession over it. Raised‐leg urination and ground scratching probably play a role in olfactory and visual communication in both males and females. Urinations released by females, especially through flexed‐leg posture, may also convey information about their reproductive state. Finally, our observations suggest that defecation does not play an essential role in olfactory communication among free‐ranging dogs and that standing and squat postures are associated with normal excretion. Our results suggest that many of the proposed functions of marking behaviours are not mutually exclusive, and all should be explored through detailed field and laboratory studies.
Assessment of Different Functional Parameters of Frozen–Thawed Buffalo Spermatozoa by Using Cytofluorimetric Determinations
Authors: Minervini F , Guastamacchia R , Pizzi F , Dell’Aquila ME , Barile VL
Published: July 2012

Contents

Flow cytometry is a useful tool that provides an accurate, objective and rapid evaluation of semen quality. The use of this technique could significantly improve the quality of buffalo semen samples used in artificial insemination. This study was carried out to evaluate, by flow cytometry, frozen–thawed buffalo spermatozoa quality parameters such as sperm viability by SYBR‐14/propidium iodide staining; mitochondrial function by JC‐1 potentiometric probe; sperm chromatin stability (SCSA) by acridine orange; and acrosome reaction (AR) by FITC‐PNA staining. Semen samples from five Italian Mediterranean buffalo bulls were used. Sperm viability was not different between bulls and ranged from 33.4% to 43.6%. A consistent rate (55.1 ± 10.8%) of sperm cells showed high mitochondrial membrane potential (Δψhigh), with no significant differences between subjects. Sperm chromatin structure assay differed significantly between the five buffalo bulls; moreover, data showed high stability within each buffalo. DNA fragmentation indexes (DFI), such as %‐DFI,‐DFI, SD‐DFI, were 11.2 ± 8.6, 153.3 ± 24.6 and 81.6 ± 21.2, respectively. Regarding AR, the percentage of acrosome‐reacted live (ARL) and acrosome‐reacted dead (ARD) spermatozoa was 0.3 ± 0.2 and 15.3 ± 5.5, respectively. This functional parameter differed significantly between buffalo bulls and showed high stability. Following to Ca2+ionophore A23187 for 3 h, AR significantly differed between subjects and was characterized by an increase in both ARL (10.8%) and ARD population (22.0%). This study indicates that flow cytometry could be a useful tool for a quick multiparametric evaluation of sperm quality in buffalo. In particular, SCSA and AR resulted in sperm functional parameters sensitive enough for the diagnosis of frozen‐thawed semen fertilizing potential.