bluuebunny/crossref_metadata_2025 huggingface dataset:
Politics of Trade in Post‐neoliberal Latin America: The Case of Bolivia
Authors: MEJIDO COSTOYA MANUEL
Published: August 2010

Deploying a two‐level perspective, this article analyses the regional and domestic space that the Morales administration has in which to implement the vision of trade articulated in its Plan Nacional de Desarrollo (PND; National Development Plan). Regionally the Morales administration has attempted to combine the solidarity principles of the Alianza Bolivariana para los Pueblos de Nuestra América (ALBA; Bolivarian Alliance for the Peoples of Our America) with the market‐oriented growth possibilities provided by more orthodox integration projects such as the Comunidad Andina de Naciones (CAN; Andean Community of Nations) and the Mercado Común del Sur (Mercosur; Southern Common Market). Domestically the Movimiento al socialismo (MAS; Movement Toward Socialism) government must negotiate the destabilising effects of its trade strategy in a polarised national context where business and civil society actors are critiquing from their respective positions both the solidarity principles and market‐oriented elements of the PND trade strategy.
The Changing Spaces of Local Governance in Nicaragua
Authors: HOWARD JOANNA , VASQUEZ LUIS SERRA
Published: August 2010

This article considers the new spaces for the participation of civil society organisations (CSOs) in local governance that have emerged in Nicaragua between 2000 and 2009, and how government and CSOs interact in these spaces. It discusses the significant changes that have taken place in Nicaraguan local governance during this period, and highlights the challenges for CSOs to engage with these spaces at different points in time. It finds that grassroots CSOs in Managua that based their engagement with the Bolaños government through these spaces on citizenship have been drawn into a more clientelist relationship with Ortega's government.
On the viability of five probiotic strains when immobilised on various polymers
Authors: RODRIGUES DINA , ROCHA‐SANTOS TERESA , SOUSA SÉRGIO , GOMES ANA M , PINTADO MARIA M , XAVIER MALCATA F , SOUSA LOBO JOSÉ M , SILVA JOSÉ P , COSTA PAULO , AMARAL MARIA H , FREITAS ANA C
Published: August 2010

The viability of probiotic bacteria in six food‐grade polymers, at two concentrations, was evaluated in order to predict their feasibility as materials for bacterium immobilisation. Alginate and whey proteins were the most adequate polymers, except for Lactobacillus acidophilus Ki and Lactobacillus casei 01 at 2% (m/v) alginate. Xanthan gum appeared to be a potential vector for three strains. L‐carrageenan was adequate for both Bifidobacterium strains, but not for Lactobacillus at 2% (m/v). Bifidobacterium strains were not negatively affected by cellulose acetate phthalate, while the opposite held for L. acidophilus strains. Chitosan was the poorest polymer for immobilisation of probiotic bacteria.
Foaming properties of milk: A review of the influence of composition and processing
Authors: HUPPERTZ THOM
Published: August 2010

Milk foams can be either desirable, e.g. for cappuccino‐style beverages, or undesirable, e.g. in the reconstitution of milk powders or infant formula. In this article, compositional and processing factors affecting the foaming properties of milk are reviewed. Skim milk foams can be extremely stable, particularly when they are formed at ∼40–50°C. The presence of lipids can be detrimental to the formation and stability of milk foams, particularly at a temperature where the milk fat is partially crystalline, e.g. 20°C. The presence of phospholipids, free fatty acids and partial glycerides strongly impairs foaming of milk.
Intrapartum risk factors for levator trauma
Authors: Shek KL , Dietz HP
Published: August 2010

Please cite this paper as: Shek K, Dietz H. Intrapartum risk factors for levator trauma. BJOG 2010;117:1485–1492.

Objective  To determine intrapartum risk factors associated with levator trauma as identified by ultrasound imaging.

Design  A prospective observational study.

Setting  Antenatal clinic of a tertiary hospital between May 2005 and February 2008.

Population  Nulliparous women (n = 488) in their first ongoing pregnancy.

Methods  An interview and four‐dimensional translabial ultrasound was carried out between 36 and 38 weeks and again 3–4 months after delivery. Obstetric data were collected from the hospital database and/or participants’ records.

Main outcome measures  Levator macrotrauma (‘avulsion’) and microtrauma (irreversible overdistension).

Results  A total of 367 women (75%) returned for the postpartum assessment after normal vaginal delivery (n = 187, 51%), vacuum (n = 34, 9%), forceps (n = 20, 5%) and caesarean section (n = 126, 34%). Median follow up was 4.08 months (interquartile range 3.68–5.03 months). Levator avulsion was diagnosed in 32 (13%) of the women who delivered vaginally and in none of the caesarean section group regardless of indication. On multivariable regression forceps delivery was significantly associated with avulsion (P = 0.01; OR 3.83; 95% CI 1.34–10.94). Using >20% peripartum increase in hiatal area on Valsalva as the cutoff, 28.5% of vaginally parous women were shown to have suffered irreversible overdistension. This was positively associated with the length of second stage (P = 0.001; OR 1.01 per minute; 95% CI 1.0–1.02). Intrapartum epidural appeared to have a protective effect (P = 0.03; OR 0.42; 95% CI 0.19–0.93).

Conclusion  Levator trauma at the time of first delivery is associated with vaginal delivery, forceps and a longer second stage. Epidural pain relief may exert a protective effect.
Analysis of library associated information needs of staff in a specialist palliative and gerontological care centre in Mid‐West Ireland
Authors: Callinan Joanne , McLoughlin Kathleen , McCarthy Pauline
Published: August 2010

Background:  Milford Care Centre is a major centre for specialist palliative and gerontological care in the Mid‐West of Ireland. In August 2008, a Librarian was employed to support the information, research, teaching and professional development needs of staff and students. In planning associated with this role, it was necessary to undertake an analysis of the information needs of staff.

Objectives:  (1) To understand the information needs of staff with regard to the new Library and Information Service. (2) To identify current access to and levels of skill in information literacy and ICT. (3) To ascertain the need for training in those skills.

Methods:  A web‐based questionnaire was disseminated in November by email and printed copies were left at other locations.

Results:  Assistance with obtaining journal articles was rated most highly by respondents as being an important service. Eighty‐three per cent indicated that they did not have access to online health databases. Small group classes were considered the preferred method of providing training. Afternoons were also considered more convenient for visiting the library.

Conclusion:  The results will be used to plan the development of the library with a better insight of users needs and assist us to utilise resources more effectively.
Acidification of the Golgi apparatus is indispensable for maturation but not for cell surface delivery of Ret
Authors: Hirata Yoko , Shimokawa Norihiro , Oh‐hashi Kentaro , Yu Zu‐Xi , Kiuchi Kazutoshi
Published: August 2010

J. Neurochem. (2010) 115, 606–613.

We examined the effect of concanamycin A and bafilomycin A1, inhibitors of the vacuolar proton‐ATPase, on maturation and expression of Ret, a tyrosine kinase receptor for glial cell line‐derived neurotrophic factor. Ret appeared as 150‐ and 170‐kDa bands on sodium dodecyl sulfate–polyacrylamide gel electrophoresis gels and both forms were sensitive to peptide‐N‐glycosidase F. Western and immunocytochemical analyses revealed that the 150‐kDa immature form of Ret accumulated in the Golgi apparatus upon treatment with vacuolar proton‐ATPase inhibitors, whereas, the 170‐kDa mature form of Ret was dramatically decreased. The result suggests that glycosylation of Ret during the conversion from immature forms to mature forms is pH sensitive, and is likely initiated in the acidic trans‐Golgi apparatus. In contrast, glycosylation of nascent receptors to become immature receptors appeared to be pH insensitive, and are likely to take place in the endoplasmic reticulum. The immature form of Ret was present in the plasma membrane when the cells were treated with the vacuolar proton‐ATPase inhibitors. In conclusion, the acidification of the Golgi apparatus is crucial for maturation of Ret but not indispensable for trafficking of receptors to the membrane.
Quantitative analysis of the heteromeric neuronal nicotinic receptors in the rat hippocampus
Authors: Lomazzo Ermelinda , MacArthur Linda , Yasuda Robert P. , Wolfe Barry B. , Kellar Kenneth J.
Published: August 2010

J. Neurochem.(2010)115, 625–634.

The objective of this study was to identify and quantify the heteromeric neuronal nicotinic receptors (nAChRs) in the rat hippocampus. The density of nAChR subtypes was assessed by labeling them with [3H]epibatidine ([3H]EB) followed by immunoprecipitation with subunit‐selective antibodies. Sequential immunoprecipitation assays were used to establish associations between two different subunits, which then allowed the full subunit composition of the receptors to be deduced. Our results show that most of the hippocampal heteromeric nAChRs contain α4 and β2 subunits. In fact, we identified two populations containing these two predominant subunits, the α4β2 and α4β2α5 subtypes which account for ∼ 40% and ∼ 35%, respectively, of the total [3H]EB‐labeled receptors. An additional heteromeric subtype with the subunit composition of α4β2α3 represented ∼ 10% of the total nAChRs, and another 10% of the immunoprecipitated receptors contained α4 and β4 subunits, with or without the α3 subunit. To determine if α4β2 and α4β2α5 nAChR subtypes differ in their ligand binding affinities, the α3‐ and β4‐containing receptors were first removed by immunoprecipitation and then, competition studies with acetylcholine, nicotine, cytisine and sazetidine‐A against [3H]EB were carried out on the remaining α4β2 and α4β2α5 subtypes. Results suggested these subtypes have comparable binding affinities for the nicotinic ligands used here.
Hyperdopaminergic tone in HIV‐1 protein treated rats and cocaine sensitization
Authors: Ferris Mark J. , Frederick‐Duus Danielle , Fadel Jim , Mactutus Charles F. , Booze Rosemarie M.
Published: August 2010

J. Neurochem. (2010) 115, 885–896.

In the United States, one‐third of infected individuals contracted Human Immunodeficiency Virus‐1 (HIV‐1) via injecting drugs with contaminated needles or through risky behaviors associated with drug use. Research demonstrates concomitant administration of psychostimulants and HIV‐1‐proteins damage neurons to a greater extent than viral proteins or the drug alone. To model the onset of HIV‐1‐infection in relation to a history of drug use, the current research compared behavior and extracellular dopamine and metabolite levels following Tat1–86 infusions in animals with and without a history of cocaine (Coc) experience (10 mg/kg; i.p.; 1 injection/day × 9 days). Animals receiving a behaviorally sensitizing regimen of Coc demonstrated a decrease in extracellular dopamine concentration in the nucleus accumbens, consistent with evidence describing up‐regulation of dopamine transporter uptake. Contrary to this effect, Tat1–86 microinfusion into the nucleus accumbens following the sensitizing regimen of Coc caused a significant increase in extracellular dopamine levels (nM) within 48 h with no difference in percent of baseline response to Coc. After 72 h, Tat + Coc treated animals demonstrated a blunted effect on potassium‐stimulated extracellular dopamine release (percent of baseline) with a corresponding decrease in expression of behavioral sensitization to Coc challenge. A persistent decrease in extracellular dopamine metabolite levels was found across all time‐points in Tat‐treated animals, regardless of experience with Coc. The current study provides evidence for divergent neurochemical and behavioral outcomes following Tat‐treatment; contingent upon experience with Coc.
Therapeutic evaluation of etanercept in a model of traumatic brain injury
Authors: Chio Chung‐Ching , Lin Jia‐Wei , Chang Ming‐Wen , Wang Che‐Chuan , Kuo Jinn‐Rung , Yang Chung‐Zhing , Chang Ching‐Ping
Published: August 2010

J. Neurochem. (2010) 115, 921–929.

Antagonism of tumor necrosis factor‐alpha with etanercept has proved to be effective in the treatment of spinal cord injury and centrally endotoxin‐induced brain injury. However, etanercept may offer promise as therapy for traumatic brain injury (TBI). In this study, anesthetized rats, immediately after the onset of TBI, were divided into two major groups and given the vehicle solution (1 mL/kg of body weight) or etanercept (5 mg/kg of body weight) intraperitoneally once per 12 h for consecutive 3 days. Etanercept caused attenuation of TBI‐induced cerebral ischemia (e.g., increased cellular levels of glutamate and lactate‐to‐pyruvate ratio), damage (e.g., increased cellular levels of glycerol) and contusion and motor and cognitive function deficits. TBI‐induced neuronal apoptosis (e.g., increased numbers of terminal deoxynucleotidyl transferase αUTP nick‐end labeling and neuronal‐specific nuclear protein double‐positive cells), glial apoptosis (e.g., increased numbers of terminal deoxynucleotidyl transferase αUTP nick‐end labeling and glial fibrillary acidic protein double‐positive cells), astrocytic (e.g., increased numbers of glial fibrillary acidic protein positive cells) and microglial (e.g., increased numbers of ionized calcium‐binding adapter molecule 1‐positive cells) activation and activated inflammation (e.g., increased levels of tumor necrosis factor‐alpha, interleukin‐1β and interleukin‐6) were all significantly reduced by etanercept treatment. These findings suggest that etanercept may improve outcomes of TBI by penetrating into the cerebrospinal fluid in rats.
Subcellular rearrangement of hsp90‐binding immunophilins accompanies neuronal differentiation and neurite outgrowth
Authors: Quintá Héctor R. , Maschi Darío , Gomez‐Sanchez Celso , Piwien‐Pilipuk Graciela , Galigniana Mario D.
Published: August 2010

J. Neurochem.(2010)115, 716–734.

FKBP51 and FKBP52 (FK506‐binding protein 51 and 52) are tetratricopeptide repeat‐domain immunophilins belonging to the tetratricopeptide‐protein•hsp90•hsp70•p23 heterocomplex bound to steroid receptors. Immunophilins are related to receptor folding, subcellular localization, and hormone‐dependent transcription. Also, they bind the immunosuppressant macrolide FK506, which shows neuroregenerative and neuroprotective actions by a still unknown mechanism. In this study, we demonstrate that in both, undifferentiated neuroblastoma cells and embryonic hippocampal neurons, the FKBP52•hsp90•p23 heterocomplex concentrates in a perinuclear structure. Upon cell stimulation with FK506, this structure disassembles and this perinuclear area becomes transcriptionally active. The acquisition of a neuronal phenotype is accompanied by increased expression of βIII‐tubulin, Map‐2, Tau‐1, but also hsp90, hsp70, p23, and FKBP52. During the early differentiation steps, the perinuclear heterocomplex redistributes along the cytoplasm and nascent neurites, p23 binds to intermediate filaments and microtubules acquired higher filamentary organization. While FKBP52 moves towards neurites and concentrates in arborization bodies and terminal axons, FKBP51, whose expression remains constant, replaces FKBP52 in the perinuclear structure. Importantly, neurite outgrowth is favored by FKBP52 over‐expression or FKBP51 knock‐down, and is impaired by FKBP52 knock‐down or FKBP51 over‐expression, indicating that the balance between these FK506‐binding proteins plays a key role during the early mechanism of neuronal differentiation.
The E3‐ubiquitin ligase TRIM2 regulates neuronal polarization
Authors: Khazaei Mohammad R. , Bunk Eva C. , Hillje Anna‐Lena , Jahn Hannah M. , Riegler Eva M. , Knoblich Jürgen A. , Young Peter , Schwamborn Jens C.
Published: August 2010

J. Neurochem. (2011) 117, 29–37.

The establishment of a polarized morphology with a single axon and multiple dendrites is an essential step during neuronal differentiation. This cellular polarization is largely depending on changes in the dynamics of the neuronal cytoskeleton. Here, we show that the tripartite motif (TRIM)‐NHL protein TRIM2 is regulating axon specification in cultured mouse hippocampal neurons, where one of several initially indistinguishable neurites is selected to become the axon. Suppression of TRIM2 by RNA interference results in the loss of neuronal polarity while over‐expression of TRIM2 induces the specification of multiple axons. TRIM2 conducts its function during neuronal polarization by ubiquitination of the neurofilament light chain. Together, our results imply an important function of TRIM2 for axon outgrowth during development.
Burnout as an existential deficiency – lived experiences of burnout sufferers
Authors: Arman Maria , Hammarqvist Anne‐Sofie , Rehnsfeldt Arne
Published: August 2010

Scand J Caring Sci; 2011; 25; 294–302
 
Burnout as an existential deficiency – lived experiences of burnout sufferers

Aiming at a deeper and existential understanding of burnout, by looking especially at the patterns of health, suffering and expressions of understanding of life in a longitudinal perspective, qualitative data from 18 Swedish women and men were analysed. Burnout as an illness has been subject to constant questioning during its incidence in western societies. Yet it is generally agreed that people afflicted by burnout experience huge problems and suffering. Data from interviews face to face, telephone follow‐up interviewing during 1 year and e‐mail interview dialogues were collected. With a nursing science perspective in which health and suffering are basic concepts, an interpretive analysis revealed signs of existential deficiencies in the lived experience of the people afflicted. The images of the patterns of lived experience elucidated reveal a discord between the people and their work, a blindness towards their own actions, bodily illness as signs of burnout, experiencing a collapse as a ‘crossroad’, secondary suffering related to the social system and a struggle towards a way out. Our interpretation reveals assumptions concerning three levels of life: actions, values and universal existence, which is somewhat different from previous studies. Unless a person is in contact with these three dimensions, he/she seems to find it difficult to maintain health in his/her encounters with life. Implications for health care are existential interest on the part of caregivers and understanding of life as signs of universal values. Patients’‘shut off’ and restrained longings understood as signs of ‘darkness’ in their understanding of life may induce caring acts on the part of caregivers that offer patients an opening and a glimpse of what it might be like to find health in the midst of their suffering. The caregivers’ own natural light of understanding of life can then work as a caring component.
Prey capture success of Sandwich Terns Sterna sandvicensis varies non‐linearly with water transparency
Authors: BAPTIST MARTIN J. , LEOPOLD MARDIK F.
Published: August 2010

Human impacts on water transparency may affect plunge‐diving seabirds. We studied prey capture success of Sandwich Terns Sterna sandvicensis as a function of six environmental variables during the breeding season. We observed diving terns in the south eastern North Sea and found a non‐linear optimum curve for the relationship between Secchi transparency and prey capture probability. High capture probability was found at 1.5–2.0 m, with an optimum of 63% at 1.74 m. At a minimum transparency of 0.4 m and at a maximum transparency of 3.2 m, capture probabilities were about halved. Conversion of transparency to total suspended matter (TSM) concentration showed that the optimum concentration for foraging terns would be 5–10 mg/L under mean summer conditions for chlorophyll‐a. However, the summer‐averaged TSM concentrations in the nearshore Dutch coastal waters range between 10 and 30 mg/L, which implies that foraging Terns in the breeding season do not encounter optimal foraging conditions. The Full Plunge Dive, with which the largest diving depth can be achieved, was applied dominantly in clear water, while the Partial Plunge Dive and Contact Dip were applied more frequently in turbid water, thus showing that Sandwich Terns adjust their diving technique in response to water transparency.
Corrosion Fracture of Structural Metallic Materials: Effect of Electrochemical Conditions in Crack
Authors: Dmytrakh I. M.
Published: August 2010

Abstract: The work is a compressed review based on the summarised results and the original approach for study of corrosion crack growth, taking into account local electrochemical conditions in the crack tip, which was developed at the Karpenko Physico‐Mechanical Institute of NASU. The model scheme of the pre‐fracture zone in the corrosion crack tip, which can be defined by the local values of pH of solution, electrode potential of metalEand stress intensity factorKIis proposed. For its realisation, the special method and testing equipment for corrosion crack growth study and local electrochemical measurements in the crack were developed. The variation of the electrochemical conditions in corrosion cracks was studied, and it has been found that some stabilised levels of the pH andEvalues can be achieved in the tip of a non‐propagating and a propagating crack under static and cyclic loading during of exposure time. On this ground, the method for forecasting of the threshold stress intensity factorKISCCunder stress corrosion cracking was proposed using these characteristic values of pH andE. This method was also adopted for the determination of the threshold stress intensity factorKthunder corrosion fatigue. The special method for determining corrosion fatigue crack growth rate diagrams based on consideration of extreme electrochemical conditions in the crack tip was developed. It has been proven that such diagrams reflect the extreme influence of the environmental factor on corrosion fracture of material, and they may be recommended as the base for the remaining lifetime calculation of the structural elements exploited under environmental conditions.
Analysis of the actions of the novel dopamine receptor‐directed compounds (S)‐OSU6162 and ACR16 at the D2dopamine receptor
Authors: Kara Elodie , Lin Hong , Svensson Kjell , Johansson Anette M , Strange Philip G
Published: August 2010

BACKGROUND AND PURPOSEThe two phenylpiperidines, OSU6162 and ACR16, have been proposed as novel drugs for the treatment of brain disorders, including schizophrenia and Huntington's disease, because of their putative dopamine stabilizing effects. Here we evaluated the activities of these compounds in a range of assays for the D2dopamine receptorin vitro.

EXPERIMENTAL APPROACHThe affinities of these compounds for the D2dopamine receptor were evaluated in competition with [3H]spiperone and [3H]NPA. Agonist activity of these compounds was evaluated in terms of their ability to stimulate [35S]GTPγS binding.

KEY RESULTSBoth compounds had low affinities for inhibition of [3H]spiperone binding (pKivs. [3H]spiperone, ACR16: <5, OSU6162: 5.36). Neither compound was able to stimulate [35S]GTPγS binding when assayed in the presence of Na+ions, but if the Na+ions were removed, both compounds were low‐affinity, partial agonists (Emaxrelative to dopamine: ACR16: 10.2%, OSU6162:54.3%). Schild analysis of the effects of OSU6162 to inhibit dopamine‐stimulated [35S]GTPγS binding indicated Schild slopes of ∼0.9, suggesting little deviation from competitive inhibition. OSU6162 was, however, able to accelerate [3H]NPA dissociation from D2dopamine receptors, indicating some allosteric effects of this compound.

CONCLUSIONS AND IMPLICATIONSThe two phenylpiperidines were low‐affinity, low‐efficacy partial agonists at the D2dopamine receptorin vitro, possibly exhibiting some allosteric effects. Comparing theirin vitroandin vivoeffects, thein vitroaffinities were a reasonable guide to potenciesin vivo. However, the lack ofin vitro–in vivocorrelation for agonist efficacy needs to be further addressed.

LINKED ARTICLESThis article is part of a themed section on Analytical Receptor Pharmacology in Drug Discovery. To view the other articles in this section visithttp://dx.doi.org/10.1111/bph.2010.161.issue‐6
Amphibian Encounter Rates on Roads with Different Amounts of Traffic and Urbanization
Authors: SUTHERLAND RONALD W. , DUNNING PHILLIP R. , BAKER WHIT M.
Published: August 2010

Abstract: Although amphibians have relatively high rates of road mortality in urban areas, the conditions under which traffic threatens the survival of local amphibian populations remain unclear. In the Sandhills region of North Carolina (U.S.A.), we counted living and dead amphibians along two transects (total length 165 km) established on roads in areas with varying degrees of urbanization. We found 2665 individuals of 15 species, and amphibian encounter rates declined sharply as traffic and urban development increased. Regression‐tree models indicated that 35 amphibians/100 km occurred on roads with <535 vehicles/day, whereas the encounter rate decreased to only 2 amphibians/100 km on roads with >2048 vehicles/day. Although mortality rate peaked at higher traffic levels (47% dead on roads with >5200 vehicles/day), the number of dead amphibians was highest at low levels of traffic. This suggests that areas where amphibian mortality is concentrated may actually contain the largest populations remaining on a given road transect.
Study of Metamemory in Patients With Chronic Alcoholism Using a Feeling‐of‐Knowing Episodic Memory Task
Authors: Le Berre Anne‐Pascale , Pinon Karine , Vabret François , Pitel Anne‐Lise , Allain Philippe , Eustache Francis , Beaunieux Hélène
Published: August 2010

Background:  Alcoholism affects various cognitive processes, including components of memory. Metamemory, though of particular interest for patient treatment, has not yet been extensively investigated.

Methods:  A feeling‐of‐knowing (FOK) measure of metamemory was administered to 28 alcoholic patients and 28 healthy controls during an episodic memory task including the learning of 20 pairs of items, followed by a 20‐minute delayed recall and a recognition task. Prior to recognition, participants rated their ability to recognize each nonrecalled word among 4 items. This episodic FOK measure served to compare predictions of future recognition performance and actual recognition performance. Furthermore, a subjective measure of metamemory, the Metamemory In Adulthood (MIA) questionnaire, was completed by patients and controls. This assessment of alcoholic patients’ metamemory profile was accompanied by an evaluation of episodic memory and executive functioning.

Results:  FOK results revealed deficits in accuracy, with the alcoholic patients providing overestimations. There were also links between FOK inaccuracy, executive decline, and episodic memory impairment in patients. MIA results showed that although alcoholics did display memory difficulties, they did not differ from controls on questions about memory capacity.

Conclusions:  Chronic alcoholism affects both episodic memory and metamemory for novel information. Patients were relatively unaware of their memory deficits and believed that their memory was as good as that of the healthy controls. The monitoring measure (FOK) and the subjective measure of metamemory (MIA) showed that patients with chronic alcoholism overestimated their memory capacities. Episodic memory deficit and executive dysfunction would explain metamemory decline in this clinical population.
Reduced Expression of Circadian Clock Genes in Male Alcoholic Patients
Authors: Huang Ming‐Chyi , Ho Chia‐Wei , Chen Chun‐Hsin , Liu Shing‐Cheng , Chen Chiao‐Chicy , Leu Sy‐Jye
Published: August 2010

Background:  There are clear interactions between chronic alcohol consumption and circadian rhythmicity that is regulated by several circadian clock genes. The altered expressions of these genes have been mainly described in animals. The mammalian master clock in the suprachiasmatic nuclei orchestrates the biological rhythms in peripheral tissues. As peripheral blood mononuclear cells (PBMCs) are the most accessible tissue clinically, we assessed the mRNA levels of these genes in patients with alcohol dependence (AD) undergoing alcohol‐withdrawal (AW) treatment.

Methods:  Twenty‐two male patients fulfilled the DSM‐IV diagnostic criteria of AD, and 12 comparison healthy control subjects were recruited. The patients with AD were further divided by the presence of delirium tremens (DTs), the most severe form of AW syndrome, into DT group and non‐DT group. All the participants received blood withdrawal at 9 am, while the patients with AD had blood collection twice: on the next morning of admission (baseline) and on the seventh day. PBMCs were isolated from whole blood, and the mRNA expression profiles of hClock1, hBmal1, hPer1, hPer2, hCry1, and hCry2 were determined by quantitative real‐time PCR.

Results:  The baseline mRNA levels of the target circadian clock genes were markedly lower in patients with AD than in control subjects. After 1 week of alcohol detoxification, there were very limited restorations of discrete circadian gene expressions. DT group did not differ in the expression patterns of circadian clock genes from non‐DT group.

Conclusions:  This is the first study demonstrating the overall lowering of circadian clock genes among patients with AD. The expression pattern is comparable between patients with and without DTs. Although preliminary with data at only one single time point, the observation of strikingly reduced mRNA levels supports the association between circadian clock gene dysregulation and chronic alcohol intake.
Late‐Life Alcohol Consumption and 20‐Year Mortality
Authors: Holahan Charles J. , Schutte Kathleen K. , Brennan Penny L. , Holahan Carole K. , Moos Bernice S. , Moos Rudolf H.
Published: August 2010

Background:  Growing epidemiological evidence indicates that moderate alcohol consumption is associated with reduced total mortality among middle‐aged and older adults. However, the salutary effect of moderate drinking may be overestimated owing to confounding factors. Abstainers may include former problem drinkers with existing health problems and may be atypical compared to drinkers in terms of sociodemographic and social‐behavioral factors. The purpose of this study was to examine the association between alcohol consumption and all‐cause mortality over 20 years among 1,824 older adults, controlling for a wide range of potential confounding factors associated with abstention.

Methods:  The sample at baseline included 1,824 individuals between the ages of 55 and 65. The database at baseline included information on daily alcohol consumption, sociodemographic factors, former problem drinking status, health factors, and social‐behavioral factors. Abstention was defined as abstaining from alcohol at baseline. Death across a 20‐year follow‐up period was confirmed primarily by death certificate.

Results:  Controlling only for age and gender, compared to moderate drinkers, abstainers had a more than 2 times increased mortality risk, heavy drinkers had 70% increased risk, and light drinkers had 23% increased risk. A model controlling for former problem drinking status, existing health problems, and key sociodemographic and social‐behavioral factors, as well as for age and gender, substantially reduced the mortality effect for abstainers compared to moderate drinkers. However, even after adjusting for all covariates, abstainers and heavy drinkers continued to show increased mortality risks of 51 and 45%, respectively, compared to moderate drinkers.

Conclusions:  Findings are consistent with an interpretation that the survival effect for moderate drinking compared to abstention among older adults reflects 2 processes. First, the effect of confounding factors associated with alcohol abstention is considerable. However, even after taking account of traditional and nontraditional covariates, moderate alcohol consumption continued to show a beneficial effect in predicting mortality risk.
Increased Risk of Esophageal Varices, Liver Cancer, and Death in Patients With Alcoholic Liver Disease
Authors: Stokkeland Knut , Ebrahim Fereshte , Ekbom Anders
Published: August 2010

Background and Aims:  During the last decades, a multitude of different treatments for chronic liver disease have been introduced. New surveillance programs have been established to detect esophageal varices and liver cancer. The aims of our study were to assess whether the prognosis for patients hospitalized with liver diseases between 1969 and 2006 had improved and to study the differences in mortality and complications between patients with alcoholic liver disease and nonalcoholic liver diseases.

Methods:  We used the Swedish Hospital Discharge Register and Cause of Death Register at the National Board of Health and Welfare in Sweden between 1969 and 2006 to identify and follow‐up a cohort of patients with liver disease according to the International Classification of Diseases‐8, ‐9, and ‐10.

Results:  There were 36,462 patients hospitalized with alcoholic and 95,842 with nonalcoholic liver diseases. The main finding was that patients hospitalized with alcoholic liver disease had an increased mortality risk, compared to patient with nonalcoholic liver disease, 1.89 (1.85 to 1.92). In addition, the patients with alcoholic liver disease had an increased risk for esophageal varices and liver cancer. There was a reduced risk for hospitalization with esophageal varices for patients with nonalcoholic liver disease up to 1998.

Conclusions:  We found that the prognosis for patients hospitalized with chronic liver diseases had not improved. Patients with alcoholic liver disease have an increased risk of complications, which suggest that the disease is more aggressive and are in need of closer follow‐up than other chronic liver diseases.
The Energy and Climate Change Implications of Different Music Delivery Methods
Authors: Weber Christopher L. , Koomey Jonathan G. , Matthews H. Scott
Published: August 2010

The impacts of information and communications technology (ICT) on the environment have been a rich area for research in recent years. A prime example is the continuing rise of digital music delivery, which has obvious potential for reducing the energy and environmental impacts of producing and delivering music to final consumers. This study assesses the energy and carbon dioxide (CO2) emissions associated with several alternative methods for delivering one album of music to a final customer, either through traditional retail or e‐commerce sales of compact discs or through a digital download service. We analyze a set of six (three compact disc and three digital download) scenarios for the delivery of one music album from the recording stage to the consumer's home in either CD or digital form. We find that despite the increased energy and emissions associated with Internet data flows, purchasing music digitally reduces the energy and carbon dioxide (CO2) emissions associated with delivering music to customers by between 40% and 80% from the best‐case physical CD delivery, depending on whether a customer then burns the files to CD. Despite the dominance of the digital music delivery method, however, there are scenarios by which digital music performs less well, and these scenarios are explored. We suggest future areas of research, including alternative digital media services, such as subscription and streaming systems, for which Internet energy usage may be larger than for direct downloads.
Length of Stay for Older Adults Residing in Nursing Homes at the End of Life
Authors: Kelly Anne , Conell‐Price Jessamyn , Covinsky Kenneth , Cenzer Irena Stijacic , Chang Anna , Boscardin W. John , Smith Alexander K.
Published: August 2010

OBJECTIVES: To describe lengths of stay of nursing home decedents.

DESIGN: Retrospective cohort study.

SETTING: The Health and Retirement Study (HRS), a nationally representative survey of U.S. adults aged 50 and older.

PARTICIPANTS: One thousand eight hundred seventeen nursing home residents who died between 1992 and 2006.

MEASUREMENTS: The primary outcome was length of stay, defined as the number of months between nursing home admission and date of death. Covariates were demographic, social, and clinical factors drawn from the HRS interview conducted closest to the date of nursing home admission.

RESULTS: The mean age of decedents was 83.3±9.0; 59.1% were female, and 81.5% were white. Median and mean length of stay before death were 5 months (interquartile range 1–20) and 13.7±18.4 months, respectively. Fifty‐three percent died within 6 months of placement. Large differences in median length of stay were observed according to sex (men, 3 months vs women, 8 months) and net worth (highest quartile, 3 months vs lowest quartile, 9 months) (all P<.001). These differences persisted after adjustment for age, sex, marital status, net worth, geographic region, and diagnosed chronic conditions (cancer, hypertension, diabetes mellitus, lung disease, heart disease, and stroke).

CONCLUSION: Nursing home lengths of stay are brief for the majority of decedents. Lengths of stay varied markedly according to factors related to social support.
Relationship Between Physical Functioning and Physical Activity in the Lifestyle Interventions and Independence for Elders Pilot
Authors: Chalé‐Rush Angela , Guralnik Jack M. , Walkup Michael P. , Miller Michael E. , Rejeski W. Jack , Katula Jeffrey A. , King Abby C. , Glynn Nancy W. , Manini Todd M. , Blair Steven N. , Fielding Roger A.
Published: August 2010

OBJECTIVES: To determine whether participation in usual moderate‐intensity or more‐vigorous physical activity (MVPA) is associated with physical function performance and to identify sociodemographic, psychosocial, and disease‐related covariates that may also compromise physical function performance.

DESIGN: Cross‐sectional analysis of baseline variables of a randomized controlled intervention trial.

SETTING: Four academic research centers.

PARTICIPANTS: Four hundred twenty‐four older adults aged 70 to 89 at risk for mobility disability (scoring <10 on the Short Physical Performance Battery (SPPB)) and able to complete the 400‐m walk test within 15 minutes.

MEASUREMENTS: Minutes of MVPA (dichotomized according to above or below 150 min/wk of MVPA) assessed according to the Community Healthy Activities Model Program for Seniors questionnaire, SPPB score, 400‐m walk test, sex, body mass index (BMI), depressive symptoms, age, and number of medications.

RESULTS: The SPPB summary score was associated with minutes of MVPA (ρ=0.16, P=.001). In multiple regression analyses, age, minutes of MVPA, number of medications, and depressive symptoms were associated with performance on the composite SPPB (P<.05). There was an association between 400‐m walk time and minutes of MVPA (ρ=−0.18; P<.001). In multiple regression analyses, age, sex, minutes of MVPA, BMI, and number of medications were associated with performance on the 400‐m walk test (P<.05).

CONCLUSION: Minutes of MVPA, sex, BMI, depressive symptoms, age, and number of medications are associated with physical function performance and should all be taken into consideration in the prevention of mobility disability.
Habitual Physical Activity Levels Are Associated with Performance in Measures of Physical Function and Mobility in Older Men
Authors: Morie Marina , Reid Kieran F. , Miciek Renee , Lajevardi Newsha , Choong Karen , Krasnoff Joanne B. , Storer Thomas W. , Fielding Roger A. , Bhasin Shalender , LeBrasseur Nathan K.
Published: August 2010

OBJECTIVES: To determine whether objectively measured physical activity levels are associated with physical function and mobility in older men.

DESIGN: Cross‐sectional.

SETTING: Academic research center.

PARTICIPANTS: Eighty‐two community‐dwelling men aged 65 and older with self‐reported mobility limitations were divided into a low‐activity and a high‐activity group based on the median average daily physical activity counts of the whole sample.

MEASUREMENTS: Physical activity according to triaxial accelerometers; physical function and mobility according to the Short Physical Performance Battery (SPPB), gait speed, stair climb time, and a lift‐and‐lower task; aerobic capacity according to maximum oxygen consumption (VO2max); and leg press and chest press maximal strength and peak power.

RESULTS: Older men with higher physical activity levels had a 1.4‐point higher mean SPPB score and a 0.35‐m/s faster walking speed than those with lower physical activity levels. They also climbed a standard flight of stairs 1.85 seconds faster and completed 60% more shelves in a lift‐and‐lower task (all P<.01); muscle strength and power measures were not significantly different between the low‐ and high‐activity groups. Correlation analyses and multiple linear regression models showed that physical activity is positively associated with all physical function and mobility measures, leg press strength, and VO2max.

CONCLUSION: Older men with higher physical activity levels demonstrate better physical function and mobility than their less‐active peers. Moreover, physical activity levels are predictive of performance in measures of physical function and mobility in older men. Future work is needed to determine whether modifications in physical activity levels can improve or preserve physical performance in later life.
The Practice of Continuous Palliative Sedation in Elderly Patients: A Nationwide Explorative Study Among Dutch Nursing Home Physicians
Authors: van Deijck Rogier H.P.D. , Krijnsen Petrus J.C. , Hasselaar Jeroen G.J. , Verhagen Stans C.A.H.H.V.M. , Vissers Kris C.P. , Koopmans Raymond T.C.M.
Published: August 2010

OBJECTIVES: To study the practice of continuous palliative sedation (CPS) by Dutch nursing home physicians in 2007.

DESIGN: A structured retrospective questionnaire.

SETTING: Nationwide nursing home physician study in the Netherlands.

PARTICIPANTS: One thousand two hundred fifty‐four nursing home physicians received a questionnaire concerning their last case of CPS in 2007; 54% (n=675) responded.

MEASUREMENTS: Characteristics of CPS and requests for euthanasia were measured.

RESULTS: Three hundred sixteen patients were described. The majority had cancer or dementia. The most‐reported refractory symptoms were pain (52%), anxiety (44%), exhaustion (44%), dyspnea (40%), delirium (24%), loss of dignity (18%), and existential distress (16%). In 98% of cases, CPS was aimed at symptom relief. Of patients with cancer, 17% had previously requested euthanasia. The mean starting dose of midazolam was 31 mg every 24 hours (range 0–240 mg/24 h), and the mean end dose was 48 mg every 24 hours (range 0–480 mg/24 h).

CONCLUSION: In addition to physical symptoms, anxiety, exhaustion, loss of dignity, and existential distress are often mentioned as refractory symptoms in the decision to start CPS by nursing home physicians. Furthermore, close to one in five patients with cancer had made a previous request for euthanasia. The dosage range of midazolam in this study fits the recommendations of the Dutch national guideline on palliative sedation, although international studies show smaller dosage ranges. Finally, prospective research about the acceptability and assessment of nonphysical symptoms as indications for CPS is recommended.
Mitochondrial dysfunction of platelets stored in first‐ and second‐generation containers is, in part, associated with elevated carbon dioxide levels
Authors: Skripchenko Andrey , Myrup Andrew , Thompson‐Montgomery Dedeene , Awatefe Helen , Wagner Stephen J.
Published: August 2010

BACKGROUND: The gas permeability of platelet (PLT) storage bags influences the retention of in vitro PLT parameters during storage. The aim of this study was to evaluate mitochondrial function of PLTs stored in first‐ and second‐generation bags with different gas permeabilities.

STUDY DESIGN AND METHODS: Identical whole blood–derived PLT concentrates were stored in second‐generation CLX (Pall Corp.) and first‐generation PL146 (Baxter Healthcare Corp.) bags (n = 12). PLTs were assayed for standard in vitro PLT assays as well as for mitochondrial membrane potential (MMP), accumulation of reactive oxygen species, Annexin V binding, mitochondrial mass, and activity of mitochondrial reduction power on Days 1, 4, 5, 6, and 7. Results were analyzed by paired t test and by multiple regression analysis.

RESULTS: With PLTs stored in PL146 bags that underwent large pH declines, there was greater superoxide production, greater peroxide accumulation, and greater mitochondrial membrane depolarization. Superoxide anion generation was correlated with higher levels of carbon dioxide (p = 0.0001) and lower oxygen levels (p = 0.0064; multiple regression R2 = 0.9204). Changes in MMP were correlated with higher levels of carbon dioxide (p = 0.0288) and PLT activation (p = 0.0178; multiple regression R2 = 0.9511).

CONCLUSION: Prolonged periods of elevated carbon dioxide levels, potentially coupled with other factors, is associated with PLT mitochondria dysfunction and poor pH control during storage.
An unusual febrile nonhemolytic reaction occurred after transfusion in a thalassemia major patient with asymptomatic Plasmodium falciparum infection
Authors: Boschetti Carla , Cappellini Maria D. , Colombi Mariangela , Villa Antonietta , Grande Romualdo , Vercellati Cristina , Radaelli Franca , Caspani Luisa , Zanella Alberto
Published: August 2010

BACKGROUND: Febrile nonhemolytic transfusion reactions occur in 0.12% of transfusions, usually during transfusion or within 4 to 6 hours after transfusion and are not medically dangerous.

CASE REPORT: A patient with thalassemia from Togo with asymptomatic malaria in which the infection became clinically manifest only after blood transfusion, mimicking a febrile nonhemolytic transfusion reaction, is presented. Thirty‐two hours after transfusion of 2 O D− red blood cell (RBC) units, the patient (phenotype A2 D+) developed fever and multiorgan failure and was admitted to the intensive care unit. Direct and indirect antiglobulin tests were negative on posttransfusion samples. Blood cultures and infectious diseases testing were negative. No malaria parasites were found at thick blood smear microscopic examination on Days 1 and 2 and the malaria rapid diagnostic test gave inconsistent results. Plasmodium total antibodies were detected in the serum at high levels. On Day 5, routine microscopic examination of blood smear revealed the presence of parasites in a very small number of RBCs. This finding was almost simultaneous to the availability of polymerase chain reaction testing results that were positive for P. falciparum. The sequential agglutination with anti‐A antiserum allowed patient's and donors' RBCs to be separated and revealed that the parasitized cells were almost exclusively those of donors (14.4% vs. 0.029%). Malaria infection in implicated donors was excluded.

CONCLUSION: In this patient with thalassemia with asymptomatic malaria, the infusion of two normal RBC units provided a favorable environment for a rapid parasite replication leading to a dramatic acute malaria attack.