bluuebunny/crossref_metadata_2025 huggingface dataset:
Rebuilding the foundations: Major renovations to the mental health component of an undergraduate nursing curriculum
Authors: Spence Deborah , Garrick Helen , McKay Marie
Published: May 2012

Concerns relating to the adequacy of nurses' preparation for the care of people with mental illness prompted significant revision of the mental health component in a Bachelor of Health Science nursing programme in New Zealand that prepares approximately 200 students per year. Working collaboratively with clinical providers, university staff developed and introduced three courses (equivalent to 450 hours of learning) specifically focused on mental health science, inpatient practice, and primary community mental health practice. This paper provides an overview of the new courses and reports the findings of an appreciative inquiry evaluation of this curriculum innovation.
Ecological thresholds at the savanna‐forest boundary: how plant traits, resources and fire govern the distribution of tropical biomes
Authors: Hoffmann William A. , Geiger Erika L. , Gotsch Sybil G. , Rossatto Davi R. , Silva Lucas C. R. , Lau On Lee , Haridasan M. , Franco Augusto C.
Published: May 2012

Fire shapes the distribution of savanna and forest through complex interactions involving climate, resources and species traits. Based on data from central Brazil, we propose that these interactions are governed by two critical thresholds. The fire‐resistance threshold is reached when individual trees have accumulated sufficient bark to avoid stem death, whereas the fire‐suppression threshold is reached when an ecosystem has sufficient canopy cover to suppress fire by excluding grasses. Surpassing either threshold is dependent upon long fire‐free intervals, which are rare in mesic savanna. On high‐resource sites, the thresholds are reached quickly, increasing the probability that savanna switches to forest, whereas low‐resource sites are likely to remain as savanna even if fire is infrequent. Species traits influence both thresholds; saplings of savanna trees accumulate bark thickness more quickly than forest trees, and are more likely to become fire resistant during fire‐free intervals. Forest trees accumulate leaf area more rapidly than savanna trees, thereby accelerating the transition to forest. Thus, multiple factors interact with fire to determine the distribution of savanna and forest by influencing the time needed to reach these thresholds. Future work should decipher multiple environmental controls over the rates of tree growth and canopy closure in savanna.
Precipitation manipulation experiments – challenges and recommendations for the future
Authors: Beier Claus , Beierkuhnlein Carl , Wohlgemuth Thomas , Penuelas Josep , Emmett Bridget , Körner Christian , de Boeck Hans , Christensen Jens Hesselbjerg , Leuzinger Sebastian , Janssens Ivan A. , Hansen Karin
Published: May 2012

Climatic changes, including altered precipitation regimes, will affect key ecosystem processes, such as plant productivity and biodiversity for many terrestrial ecosystems. Past and ongoing precipitation experiments have been conducted to quantify these potential changes. An analysis of these experiments indicates that they have provided important information on how water regulates ecosystem processes. However, they do not adequately represent global biomes nor forecasted precipitation scenarios and their potential contribution to advance our understanding of ecosystem responses to precipitation changes is therefore limited, as is their potential value for the development and testing of ecosystem models. This highlights the need for new precipitation experiments in biomes and ambient climatic conditions hitherto poorly studied applying relevant complex scenarios including changes in precipitation frequency and amplitude, seasonality, extremity and interactions with other global change drivers. A systematic and holistic approach to investigate how soil and plant community characteristics change with altered precipitation regimes and the consequent effects on ecosystem processes and functioning within these experiments will greatly increase their value to the climate change and ecosystem research communities. Experiments should specifically test how changes in precipitation leading to exceedance of biological thresholds affect ecosystem resilience and acclimation.
The impact of culturally competent diabetes care interventions for improving diabetes‐related outcomes in ethnic minority groups: a systematic review
Authors: Zeh P. , Sandhu H. K. , Cannaby A. M. , Sturt J. A.
Published: May 2012

Diabet. Med. 29, 1237–1252 (2012)

Aim  To examine the evidence on culturally competent interventions tailored to the needs of people with diabetes from ethnic minority groups.

Methods  MEDLINE (NHS Evidence), CINAHL and reference lists of retrieved papers were searched from inception to September 2011; two National Health Service specialist libraries were also searched. Google, Cochrane and DARE databases were interrogated and experts consulted. Studies were included if they reported primary research on the impact of culturally competent interventions on outcome measures of any ethnic minority group with diabetes. Paper selection and appraisal were conducted independently by two reviewers. The heterogeneity of the studies required narrative analysis. A novel culturally competent assessment tool was used to systematically assess the cultural competency of each intervention.

Results  Three hundred and twenty papers were retrieved and 11 included. Study designs varied with a diverse range of service providers. Of the interventions, 64% were found to be highly culturally competent (scoring 90–100%) and 36% moderately culturally competent (70–89%). Data were collected from 2616 participants on 22 patient‐reported outcome measures. A consistent finding from 10 of the studies was that any structured intervention, tailored to ethnic minority groups by integrating elements of culture, language, religion and health literacy skills, produced a positive impact on a range of patient‐important outcomes.

Conclusions  Benefits in using culturally competent interventions with ethnic minority groups with diabetes were identified. The majority of interventions described as culturally competent were confirmed as so, when assessed using the culturally competent assessment tool. Further good quality research is required to determine effectiveness and cost‐effectiveness of culturally competent interventions to influence diabetes service commissioners.
The homologous homeodomain‐leucine zipper transcription factors HaHB1 and AtHB13 confer tolerance to drought and salinity stresses via the induction of proteins that stabilize membranes
Authors: Cabello Julieta V. , Chan Raquel L.
Published: May 2012

Transgenic approaches to conferring tolerance to abiotic stresses have mostly resulted in some degree of plant yield penalty under normal or mild stress conditions. Recently, we have reported that the homeodomain‐leucine zipper transcription factors (TFs) HaHB1 and AtHB13 were able to confer tolerance to freezing temperatures via the induction of glucanase (GLU and PR2) and chitinase (PR4) proteins. In the present study, we show that the expression of these TFs, as well as that of their putative targets AtPR2, AtPR4 and AtGLU, is up‐regulated by drought and salinity stresses. Transgenic plants overexpressing separately these five genes exhibited tolerance to severe drought and salinity stresses, displaying a cell membrane stabilization mechanism. Under normal or mild stress conditions, these plants achieved an improved yield associated with higher chlorophyll content. Moreover, overexpression of the sunflower HaHB1 gene from its own, inducible, promoter conferred a high drought‐stress tolerance without yield penalty under normal or mild stress conditions. We propose these TFs as potential biotechnological tools to breed crops for tolerance to multiple stresses and for increased yield.
Listening: The New Democratic Deficit
Authors: Dobson Andrew
Published: May 2012

Although much prized in daily conversation, good listening has been almost completely ignored in that form of political conversation we know as democracy. Practically all the attention has been paid to speaking, both in terms of the skills to be developed and the ways in which we should understand what enhancing ‘inclusion’ might mean (i.e. getting more people to speak). The argument here is that both democratic theory and democratic practice would be reinvigorated by attention to listening. To ask why listening has been ignored is to inquire into the very nature of politics, and to suggest a range of ways in which listening could both improve political processes (particularly democratic ones) and enhance our understanding of them – including where they do not always work as well as we might want them to. Four ways in which good listening can help achieve democratic objectives are outlined: enhancing legitimacy, helping to deal with deep disagreements, improving understanding and increasing empowerment. This leads to a discussion of the difference between good and bad political listening, before the question of ‘political noise’ is broached (i.e. what we should be listening for). Finally, the listening lacuna in Habermas' theory of communicative rationality is pointed out, leading to a discussion of the potential analytic power of listening in relation to deliberative democracy in general and one citizens' jury case in particular.
Why We Should Reject ‘Nudge’
Authors: Goodwin Tom
Published: May 2012

This article argues that the use of ‘nudge’ tactics in UK policymaking ought to be rejected. Nudge contravenes the coalition government's aspirations to promote ideas such as empowerment, freedom and fairness. Moreover, it is not an effective strategy for bringing about the kind of behavioural changes required to solve society's ‘big problems’ – problems around climate change and public health, for example. The article mines political theory in a way that is distinctly absent from the current literature on ‘nudging’ and brings a fresh and insightful perspective to the nudge debate.
Six Theses on Targeted Killing
Authors: Grayson Kyle
Published: May 2012

This article presents six theses on targeted killing as a form of political violence. These explore the power relations, lawfare, scopic regimes, forms of spatial management and symbolic communications which suggest that the practice of targeted killing arises from the failures of the Western global counter-insurgency campaign to achieve its aims. Therefore, rather than demonstrating omniscience and omnipotence, targeted killing is indicative of the Western position of weakness in the wars of ‘the colonial present’.
Harnessing Political Theory to Facilitate Students' Engagement with Graduate ‘Employability’: A Critical Pyramid Approach
Authors: Ashe Fidelma
Published: May 2012

Both the business sector and government have claimed that there is a skills deficit among graduates in the UK. Universities are now under increasing pressure to develop graduate ‘employability’ strategies to improve the stock and quality of graduates' generic skills. Critical subject communities have been sceptical of an employability agenda that frames graduate employment solely around notions of personal career development and planning. This article discusses the intellectual and pedagogical debates that have surrounded the employability agenda in higher education. It details a critical pedagogical approach to graduate employment that was developed through a project funded by the Higher Education Academy's Subject Centre for Sociology, Anthropology and Politics.
Eigenfunctions and Very Singular Similarity Solutions of Odd‐Order Nonlinear Dispersion PDEs: Toward a “Nonlinear Airy Function” and Others
Authors: Fernandes R.S. , Galaktionov V.A.
Published: May 2012

Asymptotic properties of nonlinear dispersion equations

image

with fixed exponents n > 0 and p > n+ 1, and their (2k+ 1)th‐order analogies are studied. The global in time similarity solutions, which lead to “nonlinear eigenfunctions” of the rescaled ordinary differential equations (ODEs), are constructed. The basic mathematical tools include a “homotopy‐deformation” approach, where the limit in the first equation in (1) turns out to be fruitful. At n= 0 the problem is reduced to the linear dispersion one:

image

whose oscillatory fundamental solution via Airy’s classic function has been known since the nineteenth century. The corresponding Hermitian linear non‐self‐adjoint spectral theory giving a complete countable family of eigenfunctions was developed earlier in [1]. Various other nonlinear operator and numerical methods for (1) are also applied. As a key alternative, the “super‐nonlinear” limit , with the limit partial differential equation (PDE)

image
admitting three almost “algebraically explicit” nonlinear eigenfunctions, is performed.

For the second equation in (1), very singular similarity solutions (VSSs) are constructed. In particular, a “nonlinear bifurcation” phenomenon at critical values {p=pl(n)}l≥0 of the absorption exponents is discussed.
Heroic Career Changers? Gendered Identity Work in Career Transitions
Authors: LaPointe Kirsi
Published: May 2012

This article contributes to the literature on agency and its constraints in new careers by focusing on the role of gender in identity work. Drawing on the concept of positioning, this article offers a longitudinal and contextualized analysis of identity work among Finnish female business graduates considering career change. The study shows how identity work is gendered in three respects: via the masculine position of a career changer in master narratives of career change, the positions used to account for the need to change careers and the positions at the heart of identity struggles. This article problematizes individualistic new career discourses by showing how gender, intersecting with age, constrains identity work in career change. However, it also brings to light possibilities for agency via alternative resources of identity.
Social Distance and the Formerly Obese: Does the Stigma of Obesity Linger?*
Authors: Fee Holly R. , Nusbaumer Michael R.
Published: May 2012

Research has documented the stigma of obesity extensively, but little attention has been given to the study of stigma toward formerly obese individuals. The present study examines whether the stigma of obesity in romantic relationships carries over to formerly obese individuals by using primary data collected from a Midwestern university in the United States (N = 363). We consider how an individual's own body weight, demographic characteristics, familiarity, and attitudes affect the willingness to form a romantic relationship with a formerly obese person. Results suggest that obese individuals are less likely to hesitate about engaging in a romantic relationship with a formerly obese person than underweight or normal weight individuals, but only when attitudes toward obese and formerly obese individuals are controlled. In terms of demographic characteristics, men and African Americans are more likely to hesitate about forming a romantic relationship than their respective counterparts. More familiarity with currently obese family members and formerly obese close friends appears to reduce the stigma minimally. Greater social distance is also desired if weight loss is believed to be temporary.
‘Livin’ on the Straights’: Identity, Desistance, and Work among Women Post‐Incarceration*
Authors: Opsal Tara
Published: May 2012

This study explores how a group of women recently released from prison as parolees attempt to sustain their exit from deviant careers by constructing replacement selves. To examine this process, I analyze semi‐structured interviews with female ex‐offenders and show how they draw on work as a hook for change (Giordano et al. 2002) in their unfolding identity work. Contrary to traditional gendered scripts, these women view themselves as active participants in the world of work. Upon release not only do they desire to work to meet financial needs, but they also use employment as an avenue through which they begin to construct pro‐social replacement selves. Drawing on longitudinal qualitative data, I point out that as time on the outside passed, many of the women continued to use work as a way to fashion new conventional selves despite their experiences with low‐quality working conditions. I also provide evidence, however, that when women experience significant employment instability, they are unable to sustain their hopeful identity project and, instead, reengage their past deviant selves.
Role of action potential configuration and the contribution of Ca2+ and K+ currents to isoprenaline‐induced changes in canine ventricular cells
Authors: Szentandrássy N , Farkas V , Bárándi L , Hegyi B , Ruzsnavszky F , Horváth B , Bányász T , Magyar J , Márton I , Nánási PP
Published: May 2012

BACKGROUND AND PURPOSE Although isoprenaline (ISO) is known to activate several ion currents in mammalian myocardium, little is known about the role of action potential morphology in the ISO‐induced changes in ion currents. Therefore, the effects of ISO on action potential configuration, L‐type Ca2+ current (ICa), slow delayed rectifier K+ current (IKs) and fast delayed rectifier K+ current (IKr) were studied and compared in a frequency‐dependent manner using canine isolated ventricular myocytes from various transmural locations.

EXPERIMENTAL APPROACH Action potentials were recorded with conventional sharp microelectrodes; ion currents were measured using conventional and action potential voltage clamp techniques.

KEY RESULTS In myocytes displaying a spike‐and‐dome action potential configuration (epicardial and midmyocardial cells), ISO caused reversible shortening of action potentials accompanied by elevation of the plateau. ISO‐induced action potential shortening was absent in endocardial cells and in myocytes pretreated with 4‐aminopyridine. Application of the IKr blocker E‐4031 failed to modify the ISO effect, while action potentials were lengthened by ISO in the presence of the IKs blocker HMR‐1556. Both action potential shortening and elevation of the plateau were prevented by pretreatment with the ICa blocker nisoldipine. Action potential voltage clamp experiments revealed a prominent slowly inactivating ICa followed by a rise in IKs, both currents increased with increasing the cycle length.

CONCLUSIONS AND IMPLICATIONS The effect of ISO in canine ventricular cells depends critically on action potential configuration, and the ISO‐induced activation of IKs– but not IKr– may be responsible for the observed shortening of action potentials.
Bronchoprotection in conscious guinea pigs by budesonide and the NO‐donating analogue, TPI 1020, alone and combined with tiotropium or formoterol
Authors: Turner DL , Ferrari N , Ford WR , Kidd EJ , Nevin B , Paquet L , Renzi P , Broadley KJ
Published: May 2012

BACKGROUND AND PURPOSE Inhaled corticosteroids, anticholinergics and β2‐adrenoceptor agonists are frequently combined for treating chronic respiratory diseases. We examine the corticosteroid, budesonide, and novel NO‐donating derivative, TPI 1020, against histamine‐ and methacholine‐induced bronchoconstriction and whether they enhance the β2‐adrenoceptor agonist formoterol or muscarinic antagonist tiotropium in conscious guinea pigs.

EXPERIMENTAL APPROACH Dunkin‐Hartley guinea pigs received inhaled histamine (3 mM) or methacholine (1.5 mM) and specific airway conductance (sGaw) was measured before and 15 or 75 min after treatment with budesonide, TPI 1020, tiotropium or formoterol alone or in combinations.

KEY RESULTS Formoterol (0.7–10 µM) and budesonide (0.11–0.7 mM) inhibited histamine‐induced bronchoconstriction and tiotropium (2–20 µM) inhibited methacholine‐induced bronchoconstriction by up to 70.8 ± 16.6%, 34.9 ± 4.4% and 85.1 ± 14.3%, respectively. Formoterol (2.5 µM) or tiotropium (2 µM) alone exerted small non‐significant bronchoprotection. However, when co‐administered with TPI 1020 0.11 mM, which alone had no significant effect, there was significant inhibition of the bronchoconstriction (45.7 ± 12.2% and 79.7 ± 21.4%, respectively). Co‐administering budesonide (0.11 mM) with tiotropium (2 µM), which alone had no effect, also significantly inhibited the methacholine bronchoconstriction (36.5 ± 13.0%), but there was no potentiation of formoterol against histamine. The NO scavenger, CPTIO, prevented the bronchoprotection by SNAPand TPI 1020.

CONCLUSIONS AND IMPLICATIONS TPI 1020 potentiated the bronchoprotection by formoterol and tiotropium. Budesonide also enhanced the effects of tiotropium but not formoterol. Combination of TPI 1020 with a long‐acting β2‐adrenoceptor agonist or muscarinic receptor antagonist may therefore be a more potent therapeutic approach for treatment of chronic respiratory diseases.
Pregnancy outcomes for nulliparous women of advanced maternal age in South Australia, 1998–2008
Authors: Ludford Isobel , Scheil Wendy , Tucker Graeme , Grivell Rosalie
Published: May 2012

Background

Child bearing in the later reproductive years has become increasingly common in Australia with potential implications for clinical practice.

Aim

To examine pregnancy outcomes for nulliparous women of advanced maternal age with singleton pregnancies.

Methods

A retrospective population‐based cohort study was conducted to compare the pregnancy outcomes for women aged 35–39 years and ≥40 years with women aged 25–29 years, analysing 34 695 records from the South Australian Perinatal Database between 1998 and 2008.

Results

Pre‐existing hypertension [relative risks (RR) 1.98 and 2.94 for women aged 35–39 years and ≥40 years, respectively], placenta praevia (RR 2.88 and 3.68), suspected intrauterine growth restriction (RR 1.33 and 1.77) and gestational diabetes (RR 1.97 and 2.53) increased with age. Women of advanced maternal age were more likely to have not laboured prior to birth (RR 2.19 and 3.28), be induced (RR 1.12 and 1.27) and have a breech presentation (RR 1.57 and 1.60). The likelihood of fetal distress increased with advancing maternal age (RR 1.15 and 1.24). Regression analyses revealed women of advanced maternal age were significantly more likely to have small for gestational age infants [adjusted odds ratios (AOR) 1.26 and 1.50], preterm birth (AOR 1.26 and 1.43), elective caesarean [relative risk ratios (RRR) 2.55 and 4.52], emergency caesarean (RRR 1.59 and 2.21) and experience a perinatal death (RRR 1.94 and 2.18).

Conclusions

The likelihood of pre‐existing medical conditions, obstetric complications, adverse labour and birth outcomes and complications increased with advancing maternal age. Advanced maternal age was also independently associated with selected adverse pregnancy and infant outcomes.
Comparative effectiveness of mechanically and electrically powered negative pressure wound therapy devices: A multicenter randomized controlled trial
Authors: Armstrong David G. , Marston William A. , Reyzelman Alexander M. , Kirsner Robert S.
Published: May 2012

This study was designed to compare the ultraportable mechanically powered Smart Negative Pressure (SNaP) Wound Care System (Spiracur, Sunnyvale, CA) with the electrically powered Vacuum‐Assisted Closure (VAC) Therapy System (Kinetic Concepts, Inc. [KCI], San Antonio, TX) in a multicenter, comparative efficacy, noninferiority‐powered, randomized controlled trial. We enrolled 132 people with noninfected, nonischemic, nonplantar lower extremity diabetic and venous wounds. Each subject was randomly assigned (1:1) to treatment with either system in conjunction with appropriate off‐loading and compression therapy. The trial evaluated treatment for up to 16 weeks or complete wound closure (defined as complete reepithelialization without drainage). Primary end point analysis of wound size reduction found that SNaP‐treated subjects demonstrated noninferiority to the VAC‐treated subjects at 4, 8, 12, and 16 weeks (p = 0.0030, 0.0130, 0.0051, and 0.0044, respectively). Kaplan–Meier analysis showed no significant difference in complete wound closure between SNaP‐ and VAC‐treated subjects at all time points. Device related adverse events and complications such as infection were also similar between treatment groups. These data support similar wound healing outcomes between the SNaP system and the VAC system in the population studied.
Effects of collagen prosthesis cross‐linking on long‐term tissue regeneration following the repair of an abdominal wall defect
Authors: Pascual Gemma , Rodríguez Marta , Sotomayor Sandra , Moraleda Eduardo , Bellón Juan M.
Published: May 2012

Collagen prostheses used to repair abdominal wall defects, depending on their pretreatment (noncross‐linked vs. cross‐linked), besides repair may also achieve tissue regeneration. We assessed the host tissue incorporation of different bioprostheses using a new tool that combines immunofluorescence confocal microscopy with differential interference contrast images, making it possible to distinguish newly formed collagen. Partial hernial defects in the abdominal wall of rabbits were repaired using cross‐linked/noncross‐linked bioprostheses. Expanded polytetrafluoroethylene (ePTFE) was used as control. After 14/30/90/180 days of implant, specimens were taken for microscopy, immunohistochemistry, and quantitative‐reverse transcription‐polymerase chain reaction to determine host tissue ingrowth and collagen I/III protein and 1a1/3a1 gene expression. Shrinkage and stress resistance were also examined. At 14 days, cross‐linked prostheses had suffered significantly less shrinkage than ePTFE or noncross‐linked prostheses. Significantly higher shrinkage was recorded for ePTFE in the longer term. Microscopy revealed encapsulation of ePTFE by neoformed tissue, while the bioprostheses became gradually infiltrated by host tissue. Noncross‐linked prosthesis showed better tissue ingrowth, more intense inflammatory reaction and more rapid degradation than the cross‐linked prostheses. At 14 days, cross‐linked prostheses induced up‐regulated collagen 1a1 and 3a1 gene expression, while noncross‐linked only showed increased collagen III protein expression at 90 days postimplant. At 6 months, the tensile strengths of cross‐linked prostheses were significantly greater compared with ePTFE. Our findings demonstrate that despite the cross‐linked collagen prostheses promoting less tissue ingrowth than the noncross‐linked meshes, they became gradually replaced by good quality host tissue and were less rapidly degraded, leading to improved stress resistance in the long term.
Increased in vitro differentiation of fibrocytes from keloid patients is inhibited by serum amyloid P
Authors: Naylor Michelle C. , Lazar David A. , Zamora Irving J. , Mushin Oren P. , Yu Ling , Brissett Anthony E. , Olutoye Oluyinka O.
Published: May 2012

Keloid scarring is a form of fibroproliferative dermal wound healing characterized by growth beyond the confines of the original wound. Fibrocytes, derived from peripheral blood mononuclear cells and inhibited by serum amyloid P (SAP), have been linked to other fibroproliferative diseases. We hypothesized that peripheral blood mononuclear cells of keloid formers have a higher propensity to differentiate into fibrocytes and are more resistant to the effects of SAP. To test this hypothesis, plasma was isolated from peripheral blood samples of keloid (n = 10) and age/sex/race‐matched control (n = 10) subjects, and SAP levels were measured by enzyme‐linked immunosorbent assay. Equal numbers of peripheral blood mononuclear cells were also isolated from these samples and fibrocytes cultured in serum‐free media with increasing concentrations of SAP. No difference in plasma SAP levels was found between keloid and control subjects. In the absence of SAP, keloid patients (n = 7) had almost 20 times more fibrocytes than controls (n = 7) in culture (median: 1,087 cells vs. 60 cells; p < 0.01). SAP inhibited the differentiation of keloid fibrocytes in vitro, although a higher concentration of SAP was needed when compared with controls (20 μg/mL keloid vs. 5 μg/mL control). Fibrocytes may contribute to the pathogenesis of keloids, and SAP has potential as a therapeutic agent in the prevention of these lesions.
A systematic review of the performance of instruments designed to measure the dimensions of pressure ulcers
Authors: O'Meara Susan M. , Bland J. Martin , Dumville Jo C. , Cullum Nicky A.
Published: May 2012

The objective was to undertake a systematic review of the performance of wound measurement instruments used for patients with pressure ulcers. Studies of any design, evaluating methods for estimating wound diameter, depth, surface area, or volume in patients with pressure ulcers were included. Eligible evaluations had to report intra‐ or inter‐rater reliability, accuracy, agreement, or feasibility of methods. Electronic databases and other sources were accessed for study identification. Included studies were critically appraised using a modified checklist for diagnostic test evaluations. Twelve studies were included. Most had methodological problems and/or used inappropriate statistical methods. Reliable methods for measuring pressure ulcer surface area may include: grid tracings from photographs combined with whole plus partial square count; a portable digital pad; and stereophotogrammetry combined with computerized image analysis. The agreement between photographic tracing and direct transparency tracing may be satisfactory (both methods being combined with computerized planimetry). No definitive conclusions could be reached about studies of diameter or depth; this means that there is little evidence to underpin recommendations in clinical guidelines. Evaluations of volume measurement were of poor quality, and there were few data on feasibility. Further primary research is needed to evaluate methods of wound measurement used in clinical practice.
Analysis of the proteomic profile of chronic pressure ulcers
Authors: Edsberg Laura E. , Wyffels Jennifer T. , Brogan Michael S. , Fries Kristin M.
Published: May 2012

Analysis of the proteomic profile of pressure ulcers over time is a critical step in the identification of biomarkers of healing or nonhealing in pressure ulcers. The wound fluid from 32 subjects with 42 pressure ulcers was evaluated over 6 weeks at 15 time points. Samples specific to both the interior and the periphery of the wound bed were collected. Antibody screening arrays, isobaric tags for relative and absolute quantitation with mass spectrometry and multiplexed microarrays were used to characterize wound fluid and results were correlated with clinical outcome. Twenty‐one proteins were found to distinguish between healed and chronic wounds and 19 proteins were differentially expressed between the interior and periphery of wounds. Four proteins, pyruvate kinase isozymes M1/M2, profilin‐1, Ig lambda‐1 chain C regions, and Ig gamma‐1 chain C region, were present in lower levels for periphery samples when compared to interior samples and six proteins, keratin, type II cytoskeletal 6A (KRT6A), keratin, type I cytoskeletal 14, S100 calcium binding proteins A7, alpha‐1‐antitrypsin precursor, hemoglobin subunit alpha, and hemoglobin subunit beta, were present in higher levels in periphery samples when compared with interior samples. S100 calcium binding protein A6, S100 calcium binding protein A7, and soluble receptor for advanced glycation end‐products had higher levels in the periphery of chronic wounds vs. the interior in planar arrays. A significant temporal trend was noted for monokine induced by gamma interferon (MIG), synonomous with chemokine (C‐X‐C motif) ligand 9 (CXCL9), which increased as wounds healed and remained nearly constant for ulcers that were not approaching closure.
Rosiglitazone modulates the behaviors of diabetic host‐derived fibroblasts in a carboxymethyllysine‐modified collagen model
Authors: Liao Huijuan , Pastar Irena , Chen Weiliam
Published: May 2012

Utilizing a three‐dimensional in vitro glycated collagen model, we evaluated the therapeutic effects of a peroxisome proliferator‐activated receptor‐γ ligand, rosiglitazone, and its potential as a topical treatment of diabetic chronic wounds. Rosiglitazone induced fibroblast migration, α‐smooth muscle actin production, and transformation into myofibroblasts in the presence of advanced glycation end products. Both transforming growth factor β and peroxisome proliferator‐activated receptor‐γ expression were induced, while the receptor for advanced glycation end products was suppressed. Lastly, the reduced activities of matrix metalloproteinase‐2 and matrix metalloproteinases‐9 in the carboxymethyllysine‐modified collagen matrices by rosiglitazone increases extracellular matrix deposition. Our findings identify rosiglitazone as a candidate for localized topical treatment of diabetic chronic wounds.
Pulsed Radiofrequency of Suprascapular Nerve for Chronic Shoulder Pain: A Randomized Double‐Blind Active Placebo‐Controlled Study
Authors: Gofeld Michael , Restrepo‐Garces Carlos E. , Theodore Brian R. , Faclier Gil
Published: May 2012

Background:  The suprascapular nerve block is frequently implemented to treat chronic shoulder pain. Although effective the nerve blockade provides only a short‐term relief, and more compelling apaproaches have been investigated. Pulsed radiofrequency (pRF) has been anecdotally reported as safe and reliable method. However, formal efficacy study has not been published. Ostensibly evidence‐based validation of a new method is necessary for both scholastic and practical purposes.

Methods:  This study was designed as a randomized active placebo‐control double‐blind trial. Because of encountered difficulties in recruitment and high rate of dropout, the study was redesigned as to allow a smaller sample size and statistical analyses were performed utilizing the last observation carry forward method. Lidocaine injections alone or with combination of the pRF were performed. Participants were followed up during 6 months, and multiple subjective and objective outcome variables were recorded.

Results:  Thirteen of 22 participants completed 6 months follow‐up. Dropout rate was higher in the lidocaine group. A significant linear trend (P < 0.05) for improvement on the numeric rating scale, Shoulder Pain and Disability Index and Constant‐Murley score was observed in the pRF group, but not in the lidocaine group. Patients in the pRF group were on average more satisfied than the lidocaine group at 1 month (P = 0.041) and at 3 months (P = 0.035).

Discussion:  Considering limitations of the study design and statistics, it seems plausible to attribute better results in the pRF group to unique properties of this physical modality.
A national mapping assessment of blood collection and transfusion service facilities in Afghanistan
Authors: Mansoor G. Farooq , Rahmani Ahmad Masoud , Kakar M. Aziz , Hashimy Pashtoon , Abrahimi Parwiz , Scott Paul T. , Peel Sheila A. , Rentas Francisco J. , Todd Catherine S.
Published: May 2012

BACKGROUND: The purpose of this study was to assess functionality and resources of facilities providing blood collection and transfusion services in Afghanistan.

STUDY DESIGN AND METHODS: This national cross‐sectional assessment included facilities collecting or transfusing blood identified through official data sources and private key informants. At each facility, study representatives completed a standardized instrument assessing presence of records logbook, electricity, refrigeration, and required transfusion‐transmitted infection (TTI; human immunodeficiency virus, syphilis, and hepatitis B and C) test kits. Descriptive statistics were generated, with differences analyzed using chi‐square or Fisher's exact tests.

RESULTS: Between August and November 2010, a total of 243 facilities were surveyed with public (52.3%, n = 127) and private (43.2%, n = 105) sector comprising the majority. Most (63%) facilities were urban, with 23.5% located in Kabul province. Of 92,682 units collected nationally in the 12 months before evaluation, 7.5% (n = 6952) had no disposition record. Many (62%, n = 151) facilities had an established recordkeeping system; the remainder provided estimates. Half of surveyed facilities had regular power supply (57.8%), refrigerators for storing blood (52.3%), or all necessary TTI test kits (62.1%). Military (83.3%) and public (74.8%) facilities were more likely to have all TTI test kits present compared to private (46.7%, p < 0.01) but not nongovernmental organization (40.0%, p = 0.37) facilities.

CONCLUSION: In Afghanistan, blood donation and transfusion occur with substantial differences in data recording and TTI test availability, with private facilities less likely to have these resources. Efforts are needed to improve available resources and ensure that facilities are in compliance with national standards for donor screening.
The Contribution of In‐house and External Design Activities to Product Market Performance
Authors: Czarnitzki Dirk , Thorwarth Susanne
Published: May 2012

Design may be seen as one of several key factors contributing to new product development, along with research and development, marketing, manufacturing, purchasing, etc. More and more, creative design comes to the fore, and many companies believe that superior design will be the key to winning customers. It has the ability to create corporate distinctiveness and also possesses the potential to give a product an individual or new look. Furthermore, the model of open innovation suggests that firms can and should use external and internal knowledge flows in order to create valuable ideas, and also internal and external paths to the market. Also, in the design process, a common trend toward external design skills has emerged in recent years. Due to cost and control factors, firms are increasingly outsourcing design activities. By using a sample of Belgian companies, this paper explores the contribution of design activities to product market performance. While there is mounting evidence that design can be seen as a strategic tool to successfully spur sales of new product developments at the firm level, the topic of design innovation has not yet been linked to the open innovation concept. In this paper, it is empirically tested whether design activities conducted in house differ in their contribution to new product sales from externally acquired design. So, do design activities that have been developed only with internal resources lead to a greater success than those that have been carried out with external sources of knowledge? Using a large cross‐section of manufacturing and service firms, the effects on sales of products new to the market and of imitations or significantly improved products of the firm are investigated. At first glance, the findings indicate that externally acquired design is not superior to in‐house design activities: the results show that only design activities that are mainly conducted with internal knowledge sources play a crucial role regarding the product innovation's success with market novelties. Design conducted in collaboration with external partners, however, has no significant influence. This is not the case for imitations, that is, products only new to the firm. Their success is also influenced by design activities developed with external collaborators. This effect is robust for several modifications of the model specification. In contrast to earlier literature on new technological developments, this paper argues that external design may not affect the sales of market novelties as the “market news” may spill over quickly to rivals through common suppliers including external designers.
Individualized reduction in dialysate sodium in conventional in‐center hemodialysis
Authors: Arramreddy Rohini , Sun Sumi J. , Munoz Mendoza Jair , Chertow Glenn M. , Schiller Brigitte
Published: May 2012

Recent studies have focused on the association between dialysate sodium (Na+) prescriptions and interdialytic weight gain (IDWG). We report on a case series of 13 patients undergoing conventional, thrice‐weekly in‐center hemodialysis with an individualized dialysate Na+ prescription. Individualized dialysate Na+ was achieved in all patients through a stepwise weekly reduction of the standard dialysate Na+ prescription (140 mEq/L) by 2–3 mEq/L until reaching a Na+ gradient of −2 mEq/L (dialysate Na+ minus average plasma Na+ over the preceding 3 months). Interdialytic weight gain, with and without indexing to dry weight (IDWG%), blood pressure, and the proportion of treatments with cramps, intradialytic hypotension (drop in systolic blood pressure >30 mmHg) and intradialytic hypotension requiring an intervention were reviewed. At the beginning of the observation period, the pre‐hemodialysis (HD) plasma Na+ concentration ranged from 130 to 141 mEq/L. When switched from the standard to the individualized dialysate Na+ concentration, IDWG% decreased from 3.4% ± 1.6% to 2.5% ± 1.0% (P = 0.003) with no change in pre‐ or post‐HD systolic or diastolic blood pressures (all P > 0.05). We found no significant change in the proportion of treatments with cramps (6% vs. 13%), intradialytic hypotension (62% vs. 65%), or intradialytic hypotension requiring an intervention (29% vs. 33%). Individualized reduction of dialysate Na+ reduces IDWG% without significantly increasing the frequency of cramps or hypotension.
A Fatal Case of Anaphylactic Shock During Paragliding
Authors: Feltracco Paolo , Barbieri Stefania , Galligioni Helmut , Pasin Laura , Gaudio Rosa Maria , Tommasi Aurelio , Zucchetto Alessandro , Trevisiol Paride , Ori Carlo , Avato Francesco Maria
Published: May 2012

Abstract:  The growth in popularity of flying ultralight aircraft and paragliding has been associated with an increased involvement of Emergency Medical Services because of various types of trauma suffered from both inexperienced and skilled individuals. This case presentation reports on a paraglider pilot, who was seen spinning “unusually” rapidly toward the ground, without visible attempts to regain control of the aircraft. Besides the bilateral mydriasis and the absence of any ECG activity, there was a significant swelling of face, lips, neck, and tongue. Upon opening the mouth, a dead bee was found over the tongue, underneath the palate. A fatal anaphylactic shock was the likely cause of death of the pilot while still “in mid‐air.” This case is certainly different from the commonly reported accidents during paragliding. An updated review of the medical literature shows no reported cases of fatal anaphylactic shock during the practice of paragliding.
Juvenile and Adult Offenders Arrested for Sexual Homicide: An Analysis of Victim–Offender Relationship and Weapon Used by Race*
Authors: Chan Heng Choon (Oliver) , Heide Kathleen M. , Myers Wade C.
Published: May 2012

Abstract:  Limited information is available on racial offending patterns of sexual homicide offenders (SHOs). This study used a 30‐year U.S. Supplementary Homicide Reports sample of SHOs arrested in single‐victim situations (N = 3745). The analysis strength was used to determine whether the findings yielded meaningful patterns for offender profiling. Several important findings emerged for the juvenile offenders. Juvenile White SHOs were likely to target victims with whom they shared a mutual relationship. In contrast, Black juveniles were equally likely to murder strangers and those with whom they had prior and familial relationships. Notably, no juvenile Black SHOs were arrested for murdering intimate partners. Juvenile White SHOs were twice as likely to use edged weapons as their Black counterparts. Black juveniles, conversely, were more likely than White juveniles to use personal weapons. Beyond these findings, known victim–offender relationships and weapon used may not have significant utility for investigators in identifying the SHO race, even after controlling for offender age. Limitations and future directions are discussed.
Shark‐Inflicted Trauma: A Case Study of Unidentified Remains Recovered from the Gulf of Mexico*
Authors: Allaire Maria T. , Manhein Mary H. , Burgess George H.
Published: May 2012

Abstract:  Here, we present a case of an unidentified male whose remains, except for the right arm, were recovered from the Gulf of Mexico 10 years prior to osteological analysis by forensic anthropologists. After the poorly preserved soft tissue was removed and the bones cleaned, forensic analysis revealed an unusual series of hard tissue trauma later attributed by a shark expert as shark scavenging and/or predation. Identified were five unique hard tissue trauma patterns that are bite mark artifacts produced by sharks: punctures without fractures, punctures with associated fractures, striations with bone shaving, overlapping striations, and incised bone gouges. The cooperation among experts provided a comprehensive death case analysis and a better understanding of shark‐inflicted trauma on human skeletal remains.
Clinical features and prognostic model for extranasal NK/T‐cell lymphoma
Authors: Jo Jae‐Cheol , Yoon Dok Hyun , Kim Shin , Lee Bong‐Jae , Jang Yong Ju , Park Chan‐Sik , Huh Jooryung , Lee Sang‐Wook , Ryu Jin‐Sook , Suh Cheolwon
Published: May 2012

Objective

The clinical features of extranodal natural killer (NK)/T‐cell lymphoma (ENKL) that originates in extranasal sites are less well defined than those of ENKL that originates in nasal sites. Therefore, we compared the clinical characteristics and prognoses of patients with nasal ENKL and patients with extranasal ENKL.

Methods

We retrospectively analyzed 117 consecutive patients with ENKL that included 89 (76.1%) with nasal and 28 (23.9%) with extranasal disease.

Results

Extranasal ENKL was associated with more adverse clinical features than nasal ENKL, which included the presence of B symptoms, stage III/IV disease, ≥2 extranodal sites, and involvement of regional lymph nodes and bone marrow. After a median follow‐up of 33.1 months (range, 0.7–152.2 months), the median overall survival (OS) of patients with extranasal and nasal NK/T‐cell lymphoma was 8.6 and 86.5 months, respectively. Multivariate analysis revealed that extranasal NK/T‐cell lymphoma was a significant factor that affects OS. When patients with extranasal ENKL were classified into low‐risk and high‐risk categories according to the Korean Prognostic Index (KPI) and International Prognostic Index (IPI), these indices categorized the two groups with significantly different survival outcomes (P = 0.025 and 0.035, respectively).

Conclusions

Patients with extranasal ENKL have worse clinical outcomes than those with nasal ENKL. The KPI and IPI appear useful for the prognosis of patients with extranasal ENKL.
Mouse Samd9l is not a functional paralogue of the human SAMD9, the gene mutated in normophosphataemic familial tumoral calcinosis
Authors: Li Qiaoli , Guo Haitao , Matsui Hirotaka , Honda Hiroaki , Inaba Toshiya , Sundberg John P. , Sprecher Eli , Uitto Jouni
Published: May 2012

Normophosphataemic familial tumoral calcinosis, charac‐terized by ectopic mineralization of skin, is caused by mutations in the SAMD9 gene located in human chromosome 7q21, next to a paralogous gene, SAMD9‐like (SAMD9L). The mouse does not have a SAMD9 orthologue, Samd9, because it has been deleted during evolution owing to genomic rearrangements. It has been suggested that the mouse Samd9l gene serves as a functional paralogue of human SAMD9. In this study, we examined Samd9l knockout mice with respect to ectopic mineralization. We also crossed these mice with Abcc6tm1JfK mice, a model system to study pseudoxanthoma elasticum, to see whether the absence of the Samd9l gene modifies the mineralization process. Necropsy analysis of Samd9ltm1Homy mice revealed no evidence of ectopic mineralization, and deletion of the Samd9l gene in mice failed to modify the mineralization process on the Abcc6tm1JfK background. Collectively, the results suggest that mouse Samd9l is not a functional paralogue of human SAMD9.