bluuebunny/crossref_metadata_2025 huggingface dataset:
Effects of a postdischarge transitional care programme for patients with coronary heart disease in China: a randomised controlled trial
Authors: Zhao Yue , Wong Frances Kam Yuet
Published: July 2009

Aim.  To test the effects of a postdischarge transitional care programme among patients with coronary heart disease.

Background.  Coronary heart disease is a leading cause of death worldwide. Effective postdischarge care can help patients maintain a healthy lifestyle and thereby control the risk factors. Transitional care is under‐developed in mainland China.

Design.  A randomised controlled trial.

Method.  The control group (n = 100) received routine care and the study group (n = 100) received the postdischarge transitional care programme, which consisted of predischarge assessment, structured home visits and telephone follow‐ups within four weeks after discharge. Subjects were recruited in 2002–2003, with data collected at baseline before discharge, two days and four and 12 weeks after discharge.

Results.  Participants in the study group had significantly better understanding in diet, medications and health‐related lifestyle behaviour at day 2 and in weeks 4 and 12 and better understanding in exercise at weeks 4 and 12. There were significant differences between the control and study groups in diet and health‐related lifestyle at day 2 and weeks 4 and 12, in medication at weeks 4 and 12 and exercise at week 12. There was no difference in hospital readmission between the two groups. The study group was very satisfied with the care. There was no difference in willingness to pay for nurse follow‐up services between groups.

Conclusion.  This study is an original effort to establish and test a nurse‐led transitional care model in China. Results demonstrate that transitional care is effective in mainland China, concurring with studies done elsewhere.

Relevance to clinical practice.  This study has constructed a transitional care model for patients with coronary heart disease in the context of the Chinese population which is effective in enhancing healthy lifestyle among these patients.
Collection of secondary electrons in scanning electron microscopes
Authors: MÜLLEROVÁ I. , KONVALINA I.
Published: July 2009

Collection of the secondary electrons in the scanning electron microscope was simulated and the results have been experimentally verified for two types of the objective lens and three detection systems. The aberration coefficients of both objective lenses as well as maximum axial magnetic fields in the specimen region are presented. Compared are a standard side‐attached secondary electron detector, in which only weak electrostatic and nearly no magnetic field influence the signal trajectories in the specimen vicinity, and the side‐attached (lower) and upper detectors in an immersion system with weak electrostatic but strong magnetic field penetrating towards the specimen. The collection efficiency was calculated for all three detection systems and several working distances. The ability of detectors to attract secondary electron trajectories for various initial azimuthal and polar angles was calculated, too. According to expectations, the lower detector of an immersion system collects no secondary electrons I and II emitted from the specimen and only backscattered electrons and secondary electrons III form the final image. The upper detector of the immersion system exhibits nearly 100% collection efficiency decreasing, however, with the working distance, but the topographical contrast is regrettably suppressed in its image. The collection efficiency of the standard detector is low for short working distances but increases with the same, preserving strong topographical contrast.
Evidence for a discrete evolutionary lineage within Equatorial Guinea suggests that the tsetse flyGlossina palpalis palpalisexists as a species complex
Authors: DYER N. A. , FURTADO A. , CANO J. , FERREIRA F. , ODETE AFONSO M. , NDONG‐MABALE N. , NDONG‐ASUMU P. , CENTENO‐LIMA S. , BENITO A. , WEETMAN D. , DONNELLY M. J. , PINTO J.
Published: July 2009

Tsetse flies of thepalpalisgroup are major vectors of Human African Trypanosomiasis in Africa. Accurate knowledge of species identity is essential for vector control. Here, we combine ribosomalinternal transcribed spacer 1(ITS1), mitochondrialCytochrome Oxidase 1(COI) and microsatellites to determine the population structure and phylogenetic relations ofGlossina p. palpalisin Equatorial Guinea.CO1sequence data suggest thatG. p. palpalisin Equatorial Guinea is a distinct subspecies from previously describedG. p. palpalisin West Africa and Democratic Republic of Congo.Glossina p. palpalisin Equatorial Guinea and DRC share a common ancestor which diverged from West AfricanG. p. palpalisaround 1.9 Ma. PreviousITS1length polymorphism data suggested the possible presence of hybrids in Equatorial Guinea. However,ITS1showed incomplete lineage sorting compared with clearly definedCOIgroups, and data from 12 unlinked microsatellites provided no evidence of hybridization. Microsatellite data indicated moderate but significant differentiation between the populations analysed (Rio Campo, Mbini and Kogo). Moreover, unlike previous studies ofG. p. palpalis, there was no evidence for heterozygote deficiency, presence of migrants or cryptic population structure. Variance effective population size at Rio Campo was estimated at 501–731 assuming eight generations per year. This study of the population genetics ofG. p. palpalisin central Africa provides the first estimate of genetic differentiation between geographically separatedG. p. palpalispopulations.
GDP‐d‐mannose 3,5‐epimerase (GME) plays a key role at the intersection of ascorbate and non‐cellulosic cell‐wall biosynthesis in tomato
Authors: Gilbert Louise , Alhagdow Moftah , Nunes‐Nesi Adriano , Quemener Bernard , Guillon Fabienne , Bouchet Brigitte , Faurobert Mireille , Gouble Barbara , Page David , Garcia Virginie , Petit Johann , Stevens Rebecca , Causse Mathilde , Fernie Alisdair R. , Lahaye Marc , Rothan Christophe , Baldet Pierre
Published: July 2009

The GDP‐d‐mannose 3,5‐epimerase (GME, EC 5.1.3.18), which converts GDP‐d‐mannose to GDP‐l‐galactose, is generally considered to be a central enzyme of the major ascorbate biosynthesis pathway in higher plants, but experimental evidence for its role in planta is lacking. Using transgenic tomato lines that were RNAi‐silenced for GME, we confirmed that GME does indeed play a key role in the regulation of ascorbate biosynthesis in plants. In addition, the transgenic tomato lines exhibited growth defects affecting both cell division and cell expansion. A further remarkable feature of the transgenic plants was their fragility and loss of fruit firmness. Analysis of the cell‐wall composition of leaves and developing fruit revealed that the cell‐wall monosaccharide content was altered in the transgenic lines, especially those directly linked to GME activity, such as mannose and galactose. In agreement with this, immunocytochemical analyses showed an increase of mannan labelling in stem and fruit walls and of rhamnogalacturonan labelling in the stem alone. The results of MALDI‐TOF fingerprinting of mannanase cleavage products of the cell wall suggested synthesis of specific mannan structures with modified degrees of substitution by acetate in the transgenic lines. When considered together, these findings indicate an intimate linkage between ascorbate and non‐cellulosic cell‐wall polysaccharide biosynthesis in plants, a fact that helps to explain the common factors in seemingly unrelated traits such as fruit firmness and ascorbate content.
Two Arabidopsis 3‐ketoacyl CoA synthase genes, KCS20 and KCS2/DAISY, are functionally redundant in cuticular wax and root suberin biosynthesis, but differentially controlled by osmotic stress
Authors: Lee Saet‐Buyl , Jung Su‐Jin , Go Young‐Sam , Kim Hyun‐Uk , Kim Jeong‐Kook , Cho Hong‐Joo , Park Ohkmae K. , Suh Mi‐Chung
Published: July 2009

Very‐long‐chain fatty acids (VLCFAs) are essential precursors of cuticular waxes and aliphatic suberins in roots. The first committed step in VLCFA biosynthesis is condensation of C2 units to an acyl CoA by 3‐ketoacyl CoA synthase (KCS). In this study, two KCS genes, KCS20 and KCS2/DAISY, that showed higher expression in stem epidermal peels than in stems were isolated. The relative expression of KCS20 and KCS2/DAISY transcripts was compared among various Arabidopsis organs or tissues and under various stress conditions, including osmotic stress. Although the cuticular waxes were not significantly altered in the kcs20 and kcs2/daisy‐1 single mutants, the kcs20 kcs2/daisy‐1 double mutant had a glossy green appearance due to a significant reduction of the amount of epicuticular wax crystals on the stems and siliques. Complete loss of KCS20 and KCS2/DAISY decreased the total wax content in stems and leaves by 20% and 15%, respectively, and an increase of 10–34% was observed in transgenic leaves that over‐expressed KCS20 or KCS2/DAISY. The stem wax phenotype of the double mutant was rescued by expression of KSC20. In addition, the kcs20 kcs2/daisy‐1 roots exhibited growth retardation and abnormal lamellation of the suberin layer in the endodermis. When compared with the single mutants, the roots of kcs20 kcs2/daisy‐1 double mutantss exhibited significant reduction of C22 and C24 VLCFA derivatives but accumulation of C20 VLCFA derivatives in aliphatic suberin. Taken together, these findings indicate that KCS20 and KCS2/DAISY are functionally redundant in the two‐carbon elongation to C22 VLCFA that is required for cuticular wax and root suberin biosynthesis. However, their expression is differentially controlled under osmotic stress conditions.
A systematic review of the importance of milk TGF‐β on immunological outcomes in the infant and young child
Authors: Oddy Wendy H. , Rosales Francisco
Published: July 2009

Oddy WH, Rosales F. A systematic review of the importance of milk TGF‐β on immunological outcomes in the infant and young child. Pediatr Allergy Immunol 2010: 21: 47–59. © 2009 Mead Johnson Nutrition Journal compilation © 2009 John Wiley & Sons A/S

Cytokines in milk like transforming growth factor‐beta (TGF‐β) have been shown to induce oral tolerance in experimental animal studies. However, human studies are less consistent with these findings. The primary objective of this review was to conduct a systematic review of published studies on the association between TGF‐β identified in human milk and immunological outcomes in infancy and early childhood. Human prospective clinical studies were identified through MEDLINE, CAB Abstracts, Biological Abstracts and Scopus. Selection criteria included: well described populations of mothers and infants, time of milk sampling, immunological outcome measures and analytical methods of TGF‐β determination. We considered a wide range of immunological outcomes in infancy and early childhood, such as wheeze, atopy, eczema and the immunoglobulin switch. Twelve human studies were included in the review and 67% showed a positive association with TGF‐β1 or TGF‐β2 demonstrating protection against allergy‐related outcomes in infancy and early childhood. High variability in concentrations of TGF‐β was noted between and within studies, some of it explained by maternal history of atopy or by consumption of probiotics. Human milk TGF‐β appears to be essential in developing and maintaining appropriate immune responses in infants and may provide protection against adverse immunological outcomes, corroborating findings from experimental animal studies. Further large clinical studies in diverse human populations are indicated to confirm these results.
Increased oxidative stress in the anterior cingulate cortex of subjects with bipolar disorder and schizophrenia
Authors: Wang Jun‐Feng , Shao Li , Sun Xiujun , Young L Trevor
Published: July 2009

Background:  Recent studies indicate the presence of mitochondrial dysfunction in brains of subjects with bipolar disorder (BD). Because the mitochondrial electron transport chain is a major source for production of reactive oxygen species that cause oxidative stress, we sought to determine in the present study if BD is associated with oxidative stress.

Methods:  Postmortem anterior cingulate brain sections from subjects with BD, major depressive disorder (MDD), or schizophrenia, and from nonpsychiatric, non‐neurologic comparison controls were generously provided by the Stanley Foundation Neuropathology Consortium. Oxidative stress was determined by analyzing 4‐hydroxynonenal (4‐HNE), a major product of lipid peroxidation. The level of 4‐HNE was determined by measuring 4‐HNE protein adducts using immunohistochemistry.

Results:  We found that 4‐HNE levels were significantly increased by 59% in BD subjects and by 47% in schizophrenia subjects, but not in MDD subjects, when compared with controls. Levels of 4‐HNE were negatively correlated with pH in all 60 subjects. When pH was used as covariate, 4‐HNE levels were still significantly increased in BD subjects when compared with controls. Further, 4‐HNE levels were significantly correlated with pH values only in BD subjects, but not in MDD, schizophrenia, or control subjects.

Conclusions:  Oxidative damage in the brain may contribute in part to the pathological process in BD and schizophrenia. This finding also suggests antioxidative stress as a probable alternative approach to the pharmacological treatment of these psychiatric disorders.
Remission from mania is associated with a decrease in amygdala activation during motor response inhibition
Authors: Kaladjian Arthur , Jeanningros Régine , Azorin Jean‐Michel , Nazarian Bruno , Roth Muriel , Anton Jean‐Luc , Mazzola‐Pomietto Pascale
Published: July 2009

Objectives:  Neuroimaging studies of bipolar disorder (BD) have provided evidence of brain functional abnormalities during both the states of mania and remission. However, the differences in brain function between these two states are still poorly known. In the current study, we aimed to use a longitudinal design to examine the functional changes associated with symptomatic remission from mania within the brain network underlying motor response inhibition.

Methods:  Using event‐related functional magnetic resonance imaging (fMRI), 10 BD patients and 10 healthy subjects were imaged twice while performing a Go/NoGo task. Patients were in a manic state when they underwent the first scan and fully remitted during the second scan. A mixed‐effect ANOVA was used to identify brain regions showing differences in activation change over time between the two groups.

Results:  The left amygdala was the only brain region to show a time‐dependent change in activation that was significantly different between BD patients and healthy subjects. Further analyses revealed that this difference arose from the patient group, in which amygdala activation was decreased between mania and subsequent remission.

Conclusions:  This finding suggests that a decrease in left amygdala responsiveness is a critical phenomenon associated with remission from mania. It emphasizes the relevance of longitudinal approaches for identifying neurofunctional modifications associated with mood changes in BD.
The International Society for Bipolar Disorders (ISBD) Task Force report on the nomenclature of course and outcome in bipolar disorders
Authors: Tohen Mauricio , Frank Ellen , Bowden Charles L , Colom Francesc , Ghaemi S Nassir , Yatham Lakshmi N , Malhi Gin S , Calabrese Joseph R , Nolen Willem A , Vieta Eduard , Kapczinski Flávio , Goodwin Guy M , Suppes Trisha , Sachs Gary S , Chengappa KN Roy , Grunze Heinz , Mitchell Philip B , Kanba Shigenobu , Berk Michael
Published: July 2009

Objectives:  Via an international panel of experts, this paper attempts to document, review, interpret, and propose operational definitions used to describe the course of bipolar disorders for worldwide use, and to disseminate consensus opinion, supported by the existing literature, in order to better predict course and treatment outcomes.

Methods:  Under the auspices of the International Society for Bipolar Disorders, a task force was convened to examine, report, discuss, and integrate findings from the scientific literature related to observational and clinical trial studies in order to reach consensus and propose terminology describing course and outcome in bipolar disorders.

Results:  Consensus opinion was reached regarding the definition of nine terms (response, remission, recovery, relapse, recurrence, subsyndromal states, predominant polarity, switch, and functional outcome) commonly used to describe course and outcomes in bipolar disorders. Further studies are needed to validate the proposed definitions.

Conclusion:  Determination and dissemination of a consensus nomenclature serve as the first step toward producing a validated and standardized system to define course and outcome in bipolar disorders in order to identify predictors of outcome and effects of treatment. The task force acknowledges that there is limited validity to the proposed terms, as for the most part they represent a consensus opinion. These definitions need to be validated in existing databases and in future studies, and the primary goals of the task force are to stimulate research on the validity of proposed concepts and further standardize the technical nomenclature.
Do Larvae of Bertha armyworm, Mamestra configurata (Walker) (Lepidoptera: Noctuidae), express induced feeding responses?
Authors: Dosdall L. M.
Published: July 2009

The Bertha armyworm, Mamestra configurata (Walker) (Lepidoptera: Noctuidae), is a polyphagous Nearctic insect known to feed on over 40 different host plant species, and can be a pest of canola (Brassica napus L. and Brassica rapa L.), flax (Linum usitatissimum L.), and alfalfa (Medicago sativa L.) in the Northern Great Plains. Bertha armyworm is known to sometimes switch hosts through between‐field movements, prompting this study to investigate its adherence to a particular host plant species after completing a period of initial development on it. In a laboratory study, larvae were reared to either their fourth or sixth instars on either intact or excised leaf tissue of one of seven host species, and were then allowed to select feeding hosts from various choices that included canola, B. napus and B. rapa (Brassicaceae), Canada thistle, Cirsium arvense (L.) Scop. (Compositae), flax, L. usitatissimum (Linaceae), field pea and alfalfa, Pisum sativum L. and M. sativa (Leguminosae), and lamb’s quarters, Chenopodium album L. (Chenopodiaceae). In general, Bertha armyworm larvae showed little propensity to feed on the host plant species on which they had been reared in their early life stages. Exceptions occurred for larvae reared on intact tissue of B. rapa and P. sativum, where larvae were subsequently observed feeding on these hosts significantly more frequently than on other host plants. When larvae of Bertha armyworm were reared through early developmental stages on intact plant tissue of a single host, B. rapa was frequently the choice for subsequent feeding. Movements of Bertha armyworm larvae between fields therefore appear to result from larvae that have exploited food resources in one area and are dispersing to regions of improved host plant availability.
Dispersal of mass‐reared sterile, laboratory‐domesticated and wild male Queensland fruit flies
Authors: Weldon C. , Meats A.
Published: July 2009

Queensland fruit flies, Bactrocera tryoni (Froggatt) (Diptera: Tephritidae) (‘Q‐flies’) were released as sexually immature adults from a point within an orchard. Marked male Q‐flies were recaptured in the trap furthest from the release point (1087 m) by 2 weeks after release, although 98.25 ± 1.04% of recaptured males were trapped <500 m from the release point. Comparison of gamma‐irradiated (sterile), laboratory‐adapted and wild male Q‐flies indicated that dispersal distance was not significantly affected by fly type. There was no significant correlation between temperature and mean dispersal distance, but total recaptures were significantly negatively correlated with increasing daily maximum, minimum and average temperature.
Integration Between Different Hypothalamic Nuclei Involved in Stress and GnRH Secretion in the Ewe
Authors: Ghuman SPS , Morris R , Spiller DG , Smith RF , Dobson H
Published: July 2009

Contents

This study investigated possible integrated links in the neuroanatomical pathways through which the activity of neurones in the paraventricular nucleus and arcuate nucleus may modulate suppression of gonadotrophin‐releasing hormone (GnRH) secretion during stressful situations. Double‐label immunofluorescence and laser scanning confocal microscopy were used to examine the hypothalamic sections from the follicular phase ewes. Noradrenergic terminals were in close contact with 65.7 ± 6.1% corticotrophin‐releasing hormone (CRH) and 84.6 ± 3.2% arginine vasopressin (AVP) cell bodies in the paraventricular nucleus but not with β‐endorphin cell bodies in the arcuate nucleus. Furthermore, γ‐amino butyric acid (GABA) terminals were close to 80.9 ± 3.5% CRH but no AVP cell bodies in the paraventricular nucleus, as well as 60.8 ± 4.1%β‐endorphin cell bodies in the arcuate nucleus. Although CRH, AVP and β‐endorphin cell terminals were identified in the medial pre‐optic area, no direct contacts with GnRH cell bodies were observed. Within the median eminence, abundant CRH but not AVP terminals were close to GnRH cell terminals in the external zone; whereas, β‐endorphin cells and terminals were in the internal zone. In conclusion, neuroanatomical evidence is provided for the ewe supporting the hypothesis that brainstem noradrenergic and hypothalamic GABA neurones are important in modulating the activity of CRH and AVP neurones in the paraventricular nucleus, as well as β‐endorphin neurones in the arcuate nucleus. These paraventricular and arcuate neurones may also involve interneurones to influence GnRH cell bodies in medial pre‐optic area, whereas the median eminence may provide a major site for direct modulation of GnRH release by CRH terminals.
Too big for his boots: Are social costs keeping condition‐dependent status signalling honest in an Australian lizard?
Authors: HEALEY MO , OLSSON MATS
Published: July 2009

Australian painted dragon lizards Ctenophorus pictus occur in three head colours (red, orange and yellow) that differ in their level of aggression (reds being most aggressive), hormone profile (reds having higher testosterone levels) and in their frequency in our study population over time. They are also polymorphic in bib colour; some males have a bright yellow area under the chin, while others lack this coloured area entirely. We show that red males with a bib are in better body condition than red males that lack a bib. This contrasts sharply to yellow males, in which males with a bib are in poorer condition than yellow males that lack a bib. Our analysis also shows that following exposure to a high percentage of red (more aggressive) neighbours, all males suffer a reduction in body condition, and importantly, males with a bib (regardless of their head colour) suffer a more severe loss of body condition than males that lack a bib. Finally, this condition loss is significantly higher for yellow bibbed males than for red bibbed males, suggesting that the cost of sporting a bib may be higher for them. Orange males showed a non‐significant difference in condition between bib morphs. Our analysis also shows that bibbed yellow males (the morph with lower body condition), but no other morph category, declined significantly in their frequency between 2 years.
A novel type of interplexiform amacrine cell in the mouse retina
Authors: Dedek Karin , Breuninger Tobias , De Sevilla Müller Luis Pérez , Maxeiner Stephan , Schultz Konrad , Janssen‐Bienhold Ulrike , Willecke Klaus , Euler Thomas , Weiler Reto
Published: July 2009

Mammalian retinas comprise an enormous variety of amacrine cells with distinct properties and functions. The present paper describes a new interplexiform amacrine cell type in the mouse retina. A transgenic mouse mutant was used that expressed the gene for the enhanced green fluorescent protein (EGFP) instead of the coding DNA of connexin45 in several retinal cell classes, among which a single amacrine cell population was most prominently labelled. Staining for EGFP and different marker proteins showed that these amacrine cells are interplexiform: they stratify in stratum S4/5 of the inner plexiform layer and send processes to the outer plexiform layer. These cells were termed IPA‐S4/5 cells. They belong to the group of medium‐field amacrine cells and are coupled homologously and heterologously to other amacrine cells by connexin45. Immunostaining revealed that IPA‐S4/5 cells are GABAergic and express GAT‐1, a plasma‐membrane‐bound GABA transporter possibly involved in non‐vesicular GABA release. To characterize the light responses of IPA‐S4/5 cells, patch‐clamp recordings in retinal slices were made. Consistent with their stratification in the ON sublamina of the inner plexiform layer, cells depolarized in response to light ON stimuli and transiently hyperpolarized in response to light OFF. Responses of cells to green (578 nm) and blue (400 nm) light suggest that they receive input from cone bipolar cells contacting both M‐ and S‐cones, possibly with reduced S‐cone input. A new type of interplexiform ON amacrine cell is described, which is strongly coupled and uses GABA but not dopamine as its neurotransmitter.
Experience of intravenous sedation for pediatric gastrointestinal endoscopy in a large tertiary referral center in a developing country
Authors: AMORNYOTIN SOMCHAI , AANPREUNG PRAPUN , PRAKARNRATTANA UNGKAB , CHALAYONNAVIN WIYADA , CHATCHAWANKITKUL SUKANDA , SRIKUREJA WICHIT
Published: July 2009

Background: The aim of this study was to evaluate the clinical efficacy of intravenous sedation for pediatric gastrointestinal endoscopy (GIE) at a tertiary care teaching hospital in a developing country.

Methods: We undertook a retrospective review of the sedation service records of pediatric patients who underwent GIE. All endoscopies were performed by a pediatric gastroenterologist. All of the sedation was administered by staff anesthesiologist or anesthetic personnel in the gastroenterology procedure room.

Results: Sedation was provided for 222 procedures in 214 patients ranged in age from younger than 1 to 17 years and in weight from 2.7 to 80.0 kg. Intravenous sedation was provided in 176 patients (82.2%). Of these patients, 185 procedures were performed and reviewed, with 152 (82.2%) procedures were esophagogastroduodenoscopy (EGD) alone, 14 (7.6%) procedures were colonoscopy alone, 18 (9.7%) procedures were EGD and colonoscopy, and one procedure was endoscopic ultrasonography (EUS). Most common indications of the procedure were screening for esophageal varices (25.2%), abdominal pain (15.9%), history of upper gastrointestinal hemorrhage (13.6%), and unexplained anemia (10.3%). The majority of preanesthetic problems were hematologic disease, anemia (38.2%); liver disease, cirrhosis (13.5%); and electrolyte imbalance (13.5%). Propofol (94.0%), fentanyl (87.0%), and midazolam (67.8%) were frequently used. The mean dose of propofol was 7.8 ± 4.1 mg·kg−1·h−1, fentanyl 2.3 ± 1.1 mcg·kg−1·h−1, and midazolam 0.1 ± 0.1 mg·kg−1·h−1. Most of them were used in combination. The combination of propofol, fentanyl, and midazolam was commonly employed (46.4%). The mean sedation time of all procedures was 28.2 min and was different according to procedure type. Complications occurred infrequently (13.5%) and were medication or airway related. All complications were easily treated, with no adverse sequelae. Intravenous sedation was successful except for one patient who required general anesthesia. However, all procedures were completed successfully.

Conclusions: In the setting of the developing country, intravenous sedation for pediatric GIE by trained anesthetic personnel with appropriate monitoring was safe and effective. Serious adverse events were rare in our population.
Intraoperative reported adverse events in children
Authors: KAKAVOULI ATHINA , LI GUOHUA , CARSON MARGARET P. , SOBOL JULIA , LIN CHRISTINE , OHKAWA SUSUMU , HUANG LIN , GALIZA CAROLYN , WOOD ALASTAIR , SUN LENA S.
Published: July 2009

Background:  Significant intraprocedural adverse events (AE) are reported in children who receive anesthesia for procedures outside the Operating Rooms (NORA). No study, so far, has characterized AE in children who receive anesthesia in the operating rooms (ORA) and NORA when anesthesia care is provided by the same team in a consistent manner.

Objective/Aim:  We used the same patient‐specific Quality Assurance questionnaires (QAs), to elucidate incidences of intraoperative reported AE for children receiving anesthesia in NORA and ORA locations. Through multivariate logistic regression analysis, we assessed the association between patient’s AE risk and procedure’s location while adjusting for American Society of Anesthesiologists (ASA) status, age, and unscheduled nature of the procedure.

Methods/Materials:  After Institutional Review Board approval, we used returned QAs of patients under 21 years, who received anesthesia from our pediatric anesthesia faculty from May 1 2006 through September 30, 2007. We analyzed QA data on: service location, unscheduled/scheduled procedure, age, ASA status, presence, and type of AE. We excluded QAs with incomplete information on date, location, age, and ASA status.

Results:  We included 8707 cases, with 3.5% incidence of reported AE. We had 1898 NORA and 6808 ORA cases with AE incidence of 2.5% and 3.7%, respectively. Multivariate regression analysis revealed that patients with higher ASA status or younger age had higher incidence of reported AE, irrespective of location or unscheduled nature of the procedure. The most common AE type, for both sites, was respiratory related (1.9%).

Conclusions:  Pediatric reported AE incidence was comparable for NORA and ORA locations. Younger age or higher ASA status are associated with increased risk of AE.
Cerebral metabolism during deep hypothermic circulatory arrest vs moderate hypothermic selective cerebral perfusion in a piglet model: a microdialysis study
Authors: CAVUS EROL , HOFFMANN GRISCHA , BEIN BERTHOLD , SCHEEWE JENS , MEYBOHM PATRICK , RENNER JOCHEN , SCHOLZ JENS , BOENING ANDREAS
Published: July 2009

Background:  Few data exist regarding antegrade selective cerebral perfusion (ASCP) and its application in newborn and juvenile patients. Clinical data suggest ASCP alone to be superior to deep hypothermic circulatory arrest (DHCA); however, the effects of moderate hypothermia during ASCP on cerebral metabolism in this patient population are still unclear.

Methods:  After obtaining the approval from animal investigation committee, 16 piglets were randomly assigned to circulatory arrest combined with either ASCP at 27°C or DHCA at 18°C for 90 min. Cerebral oxygen extraction fraction (COEF) from blood as well as cerebral tissue glucose, glycerol, lactate, pyruvate, and the lactate/pyruvate ratio (L/P ratio) by microdialysis were obtained repeatedly.

Results:  COEF was lower during cooling and rewarming, respectively, in the DHCA18 group compared to the ASCP27 group (30 ± 8 vs 56 ± 13% and 35 ± 6 vs 58 ± 7%, respectively). Glucose decreased in both the DHCA18 and ASCP27 groups during the course of cardiopulmonary bypass (CPB), but were higher in the ASCP27 group during ASCP, compared to the DHCA18 group during circulatory arrest (0.7 ± 0.1 vs 0.2 ± 0.1 mm·l−1, P < 0.05). Pyruvate was higher (ASCP27 vs DHCA18: 53 ± 17 vs 6 ± 2 μm·l−1, P < 0.05), and the L/P ratio increased during circulatory arrest in the DHCA18 group, compared to the selective perfusion phase of the ASCP27 group (DHCA18 vs ASCP27: 1891 ± 1020 vs 70 ± 28, P < 0.01).

Conclusions:  In this piglet model, both cerebral oxygenation and microdialysis findings suggested a depletion of cerebral energy stores during circulatory arrest in the DHCA18 group, compared to selective cerebral perfusion combined with circulatory arrest in the ASCP27 group.
STARR with Contour® Transtar™: prospective multicentre European study
Authors: Lenisa L. , Schwandner O. , Stuto A. , Jayne D. , Pigot F. , Tuech J.J. , Scherer R. , Nugent K. , Corbisier F. , Espin‐Basany E. , Hetzer F. H.
Published: July 2009

Objective  The stapled transanal rectal resection (STARR) in patients with defecation disorders is limited by the shape and capacity of the circular stapler. A new device has been recently developed, the Contour® Transtar™ stapler, in order to improve the safety and effectiveness of the STARR technique. The study has been designed to confirm this declaration.

Method  From January to June 2007 a prospective European multicentre study of consecutive patients with defecation disorder caused by internal rectal prolapse underwent the new STARR technique. The assessment of perioperative morbidity and functional outcome after 6 weeks, 3 and 12 months was documented by different scores.

Results  In all 75 patients, median age 64, the Transtar procedure was performed with 9% intraoperative difficulties, 7% postoperative complications and no mortality. The mean reduction of the ODS score was −15.6 (95%−CI: −17.3 to −13.8, P < 0.0001), mean reduction of SSS was −12.6 (95%−CI: −14.2 to −11.2; P < 0.0001). 41% stated improvement of their continence status by CCF score, only 4 patients (5%) had deterioration.

Conclusion  The Transtar procedure is technically demanding, with good functional results similar to the conventional STARR.
Anastomotic leakage after resection of colorectal cancer generates prodigious use of hospital resources
Authors: Frye J. , Bokey E. L. , Chapuis P. H. , Sinclair G. , Dent O. F.
Published: July 2009

Objective  The aim of this study was to determine the demand for hospital resources generated by anastomotic leakage, including surgical, medical, imaging, pathology, and other allied health consultations or services and length of postoperative hospital stay.

Method  Data were obtained from a comprehensive, prospective hospital registry of all resections for colorectal cancer from January 1995 to December 2004 and from retrospective review of patients’ notes.

Results  Forty‐one patients with a leak spent 92 days in intensive care, required 129 days of total parenteral nutrition, 69 days of enteric feeding and 41 days on ventilation and had a median postoperative hospital stay of 28 days (range 11–104). These patients required 24 re‐operations and 2273 separate medical consultations or allied services.

Conclusion  Anastomotic leakage generates a very considerable demand for hospital resources and diverts these resources from the hospital population at large.
Anatomical branches of the superior rectal artery in the distal rectum
Authors: Schuurman J. P. , Go P. M. N. Y. H. , Bleys R. L. A. W.
Published: July 2009

Objective  The aim of this experimental study was to study the arterial supply of the corpus cavernosum recti in the inner wall of the distal rectum in relation to haemorrhoidal ligation therapy.

Method  In 10 nonfixed human cadavers, the arterial vasculature of the rectum was studied using the Araldite casting method. Subsequently, the specimens were treated with methylbenzoate in order to obtain semitransparent specimens in which the corpus cavernosum recti could be studied.

Results  Specimens were obtained permitting study of the arterial vasculature of the rectum and corpus cavernosum recti at all levels. The superior rectal artery was found to supply the corpus cavernosum recti which consisted of a variable number of equally spaced twisting arteries.

Conclusion  The distal rectum is supplied by the superior rectal artery. The supplying arteries of the corpus cavernosum recti are not confined to the strict locations described in the literature. This finding is of importance in surgical treatment of haemorrhoidal disease.
Fistulectomy and sphincteric reconstruction for complex cryptoglandular fistulas
Authors: Roig J. V. , García‐Armengol J. , Jordán J. C. , Moro D. , García‐Granero E. , Alós R.
Published: July 2009

Objective  Complex anal fistulas (CFs) are difficult to treat. Endoanal advancement flap (EAF) is one of the standard treatment options for such clinical conditions. Immediate sphincter repair after fistulectomy (ISR) is not commonly performed because of the fear of causing postoperative incontinence. The objective of this study was to compare the results of both techniques.

Method  We retrospectively analysed a prospectively entered database composed of 146 patients (112 M; 34 F), undergoing operations for CF of cryptoglandular origin. The patients were divided in two groups: Group A: (EAF); n = 71 patients; Group B: (ISR); n = 75 patients.

Results  Forty‐two fistulas (28.7%) were recurrent, 98 trans‐sphincteric (TS) and 37 suprasphincteric (SS). Twenty‐six (17.7%) patients had some degree of preoperative continence disturbances, 11 in Group A vs 15 in Group B (P = 0.47).  After a mean follow up of 13 months (12–60), fistula persisted or recurred in 13 (18.3%) patients in Group A vs eight (10.6%) in Group B (P = 0.19) irrespective of the fistula type (TS or SS). Thirty‐one (43.6%) patients in Group A vs 16 (21.3%) in Group B presented postoperative continence disturbances (P < 0.001). No changes were observed with the Faecal Incontinence Quality of Life Scale (FIQLS). Group A patients had a significant reduction of maximal rest pressure after surgery. After ISR, no significant changes in pressures were observed.

Conclusion  Immediate sphincter repair can be a therapeutic option in selected cases of CF, mainly when associated with incontinence or increased risk factors.
Intrinsic vs. Extrinsic Motivations to Volunteer and Social Capital Formation
Authors: Degli Antoni Giacomo
Published: July 2009

Although intrinsic motivations receive increasing attention in explaining human actions, our knowledge on their causes and effects is incomplete. Quite surprisingly, the existing literature fails to consider the relationship between intrinsic motivations and social capital formation. The present paper increases the understanding on the effect of intrinsic motivations by studying the role that different motivations to volunteer have on the creation of volunteers' social capital which is intended as networks of cooperative relations.

Our empirical analysis considers three indices of social capital, aimed at measuring both the quantitative (number) and the qualitative (degree of familiarity and cooperation) character of social relations, and intrinsic and extrinsic motivations to volunteer (ideal motivations, the desire to feel useful to others, the pursuit of social recognition and the desire to increase the number of acquaintances or friends).

We find that the creation of social capital through participation in voluntary associations is not indifferent to the motivations which induced the volunteer to start his/her unpaid activity. In particular, we show that intrinsic motivations enable people to extend their social networks by creating relations characterized by a significant degree of familiarity. By contrast, extrinsic motivations, and in particular the decision to join an association in order to increase the number of acquaintances or friends, promote the creation of networks from a quantitative point of view, but they do not facilitate the creation of relations based on a particular degree of confidence.
Government size and openness revisited: the case of financial globalization
Authors: Kimakova Alena
Published: July 2009

The volatility of international capital flows to emerging markets has been well documented. Financial globalization may not in general fulfill its theoretical role as a risk sharing mechanism in financially underdeveloped economies, and hence may provide an impetus for compensating government spending. Comparative studies of the public sector have provided evidence of a robust positive association between government size and openness of the economy to trade flows. This paper extends the existing literature by investigating the relationship between government size and financial openness for 87 developing and developed countries between 1976 and 2003. The analysis reveals a positive relationship between exposure to international capital flows and government size. Furthermore, interacting capital flows with income levels shows that richer open economies tend to have smaller government size. These findings are consistent with the hypothesis that benefits of financial integration, in terms of improved risk‐sharing and consumption smoothing, accrue only beyond a certain minimum level of financial development.
Are Gangs a Substitute for Legitimate Employment? Investigating the Impact of Labor Market Effects on Gang Affiliation
Authors: Seals Alan
Published: July 2009

This paper adds to the literature estimates of local labor market effects on gang participation. The local unemployment rate is a proxy for the availability of legitimate employment. I use data from the 1997 cohort of the National Longitudinal Survey of Youth (NLSY97) to model the probability of gang involvement. The effect of the local unemployment rate is statistically significant and positive. Robustness checks reveal gang participation of individuals less than sixteen years of age (the legal minimum age for most jobs) is not responsive to the local unemployment rate. However, the effect of the local unemployment rate on sixteen‐ and seventeen‐year‐olds is statistically significant and positive, which suggests juvenile gang participation depends on economic incentives. Gang participation among individuals with lower ASVAB scores is more sensitive to the local unemployment rate.
Organizational Memory: From Expectations Memory to Procedural Memory
Authors: Ebbers Joris J. , Wijnberg Nachoem M.
Published: July 2009

Organizational memory is not just the stock of knowledge about how to do things, but also of expectations of organizational membersvis‐à‐viseach other and the organization as a whole. The central argument of this paper is that this second type of organizational memory –organizational expectations memory– is a necessary precondition for successfully creating and maintainingorganizational procedural memory, which is at the basis of organizational performance. If members of organizations have fewer expectations of being rewarded beyond what is stipulated in formal contracts, these individuals are less likely to risk investing in collective tacit and firm‐specific knowledge resources and more likely to focus on building individual and mobile knowledge resources that have value outside the boundaries of the organization. A case study of latent organizations in the Dutch film industry is presented to support the central argument and suggests further avenues of research, in particular concerning the effects of labour mobility on organizational expectations memory.
Inter‐organizational Cooperation and Environmental Change: Moderating Effects between Flexibility and Innovation Performance
Authors: Martínez‐Sánchez Angel , Vela‐Jiménez M. José , Pérez‐Pérez Manuela , De‐Luis‐Carnicer Pilar
Published: July 2009

The paper investigates the moderator effect of inter‐organizational cooperation in the relationship between workplace flexibility and innovation performance. This research question is important because innovation is dependent on the strategic integration of technological knowledge, requiring organizations to acquire new capabilities rapidly or to ensure the presence of knowledge that may be beyond existing internal capabilities. Inter‐organizational cooperation constitutes a relevant mechanism for a firm to increase its knowledge base concerning new products and processes. High‐cooperation firms may have more opportunities to take advantage of flexibility for innovation performance because it facilitates the access and dispersion of knowledge within the firm. We test the research hypotheses in a sample of manufacturing and service firms. The results contribute to the literature on flexibility and innovation because they demonstrate that inter‐organizational cooperation moderates the relationship between flexibility and innovation performance. We discuss the implications of these results for future research and managerial practice.
The Color of Sin
Authors: Sherman Gary D. , Clore Gerald L.
Published: July 2009

Three studies examined automatic associations between words with moral and immoral meanings and the colors black and white. The speed of color naming in a Stroop task was faster when words in black concerned immorality (e.g., greed), rather than morality, and when words in white concerned morality (e.g., honesty), rather than immorality. In addition, priming immorality by having participants hand-copy an unethical statement speeded identification of words in the black font. Making immorality salient in this way also increased the moral Stroop effect among participants who had not previously shown it. In the final study, participants also rated consumer products. Moral meanings interfered with color naming most strongly among those participants who rated personal cleaning products as especially desirable. The moderation of the moral Stroop effect by individual differences in concerns about personal cleanliness suggests that ideas about purity and pollution are central to seeing morality in black and white.
Depression in patients with HIV is under‐diagnosed: a cross‐sectional study in Denmark
Authors: Rodkjaer L , Laursen T , Balle N , Sodemann M
Published: July 2009

Background

International studies suggesting that 20–37% of HIV‐positive patients have diagnosable depression may underestimate the prevalence of this condition. The aim of this study was to investigate the prevalence of depression among HIV‐positive patients in an out‐patient clinic in Denmark and to detect factors of importance for the development of depression.

Methods

In 2005, a population of 205 HIV‐positive patients was included in a questionnaire‐based study. The Beck Depression Inventory II (BDI‐II) was used to assess the prevalence and severity of depressive symptoms. Patients with a BDI score of 20 or above were offered a clinical evaluation by a consultant psychiatrist.

Results

Symptoms of depression (BDI>14) were observed in 77 (38%) patients and symptoms of major depression (BDI≥20) in 53 (26%). Eighteen patients subsequently started treatment with anti‐depressants. In a reduced logistic regression model, self‐reported stress, loneliness, constant thoughts about HIV and being in a difficult financial situation were associated with risk of depression. Patients at risk of major depression were nearly six times more likely to have missed at least one dose of highly active antiretroviral therapy (HAART) in the 4 days prior to assessment (odds ratio 5.7, 95% confidence interval 1.7–18.6). There was a dose–response trend in relation to unsafe sex (P=0.03).

Conclusions

The study found that depression was under‐diagnosed among HIV‐positive patients and was associated with stress, loneliness, a difficult financial situation, low adherence and unsafe sex. Screening for depression should be conducted regularly to provide full evaluation and relevant psychiatric treatment. This is particularly important at the time of diagnosis and before initiating HAART.
Old‐time militancy and the economic realities: towards a reassessment of the dockers' experience
Authors: Coffey Dan
Published: July 2009

This article makes the case for a fundamental reassessment of an important stage in the history of industrial relations in the UK port transport sector vis‐à‐vis the regulation of employment and the controversial demise of the National Dock Labour Scheme. It argues that the popular view that state regulation combined with trade union organisation and restrictive working practices in the 1970s and 1980s to undermine the competitiveness of the port transport sector lacks convincing empirical foundations. It notes some implications for wider debates around Britain's variety of capitalism.