bluuebunny/crossref_metadata_2025 huggingface dataset:
Health Care Emergency Management: Establishing the Science of Managing Mass Casualty and Mass Effect Incidents
Authors: Macintyre Anthony G. , Barbera Joseph A. , Brewster Peter
Published: June 2009

Particularly since 2001, the health care industry has witnessed many independent and often competing efforts to address mitigation and preparedness for emergencies. Clinicians, health care administrators, engineers, safety and security personnel, and others have each developed relatively independent efforts to improve emergency response. A broader conceptual approach through the development of a health care emergency management profession should be considered to integrate these various critical initiatives. When based on long-standing emergency management principles and practices, health care emergency management provides standardized, widely accepted management principles, application concepts, and terminology. This approach could also promote health care integration into the larger community emergency response system. The case for a formally defined health care emergency management profession is presented with discussion points outlining the advantages of this approach. (Disaster Med Public Health Preparedness. 2009;3(Suppl 1):S52–S58)
Major Influences on Hospital Emergency Management and Disaster Preparedness
Authors: Sauer Lauren M. , McCarthy Melissa L. , Knebel Ann , Brewster Peter
Published: June 2009

The role of hospitals in the community response to disasters has received increased attention, particularly since the terrorist attacks of September 11, 2001. Hospitals must be prepared to respond to and recover from all-hazards emergencies and disasters. There have been several initiatives to guide hospitals’ role in these events and to assist hospitals in their effort to prepare for them. This article focuses on the efforts of 4 distinct groups: The Joint Commission (TJC), the executive branch of the US government, the US Congress, and the Department of Health and Human Services (DHHS). Despite the different approach each group uses to assist hospitals to improve their emergency management capabilities, the initiatives reinforce one another and have resulted in increased efforts by hospitals to improve their disaster preparedness and response capabilities and community integration. The continued progress of our medical response system in all-hazard emergencies and disasters depends in large part on the future guidance and support of these 4 key institutions. (Disaster Med Public Health Preparedness. 2009;3(Suppl 1):S68–S73)
Consensus and Tools Needed to Measure Health Care Emergency Management Capabilities
Authors: McCarthy Melissa L. , Brewster Peter , Hsu Edbert B. , Macintyre Anthony G. , Kelen Gabor D.
Published: June 2009

There is no widely accepted, validated framework of health care emergency management capabilities (HEMCs) that can be used by facilities to guide their disaster preparedness and response efforts. We reviewed the HEMCs and the evaluation methods used by the Veterans Health Administration, The Joint Commission, the Institute of Medicine Metropolitan Medical Response System committee, the Department of Homeland Security, and the Department of Health and Human Services to determine whether a core set of HEMCs and evaluative methods could be identified.

Despite differences in the conceptualization of health care emergency management, there is considerable overlap among the agencies regarding major capabilities and capability-specific elements. Of the 5 agencies, 4 identified occupant safety and continuity of operations as major capabilities. An additional 5 capabilities were identified as major by 3 agencies. Most often the differences were related to whether a capability should be a major one versus a capability-specific element (eg, decontamination, management of resources). All of the agencies rely on multiple indicators and data sources to evaluate HEMCs. Few performance-based tools have been developed and none have been fully tested for their reliability and validity. Consensus on a framework and tools to measure HEMCs is needed. (Disaster Med Public Health Preparedness. 2009;3(Suppl 1):S45–S51)
Access to Health Services and Care-seeking Behaviors After the 2007 Ica Earthquake in Peru
Authors: Daniels Amy , Chapin Erica , Aspilcueta Daniel , Doocy Shannon ,   With The Instituto Peruano de Paternidad Responsable-Johns Hopkins Bloomberg School of Public Health-City University of New York Study Team
Published: June 2009

Objective: To assess care-seeking behaviors, perceptions of quality, and access to health services among populations affected by the 2007 Peruvian earthquake.

Methods: A stratified cluster survey design was used to allow for comparison between urban, periurban, and rural populations of the 4 provinces most affected by the earthquake. Forty-two clusters of 16 households (n = 672) were interviewed approximately 6 months after the earthquake.

Results: Of all of the respondents, 38% reported that a household member sought medical care within 2 weeks after the earthquake. Earthquake-related injury, presence of a chronic medical condition, and residence in temporary housing were significantly associated with care seeking in adjusted models. Individuals experiencing earthquake-related injuries and those with chronic medical conditions, respectively, were 7.1 times (95% confidence interval [CI] 3.7–13.7) and 1.9 times (95% CI 1.3–2.9) more likely to seek medical care; temporary housing residents were 1.7 times (95% CI 1.0–2.8) more likely to seek care than those residing in permanent housing.

Conclusions: Earthquake-related injury and chronic medical conditions were associated with care seeking in the first 2 weeks after the 2007 Ica earthquake. Households living in temporary housing were more likely to seek medical care than those residing in permanent structures, suggesting that displaced people are more likely to need medical attention. (Disaster Med Public Health Preparedness. 2009;3:97–103)
Update on Mortality in the Democratic Republic of Congo: Results From a Third Nationwide Survey
Authors: Coghlan Benjamin , Ngoy Pascal , Mulumba Flavien , Hardy Colleen , Bemo Valerie Nkamgang , Stewart Tony , Lewis Jennifer , Brennan Richard J.
Published: June 2009

Background:The humanitarian crisis in the Democratic Republic of Congo (DRC) has been among the world’s deadliest in recent decades. We conducted our third nationwide survey to examine trends in mortality rates during a period of changing political, security, and humanitarian conditions.

Methods:We used a 3-stage, household-based cluster sampling technique to compare east and west DRC. Sixteen east health zones and 15 west zones were selected with a probability proportional to population size. Four east zones were purposely selected to allow historical comparisons. The 20 smallest population units were sampled in each zone, 20 households in each unit. The number and distribution of households determined whether they were selected using systematic random or random walk sampling. Respondents were asked about deaths of household members during the recall period: January 2006–April 2007.

Findings:In all, 14,000 households were visited. The national crude mortality rate of 2.2 deaths per 1000 population per month (95% confidence interval [CI] 2.1–2.3) is almost 70% higher than that documented for DRC in the 1984 census (1.3) and is unchanged since 2004. A small but significant decrease in mortality since 2004 in the insecure east (rate ratio: 0.96,P= .026) was offset by increases in the western provinces and a transition area in the center of the country. Nonetheless, the crude mortality rate in the insecure east (2.6) remains significantly higher than in the other regions (2.0 and 2.1, respectively). Deaths from violence have declined since 2004 (rate ratio 0.7,P= .02).

Conclusions:More than 4 years after the official end of war, the crude mortality rate remains elevated across DRC. Slight but significant improvements in mortality in the insecure east coincided temporally with recent progress on security, humanitarian, and political fronts. (Disaster Med Public Health Preparedness. 2009;3:88–96)
A Novel Approach to Multihazard Modeling and Simulation
Authors: Smith Silas W. , Portelli Ian , Narzisi Giuseppe , Nelson Lewis S. , Menges Fabian , Rekow E Dianne , Mincer Joshua S. , Mishra Bhubaneswar , Goldfrank Lewis R.
Published: June 2009

Objective:To develop and apply a novel modeling approach to support medical and public health disaster planning and response using a sarin release scenario in a metropolitan environment.

Methods:An agent-based disaster simulation model was developed incorporating the principles of dose response, surge response, and psychosocial characteristics superimposed on topographically accurate geographic information system architecture. The modeling scenarios involved passive and active releases of sarin in multiple transportation hubs in a metropolitan city. Parameters evaluated included emergency medical services, hospital surge capacity (including implementation of disaster plan), and behavioral and psychosocial characteristics of the victims.

Results:In passive sarin release scenarios of 5 to 15 L, mortality increased nonlinearly from 0.13% to 8.69%, reaching 55.4% with active dispersion, reflecting higher initial doses. Cumulative mortality rates from releases in 1 to 3 major transportation hubs similarly increased nonlinearly as a function of dose and systemic stress. The increase in mortality rate was most pronounced in the 80% to 100% emergency department occupancy range, analogous to the previously observed queuing phenomenon. Effective implementation of hospital disaster plans decreased mortality and injury severity. Decreasing ambulance response time and increasing available responding units reduced mortality among potentially salvageable patients. Adverse psychosocial characteristics (excess worry and low compliance) increased demands on health care resources. Transfer to alternative urban sites was possible.

Conclusions:An agent-based modeling approach provides a mechanism to assess complex individual and systemwide effects in rare events. (Disaster Med Public Health Preparedness. 2009;3:75–87)
Boundary algebraic equations for lattice problems
Authors: Martinsson Per-Gunnar , Rodin Gregory J.
Published: June 2009

Procedures for constructing boundary integral equations equivalent to linear boundary-value problems governed by partial differential equations are well established. In this paper, it is demonstrated how these procedures can be extended to linear boundary-value problems defined on lattices and governed by algebraic (‘difference’) equations. The boundary equations that arise are then themselves algebraic equations. Such ‘boundary algebraic equations’ (BAEs) are derived for fundamental boundary-value problems defined on both perfect lattices and lattices with defects. It is demonstrated that key advantages of representing a continuum boundary-value problem as an equation on the boundary, such as favourable spectral properties and minimal problem size, are preserved in the lattice environment. Certain spectral properties of BAEs are established rigorously, whereas others are supported by numerical experiments.
The gauge theory of dislocations: a uniformly moving screw dislocation
Authors: Lazar Markus
Published: June 2009

In this paper, we present the equations of motion of a moving screw dislocation in the framework of the translation gauge theory of dislocations. In the gauge field theoretical formulation, a dislocation is a massive gauge field. We calculate the gauge field theoretical solutions of a uniformly moving screw dislocation. We give the subsonic and supersonic solutions. Thus, supersonic dislocations are not forbidden from the field theoretical point of view. We show that the elastic divergences at the dislocation core are removed. We also discuss the Mach cones produced by supersonic screw dislocations.
Genome-wide screen of promoter methylation identifies novel markers in melanoma
Authors: Koga Yasuo , Pelizzola Mattia , Cheng Elaine , Krauthammer Michael , Sznol Mario , Ariyan Stephan , Narayan Deepak , Molinaro Annette M. , Halaban Ruth , Weissman Sherman M.
Published: June 2009

DNA methylation is an important component of epigenetic modifications, which influences the transcriptional machinery aberrant in many human diseases. In this study we present the first genome-wide integrative analysis of promoter methylation and gene expression for the identification of methylation markers in melanoma. Genome-wide promoter methylation and gene expression of eight early-passage human melanoma cell strains were compared with newborn and adult melanocytes. We used linear mixed effect models (LME) in combination with a series of filters based on the localization of promoter methylation relative to the transcription start site, overall promoter CpG content, and differential gene expression to discover DNA methylation markers. This approach identified 76 markers, of which 68 were hyper- and eight hypomethylated (LME,P< 0.05). Promoter methylation and differential gene expression of five markers (COL1A2,NPM2,HSPB6,DDIT4L,MT1G) were validated by sequencing of bisulfite-modified DNA and real-time reverse transcriptase PCR, respectively. Importantly, the incidence of promoter methylation of the validated markers increased moderately in early and significantly in advanced-stage melanomas, using early-passage cell strains and snap-frozen tissues (n= 18 andn= 24, respectively) compared with normal melanocytes and nevi (n= 11 andn= 9, respectively). Our approach allows robust identification of methylation markers that can be applied to other studies involving genome-wide promoter methylation. In conclusion, this study represents the first unbiased systematic effort to determine methylation markers in melanoma and revealed several novel genes regulated by promoter methylation that were not described in cancer cells before.
Human leukocyte antigen profile in HIV‐1 infected individuals and AIDS patients from Chongqing, China
Authors: Huang Xia , Ling Hua , Feng Liangui , Ding Xianbin , Zhou Quanhua , Han Mei , Mao Wei , Xiong Hongyan
Published: June 2009

HIV/AIDS is currently the leading cause of infectious disease mortality around the world. Since many alleles and/or haplotypes of HLA have been reported to be associated with progressive HIV infection, more detailed information on the HLA profile in HIV‐1 infected individuals in Chongqing, southwest China would facilitate further understanding of HIV‐1 infection, help AIDS vaccine design and the planning of effective preventive strategies. In this study, we performed 4‐digit resolution HLA‐A, B, DRB1 genotyping of 759 HIV‐1 seropositive individuals using PCR‐SSO methods. Six alleles were found at more than 10% high frequency: A*1101, A*0201, A*2402, B*4601, B*4001 and DRB1*0901. The most common 2‐ and 3‐locus haplotypes were A*0201‐B*4601, A*1101‐B*4001, A*1101‐B*4601, A*3303/1‐B*5801, A*0201‐B*4601‐DRB1*0901, A*1101‐B*4601‐DRB1*0901 and A*3303/1‐B*5801‐DRB1*0301.

690 HIV‐1 seropositive individuals with records of CD4 counts were divided into two groups: an AIDS patient group comprising 216 subjects with AIDS‐defining symptoms and CD4 counts below 200 cells/mm3 and an asymptomatic, HIV seropositive group of 474 subjects with a stable CD4 count of no less than 200 individuals. In the AIDS patient group, A*3303/1 and B*5801 alleles and the A*3303/1‐B*5801 haplotype were significantly underrepresented as compared to the HIV‐infected group, whereas A*1101‐B*4001, A*1101‐B*1502, A*2402‐B*4801 haplotypes and five common haplotypes from two groups were significantly overrepresented. HLA‐A or B and HLA‐Bw6‐Bw6 homozygotes were also overrepresented in the AIDS patients group. Our observations suggest that the presence of the B*3501 allele, A*2402‐B*4801, common 2‐locus and 3‐locus haplotypes, HLA‐A or B and Bw6‐Bw6 homozygosity may predict a poor disease outcome in HIV‐1 infection. However, HIV‐1 infected individuals who have B*5801 alleles, A*3303/1‐B*5801 haplotype and are heterozygous for Bw4‐Bw6 are more likely to be resistant to progression of AIDS in this Chinese population.
Mechanisms of action of acriflavine: electron microscopic study of cell wall changes induced in Staphylococcus aureus by acriflavine
Authors: Kawai Mako , Yamagishi Jun‐ichi
Published: June 2009

The antimicrobial action of acriflavine, a quaternary ammonium compound, on Staphylococcus aureus was studied by electron microscopic observation. The bactericidal activity of acriflavine was dose‐dependent over the 4 hr of exposure time. Scanning electron micrographs showed a wavy wrinkled cell surface following treatment with acriflavine. Transmission electron micrographs showed thickened cell walls following treatment with acriflavine. Acriflavine‐induced cell wall thickness seemed to affect both the peripheral and cross walls, but was reversible after treatment removal. These findings indicate that cell wall thickness is a characteristic phenotype of S. aureus exposed to acriflavine. It is therefore believed that cell wall thickness plays an important role in the mechanism of action of acriflavine.
Development of a broadly reactive nested reverse transcription‐PCR assay to detect murine noroviruses, and investigation of the prevalence of murine noroviruses in laboratory mice in Japan
Authors: Kitajima Masaaki , Oka Tomoichiro , Tohya Yukinobu , Katayama Hiroyuki , Takeda Naokazu , Katayama Kazuhiko
Published: June 2009

A broadly reactive nested RT‐PCR assay to detect MNV was developed and subsequently used to investigate the prevalence of MNV in laboratory mice in Japan. MNV were detected in 8 (22%) of 37 murine stool specimens by second‐round PCR, although no positive band was obtained from any specimen by first‐round PCR. Genetic analysis of the second round PCR products showed that MNV sequences detected in this study were closely matched (97.2 ∼ 99.1%) to that of MNV‐3 (DQ223042). This is the first report demonstrating the prevalence of MNV in Japan.
Novel pharmacogenetic markers for treatment outcome in azathioprine‐treated inflammatory bowel disease
Authors: SMITH M. A. , MARINAKI A. M. , ARENAS M. , SHOBOWALE‐BAKRE M. , LEWIS C. M. , ANSARI A. , DULEY J. , SANDERSON J. D.
Published: June 2009

Background Azathioprine (AZA) pharmacogenetics are complex and much studied. Genetic polymorphism in TPMT is known to influence treatment outcome. Xanthine oxidase/dehydrogenase (XDH) and aldehyde oxidase (AO) compete with TPMT to inactivate AZA.

Aim To assess whether genetic polymorphism inAOX1,XDHandMOCOS(the product of which activates the essential cofactor for AO and XDH) is associated with AZA treatment outcome in IBD.

Methods Real‐time PCR was conducted for a panel of single nucleotide polymorphism (SNPs) inAOX1, XDHandMOCOSusing TaqMan SNP genotyping assays in a prospective cohort of 192 patients receiving AZA for IBD.

Results Single nucleotide polymorphismAOX1c.3404A > G (Asn1135Ser, rs55754655) predicted lack of AZA response (P = 0.035, OR 2.54, 95%CI 1.06–6.13) and when combined with TPMT activity, this information allowed stratification of a patient’s chance of AZA response, ranging from 86% in patients where both markers were favourable to 33% where they were unfavourable (P < 0.0001). We also demonstrated a weak protective effect against adverse drug reactions (ADRs) from SNPsXDHc.837C > T (P = 0.048, OR 0.23, 95% CI 0.05–1.05) andMOCOSc.2107A > C, (P = 0.058 in recessive model, OR 0.64, 95%CI 0.36–1.15), which was stronger where they coincided (P = 0.019).

Conclusion These findings have important implications for clinical practice and our understanding of AZA metabolism.
Genetic structure of a wide‐spectrum chicken gene pool
Authors: Granevitze Z. , Hillel J. , Feldman M. , Six A. , Eding H. , Weigend S.
Published: June 2009

The genetic structure of 65 chicken populations was studied using 29 simple sequence repeat loci. Six main clusters which corresponded to geographical origins and histories were identified: Brown Egg Layers; predominantly Broilers; native Chinese breeds or breeds with recent Asian origin; predominantly breeds of European derivation; a small cluster containing populations with no common history and populations that had breeding history with White Leghorn. Another group of populations that shared their genome with several clusters was defined as ‘Multi‐clusters’. Gallus gallus gallus (Multi‐clusters), one of the subspecies of the Red Jungle Fowl, which was previously suggested to be one of the ancestors of the domesticated chicken, has almost no shared loci with European and White Egg layer populations. In a further sub‐clustering of the populations, discrimination between all the 65 populations was possible, and relationships between each were suggested. The genetic variation between populations was found to account for about 34% of the total genetic variation, 11% of the variation being between clusters and 23% being between populations within clusters. The suggested clusters may assist in future studies of genetic aspects of the chicken gene pool.
Mapping of quantitative trait loci affecting eggshell quality on chromosome 9 in an F2 intercross between two chicken lines divergently selected for eggshell strength
Authors: Takahashi H. , Yang D. , Sasaki O. , Furukawa T. , Nirasawa K.
Published: June 2009

Broken and cracked eggshells are major causes of significant economic losses to the egg production industry. The quantitative trait loci (QTL) on chromosome 9 influencing the quality of eggshells were identified by analysing an intercross between two parent lines developed from the same founder population by a two‐way selection for eggshell strength with non‐destructive deformation conducted over 14 generations. Chromosome‐wide highly significant (P < 0.01) QTL associated with egg weight (EW), short length of egg (SLE), long length of egg (LLE) and eggshell weight were mapped to the distal region of chromosome 9. Among the QTL affecting EW, SLE and LLE, ovocalyxin‐32 was identified as a potential candidate gene influencing eggshell traits. Marker‐assisted selection based on these QTL could be used to develop strategies for reducing the breakage and cracking of eggs in commercial layer houses.
Fine mapping a quantitative trait locus on horse chromosome 2 associated with radiological signs of navicular disease in Hanoverian warmblood horses
Authors: Lopes M. S. , Diesterbeck U. , Da Câmara Machado A. , Distl O.
Published: June 2009

Navicular disease or podotrochlosis is one of the main causes of progressive forelimb lameness in warmblood horses. The objective of this study was to refine a quantitative trait locus on horse chromosome 2 for radiological alterations in the contour of the navicular bone (RAC) in Hanoverian warmblood horses. Genotyping was performed in 192 Hanoverian warmblood horses from 17 paternal half‐sib groups. The marker set was extended to 58 informative microsatellites including nine newly developed microsatellites. QTL for RAC could be delineated at 32.50–43.13 Mb and a further new QTL for RAC could be identified at 59.08–65.14 Mb. The markers ABGe342 and ABGe343 reached the highest multipoint Zmean and LOD scores at 34.42 and 35.23 Mb with genome‐wide error probabilities of P = 0.013 and P = 0.064. In addition, significant associations of markers and haplotypes within the QTL could be shown. The results support the location of the QTL on ECA2 associated with RAC. This work is a further step towards the development of a marker test for navicular disease in Hanoverian warmblood horses.
The significance of TP53 in lymphoid malignancies: mutation prevalence, regulation, prognostic impact and potential as a therapeutic target
Authors: Cheung K‐John J. , Horsman Douglas E. , Gascoyne Randy D.
Published: June 2009

The tumour suppressor TP53 (previously termed p53) mediates a pathway that is considered to be one of the most important mechanisms in the maintenance of genomic stability. The function of TP53 can be abrogated by genomic deletion, mutation, or deregulation of upstream and downstream participants in the TP53 pathway. While aberrations of TP53 are widely prevalent in non‐haematological malignancies (over 60%), they are present in much lower frequency in haematological malignancies (<20%). Nevertheless, in those cases where TP53 function or expression is aberrant, correlation with inferior clinical outcome (such as overall survival and progression or transformation) has generally been strong. In this review, we focus our discussion on the relationship between TP53 and lymphoid malignancies as defined by the World Health Organization. Specifically, we examine the prevalence of TP53 aberrations and their prognostic significance in various types of lymphoid cancer. Next, we discuss the various mechanisms of TP53 inactivation. Finally, we summarize progress in the use of recent therapeutic modalities that target TP53.
pH‐dependent extraction of soil and soil amendments to understand the factors controlling element mobility
Authors: Carter C. M. , Van der Sloot H. A. , Cooling D.
Published: June 2009

A combination of the pH‐dependent leaching test CEN/TS 14429 and geochemical modelling (LeachXS©‐ORCHESTRA) was used to evaluate the partitioning of major, minor and trace elements in relation to their phosphorus retention capability, the release of non‐nutrient constituents, their reduction of soil acidity and their organic matter retention. One Australian soil sample and two different soil amendments (Red Lime and Alkaloam) were studied. The pH‐dependent leaching test showed that the acid neutralization capacity and the phosphorus retention of the soil were improved, respectively, by a factor of two to five and by a factor of two to ten after addition of these amendments. The amendments improved retention of dissolved organic matter (by a factor of 3–10) and did not increase leachability of undesired contaminants. The partitioning as obtained from modelling between free and dissolved organic‐carbon‐bound metals provides insight into the potential for uptake (bioavailability). This partitioning is very pH‐dependent and therefore testing and associated chemical speciation modelling provide valuable information for judging traditional soil improvers and soil amendments, including the waste‐derived soil amendments Alkaloam and Red Lime.
Leaf diversity influences in‐stream litter decomposition through effects on shredders
Authors: SANPERA‐CALBET ISIS , LECERF ANTOINE , CHAUVET ERIC
Published: June 2009

1. The functioning of many aquatic ecosystems is controlled by surrounding terrestrial ecosystems. In a view of growing interest in linking biodiversity to ecosystem‐level processes, we examined whether and how leaf diversity influences litter decomposition and consumers in streams.

2. We tested experimentally the hypothesis that the effects of leaf diversity on decomposition are determined by the responses of leaf consumers to resource–habitat heterogeneity. Leaves from three common riparian trees, beech (Fagus sylvatica), hazel (Corylus avellana) and ash (Fraxinus excelsior), were exposed alone and in all possible mixtures of two and three species in a stream. We analysed individual leaf species for decomposition rate, microbial respiration and mycelial biomass, and we determined the species composition, abundance and biomass of shredders in leaf bags.

3. We found that the decomposition of the fastest decomposing leaves (hazel and ash) was substantially stimulated (up to twofold higher than single species leaf packs) in mixtures containing beech leaves, which are refractory. In contrast, the decomposition of beech leaves was not affected by leaf mixing. Such species‐specific behaviour of leaves in species mixtures has been overlooked in previous studies that examined the overall decomposition of litter mixtures.

4. The effects of leaf diversity on decomposition varied with the abundance and biomass of shredders but not with microbial parameters. Beech leaves alone were less attractive to shredders than leaf packs made of hazel, ash or any mixture of species. Moreover, the presence of beech leaves in mixtures led to higher shredder abundance and biomass than we had expected from data from single species exposed alone. Lastly, we found that early instars of the caddisfly Potamophylax (the dominant shredder in terms of biomass) almost exclusively used the toughest material (i.e. beech leaves) to construct their cases.

5. Leaf pack heterogeneity may have altered shredder‐mediated decomposition. Shredders colonising diverse leaf packs benefited from the stable substratum provided by beech leaves, whereas ash and hazel leaves were primarily used as food. Thus, our findings provide strong evidence for an intimate linkage between the diversity of riparian vegetation and aquatic communities.
Species co‐occurrence, nestedness and guild–environment relationships in stream macroinvertebrates
Authors: HEINO JANI
Published: June 2009

1. Describing species distribution patterns and the underlying mechanisms is at the heart of ecological research. A number of recent studies have used null model approaches to explore mechanisms behind spatial variation in community structure.

2. However, unexplored questions are the degree to which single guilds of potentially competing stream macroinvertebrate species show: (i) interspecific segregation among‐stream sites (i.e. occur together less often than expected by chance), suggesting competitive interactions; (ii) interspecific aggregation (i.e. occur together more often than expected by chance), suggesting similar responses to the environment; (iii) comply with nestedness, suggesting the existence of selective extinctions or colonisations and (iv) show similar environmental relationships.

3. The present analyses showed that guilds of stream macroinvertebrates exhibit non‐random co‐occurrence patterns that were generally contingent on the weighting of sites by stream size. Despite significant segregation of species, each guild also showed significantly nested patterns. Species richness was correlated with different environmental factors between the guilds, although these correlations were relatively low. By contrast, correlations between the major ordination axes and key environmental variables were slightly stronger in canonical correspondence analysis, and generally the same factors were most strongly correlated with variation in the species composition of each guild.

4. The present findings are the first to show that species within each stream macroinvertebrate guild show significant negative co‐occurrence at the among‐stream riffle scale. These findings present challenges for future studies that aim to disentangle whether these patterns comply with the habitat checkerboard or the competitive checkerboard explanations.
Online ads in familiar and unfamiliar sites: effects on perceived website quality and intention to reuse
Authors: McCoy Scott , Everard Andrea , Loiacono Eleanor T.
Published: June 2009

Electronic commerce is an integral part of most businesses today. The perceived quality of the website and whether users intend to reuse the site are of primary concern to online businesses. There are various factors that influence customers' intentions to reuse a site. In this paper, we investigate two of these factors: whether the site is familiar to the user and whether there are online advertisements on the website. The results indicate that familiarity and online ads do have an impact on quality and reuse, although it is not entirely as expected.
The cis‐regulatory sequences required for expression of the Drosophila melanogaster adult cuticle gene ACP65A
Authors: Lestradet M. , Gervasio E. , Fraichard S. , Dupas S. , Alabouvette J. , Lemoine A. , Charles J. P.
Published: June 2009

Post‐embryonic development in insects requires successive molts. Molts are triggered by ecdysteroids, and the nature of the molt (larval, pupal or adult) is determined by juvenile hormones. The genes encoding cuticle proteins are targets of both classes of hormones, and therefore are interesting models to study hormone action at the molecular level. The Drosophila ACP65A cuticle gene is expressed exclusively during the synthesis of the adult exoskeleton, in epidermal domains synthesising flexible cuticle. We have examined the cis‐regulatory sequences of ACP65A using phylogenetic comparisons and functional analysis, and find that only about 180 bp are essential, including an 81 bp intron. The restriction of ACP65A expression appears to depend on a strong repression mechanism.
People with an intellectual disability living in an intentional community
Authors: Randell M. , Cumella S.
Published: June 2009

Background  Hospital closure programmes in England have generally sought to attain a fulfilling life for people with an intellectual disability by locating them in domestic‐style housing in urban settings. Few have been placed in intentional or ‘village’ communities. Yet comparative studies of different housing types have found that intentional communities have better or similar outcomes for their residents than dispersed housing or residential clusters on former hospital sites. A possible explanation is the distinctive pattern of social relationships that exist in many intentional communities and the impact this has on the lives of their residents. This paper reports the results of research that explores the perceptions of people with an ID living in an intentional community and the meaning of their community to them.

Methods  The research used an ethnographic approach to interview a sample of 15 residents in a large intentional community (Botton Village), which is part of the Camphill Movement. Interviews used Makaton, pictures and symbols where required.

Results  Respondents included 10 men and 5 women aged between 38 and 78 years. Length of residence in Botton Village ranged from 5 to 50 years. All lived with the families of co‐workers and valued these relationships. All but one (who had retired) worked in a diverse range of employment in the village. Almost all were positive about their work. Respondents reported that they took part in both individual and communal leisure activities and all but two had a network of friends. Opportunities for friendship were enhanced by proximity to other people with an ID and a sense of personal security in the village. As in many villages and communities in society in general, these advantages were balanced by some loss of privacy.

Conclusions  Results confirm those from earlier studies of intentional communities and suggest that positive outcomes derive from the absence of the overt subordination of residents to staff, the facilitation of friendship with other people with an ID, high levels of meaningful employment and a sense of community. These factors contrast with the experience of living in small homes funded on a contractual basis by public authorities, in which cost pressures reduce wage levels for staff resulting in difficulties in retaining suitable staff and a consequent high staff turnover.
Novel associations with dyspepsia: a community‐based study of familial aggregation, sleep dysfunction and somatization
Authors: Gathaiya N. , Locke Iii G. R. , Camilleri M. , Schleck C. D. , Zinsmeister A. R. , Talley N. J.
Published: June 2009

Abstract  Dyspepsia is a common phenomenon and the majority of patients have functional dyspepsia; however, potential risk factors are unclear, with conflicting results in the literature. Although several risk factors have been evaluated previously, this knowledge has not led to more effective management of the disease. The aim of this study was to assess potential novel risk factors for dyspepsia in both a cross‐sectional and a nested case–control study among a randomly selected community‐based cohort. A valid questionnaire was mailed to a random sample of Olmsted County, MN residents (n = 659 responders; 133 had dyspepsia). In a nested case–control study, dyspeptic patients (n = 52) and healthy controls (n = 40) identified among community respondents completed further questionnaires on diet. Independent risk factors for dyspepsia adjusted for age, sex, body mass index and anti‐secretory therapy were a positive family history of abdominal pain [odds ratio (OR) = 4.7, 95% confidence interval (CI) = 1.5–14.9, P = 0.008] and indigestion (OR = 3.4, 95% CI = 1.0–11.5, P = 0.048), difficulty falling asleep (OR = 8.2, 95% CI = 2.2–31.5, P = 0.002), poor sleep associated with worsening symptoms (OR = 15.9, 95% CI = 2.0–124.9, P = 0.009) and a high somatic symptom checklist score (OR = 5.6, 95% CI = 1.5–20.7, P = 0.01). Diet, including total calories (kcal day−1) and total protein, carbohydrate and fat intake (g day−1), was not significantly associated with dyspepsia. Familial aggregation raises the possibility of a genetic component, although environmental factors also need to be considered. Sleep dysfunction and somatization suggest a primary psychological component.
Physical activity and health related quality of life in children following kidney transplantation
Authors: Hamiwka Lorraine A. , Cantell Marja , Crawford Susan , Clark Camillia G.
Published: June 2009

Abstract:  Participation in PA is often diminished in children with CKD. Limited research exists on exercise tolerance/capacity but no studies to date have investigated lifestyle PA and its determinants in these children. The aim of this study was to investigate level of PA and potential physiological and psychological associations in a group of pediatric KTx recipients compared with CS. Twenty KTx and 33 CS participated. PA was measured by PAQ. HRQOL (PedsQL 4.0) and CY‐PSPP were also measured. BMI and WC was recorded in all subjects; GFR, BP and immunosuppressants in KTx. Body measurements indicated the two groups were similar: 25% KTx and 24% CS had BMI >85th percentile. KTx were less physically active than CS in total exercise minutes (p = 0.005). CS reported higher HRQOL than KTx (p = 0.001). Higher perceptions of HRQOL were significantly correlated with higher number of steps/day in both groups (p = 0.034). KTx showed significantly lower perceptions of sports competence (p = 0.007) and physical conditioning (p = 0.001) than CS. Higher PAQ activity scores were significantly correlated with higher perceptions of body attractiveness (p = 0.019), Sport (p = 0.003) and Conditioning (p = 0.001). These results suggest that PA may play a role in overall well‐being and HRQOL in KTx.
Synergistic effect of carbapenem–teicoplanin combination during severe Rhodococcus equi pneumonia in a kidney transplant recipient
Authors: El Karoui K. , Guillet C. , Sekkal N. , Lanternier F. , Méchaï F. , Hue K. , Hiesse C. , Mamzer Bruneel M.‐F. , Catherinot E. , Viard J.‐P. , Mainardi J.‐L. , Lecuit M. , Ferroni A. , Lortholary O.
Published: June 2009

Abstract: Rhodococcus equi is a bacterial pathogen of domestic animals that can infect immunocompromised patients, especially those with impaired cellular immunity, such as transplant recipients. No standard treatment has been established, but therapy must be prolonged, as relapses are common and can occur at the initial site or distant locations. Here we report a case of R. equi‐associated pulmonary abscess in a renal transplant recipient successfully treated with a combination of carbapenem and teicoplanin. This combination was shown to be synergistic. It has minimal side effects in transplant recipients and appears to be an effective initial treatment for this severe infection.
Sevoflurane‐ and Desflurane‐induced human myocardial post‐conditioning through Phosphatidylinositol‐3‐kinase/Akt signalling
Authors: ZHU L. , LEMOINE S. , BABATASI G. , LEPAGE O. , MASSETTI M. , GÉRARD J.‐L. , HANOUZ J.‐L.
Published: June 2009

Background: The role of phosphatidylinositol‐3‐kinase (PI3K) in sevoflurane‐ and desflurane‐induced myocardial post‐conditioning remains unknown.

Methods: We recorded isometric contraction of isolated human right atrial trabeculae (oxygenated Tyrode's at 34 °C, stimulation frequency 1 Hz). In all groups, a 30‐min hypoxic period was followed by a 60‐min reoxygenation period. At the onset of reoxygenation, muscles were exposed to 5 min of sevoflurane 1%, 2%, and 3%, and desflurane 3%, 6%, and 9%. In separate groups, sevoflurane 2% and desflurane 6% were administered in the presence of 100 nM wortmannin, a PI3K inhibitor. Recovery of force after the 60‐min reoxygenation period was compared between groups (mean ± SD).

Result: As compared with the Control group (49 ± 7% of baseline) PostC by sevoflurane 1%, 2%, and 3% (78 ± 4%, 79 ± 5%, and 85 ± 4% of baseline, respectively) and desflurane 3%, 6%, and 9% (74 ± 5%, 84 ± 4%, and 86 ± 11% of baseline, respectively) enhanced the recovery of force. This effect was abolished in the presence of wortmannin (56 ± 5% of baseline for sevoflurane 2%+wortmannin; 56 ± 3% of baseline for desflurane 6%+wortmannin). Wortmannin alone had no effect on the recovery of force (57 ± 7% of baseline).

Conclusion: In vitro, sevoflurane and desflurane post‐conditioned human myocardium against hypoxia through activation of phosphatidylinositol‐3‐kinase.
Hypothermic cardiopulmonary bypass as a determinant of late thrombocytopenia following cardiac operations in pediatric patients
Authors: RANUCCI M. , CARLUCCI C. , ISGRÒ G. , BROZZI S. , BONCILLI A. , COSTA E. , FRIGIOLA A.
Published: June 2009

Background: Thrombocytopenia after cardiac operations is a common event in both adult and pediatric patients. Late thrombocytopenia (LTCP) is a less common event that is still without a well‐recognized cause. This study explores the role of heparin‐induced thrombocytopenia (HIT) and other factors (complexity of the operation, temperature management, and drug use) in determining LTCP.

Methods: We conducted an observational study of 63 consecutive patients aged <36 months operated with or without cardiopulmonary bypass (CPB). LTCP was defined as a platelet count <100,000 cells/μl or <50% of the pre‐operative count at any point in time between post‐operative days 5 and 10. A diagnostic test for heparin‐platelet factor 4 (PF4) antibodies was performed in patients with LTCP. Other pre‐ and post‐operative factors were investigated for their association with LTCP.

Results: LTCP occurred in 15 (24%) patients. No patient had positive heparin‐PF4 antibodies. The lowest temperature on CPB was an independent predictor of LTCP, with a cut‐off value at 29 °C (sensitivity 80%, specificity 70%). Other factors associated with LTCP were prolonged post‐operative use of unfractionated heparin and milrinone. LTCP was associated with increased post‐operative morbidity.

Conclusion: LTCP was related to a combination of factors (operation severity, degree of hypothermia during CPB, prolonged use of unfractionated heparin, and milrinone). The individual contribution of each factor seems difficult to establish. However, the degree of hypothermia during CPB and drug‐associated effects were identified. HIT could be excluded in all cases.
Performance of the Airtraq™ laryngoscope after failed conventional tracheal intubation: a case series
Authors: MALIN E. , MONTBLANC J. de , YNINEB Y. , MARRET E. , BONNET F.
Published: June 2009

Background: The Airtraq™, a new disposable indirect laryngoscope, was evaluated in patients with difficult intubation.

Methods: The Airtraq™ was used in 47 patients with predicted or unpredicted difficult intubation after failed orotracheal intubation performed by two senior anaesthesiologists with the Macintosh laryngoscope.

Results: Tracheal intubation with Airtraq™ was successful in 36 patients (80%). The Cormack and Lehane score was IIb–III in 35 patients, and IV in 12 patients, with the Macintosh laryngoscope, while Cormack and Lehane score was I–IIa in 40 patients, IIb–III in three and IV in four with Airtraq™. A gum elastic bougie was used to facilitate tracheal access in one‐third (11/36) of the cases. Orotracheal intubation was not possible with Airtraq™ in nine cases, five of whom had a pharyngeal, laryngeal or basal lingual tumour.

Conclusion: In patients with difficult airway, following failed conventional orotracheal intubation, Airtraq™ allows securing the airway in 80% of cases mainly by improving glottis view. However, the Airtraq™ does not guarantee successful intubation in all instances, especially in case of laryngeal and/or pharyngeal obstruction.
Awake tracheal intubation using the Airtraq® laryngoscope: a case series
Authors: DIMITRIOU V. K. , ZOGOGIANNIS I. D. , LIOTIRI D. G.
Published: June 2009

The Airtraq® laryngoscope (AL) is a new single use indirect laryngoscope designed to facilitate tracheal intubation in anaesthetised patients either with normal or difficult airway anatomy. It is designed to provide a view of the glottis without alignment of the oral, pharyngeal and tracheal axes. We report four cases of successful awake tracheal intubation using the AL. The first case is a patient with severe ankylosing spondylitis and the other three cases with anticipated difficult airway. An awake intubation under sedation and topical airway anaesthesia was chosen. We consider that the AL can be used effectively to accomplish an awake intubation in patients with a suspected or known difficult airway and may be a useful alternative where other methods for awake intubation have failed or are not available.
Prehospital therapeutic hypothermia for comatose survivors of cardiac arrest: a randomized controlled trial
Authors: KÄMÄRÄINEN A. , VIRKKUNEN I. , TENHUNEN J. , YLI‐HANKALA A. , SILFVAST T.
Published: June 2009

Background: Intravenous infusion of ice‐cold fluid is considered a feasible method to induce mild therapeutic hypothermia in cardiac arrest survivors. However, only one randomized controlled trial evaluating this treatment exists. Furthermore, the implementation rate of prehospital cooling is low. The aim of this study was to evaluate the efficacy and safety of this method in comparison with conventional therapy with spontaneous cooling often observed in prehospital patients.

Methods: A randomized controlled trial was conducted in a physician‐staffed helicopter emergency medical service. After successful initial resuscitation, patients were randomized to receive either +4 °C Ringer's solution with a target temperature of 33 °C or conventional fluid therapy. As an endpoint, nasopharyngeal temperature was recorded at the time of hospital admission.

Results: Out of 44 screened patients, 19 were analysed in the treatment group and 18 in the control group. The two groups were comparable in terms of baseline characteristics. The core temperature was markedly lower in the hypothermia group at the time of hospital admission (34.1±0.9 °C vs. 35.2±0.8 °C, P<0.001) after a comparable duration of transportation. Otherwise, there were no significant differences between the groups regarding safety or secondary outcome measures such as neurological outcome and mortality.

Conclusion: Spontaneous cooling alone is insufficient to induce therapeutic hypothermia before hospital admission. Infusion of ice‐cold fluid after return of spontaneous circulation was found to be well tolerated and effective. This method of cooling should be considered as an important first link in the ‘cold chain’ of prehospital comatose cardiac arrest survivors.
An anaphylactic reaction to transdermal delivered fentanyl
Authors: DEWACHTER P. , LEFEBVRE D. , KALABOKA S. , BLOCH‐MOROT E.
Published: June 2009

Immediate allergic hypersensitivity reactions with fentanyl are rarely reported. We diagnosed a presumably IgE‐mediated allergic hypersensitivity reaction comprising generalized erythema and bronchospasm 4 h after the first‐time application of transdermal fentanyl. Prick test remained negative with fentanyl whereas an intradermal test (IDT) with fentanyl was positive (dilution 10−2). Cross‐reactivity was found with sufentanil but not with remifentanil. The diagnosis was supported by the clinical history and a positive IDT with fentanyl. This case report confirms the need for a systematic allergological investigation in case of immediate hypersensitivity reactions for all drugs and all modes of administration.