bluuebunny/crossref_metadata_2025 huggingface dataset:
Modelling seasonal variations in the age and incidence of Kawasaki disease to explore possible infectious aetiologies
Authors: Pitzer Virginia E. , Burgner David , Viboud Cécile , Simonsen Lone , Andreasen Viggo , Steiner Claudia A. , Lipsitch Marc
Published: March 2012

The average age of infection is expected to vary during seasonal epidemics in a way that is predictable from the epidemiological features, such as the duration of infectiousness and the nature of population mixing. However, it is not known whether such changes can be detected and verified using routinely collected data. We examined the correlation between the weekly number and average age of cases using data on pre-vaccination measles and rotavirus. We show that age–incidence patterns can be observed and predicted for these childhood infections. Incorporating additional information about important features of the transmission dynamics improves the correspondence between model predictions and empirical data. We then explored whether knowledge of the age–incidence pattern can shed light on the epidemiological features of diseases of unknown aetiology, such as Kawasaki disease (KD). Our results indicate KD is unlikely to be triggered by a single acute immunizing infection, but is consistent with an infection of longer duration, a non-immunizing infection or co-infection with an acute agent and one with longer duration. Age–incidence patterns can lend insight into important epidemiological features of infections, providing information on transmission-relevant population mixing for known infections and clues about the aetiology of complex paediatric diseases.
Brood care and social evolution in termites
Authors: Korb Judith , Buschmann Michael , Schafberg Saskia , Liebig Jürgen , Bagnères Anne-Geneviève
Published: March 2012

Cooperative brood care is assumed to be the common driving factor leading to sociality. While this seems to be true for social Hymenoptera and many cooperatively breeding vertebrates, the importance of brood care for the evolution of eusociality in termites is unclear. A first step in elucidating this problem is an assessment of the ancestral condition in termites. We investigated this by determining the overall level of brood care behaviour across four termite species that cover the phylogenetic diversity of the lower termites. Brood care was low in the three species (all from different families) that had an ancestral wood-dwelling lifestyle of living in a single piece of wood that serves as food and shelter. In the fourth species, a lower termite that evolved outside foraging, brood care was more common. Together with data for higher termites, this suggests that brood care in termites only becomes important when switching from a wood-dwelling to a foraging lifestyle. These results imply that early social evolution in termites was driven by benefits of increased defence, while eusociality in Hymenoptera and cooperative breeding in birds and mammals are primarily based on brood care.
Close kinship within multiple-genotype malaria parasite infections
Authors: Nkhoma Standwell C. , Nair Shalini , Cheeseman Ian H. , Rohr-Allegrini Cherise , Singlam Sittaporn , Nosten François , Anderson Tim J. C.
Published: March 2012

Malaria infections containing multiple parasite genotypes are ubiquitous in nature, and play a central role in models of recombination, intra-host dynamics, virulence, sex ratio, immunity and drug resistance evolution in
Plasmodium
. While these multiple infections (MIs) are often assumed to result from superinfection (bites from multiple infected mosquitoes), we know remarkably little about their composition or generation. We isolated 336 parasite clones from eight patients from Malawi (high transmission) and six from Thailand (low transmission) by dilution cloning. These were genotyped using 384 single-nucleotide polymorphisms, revealing 22 independent haplotypes in Malawi (2–6 per MI) and 15 in Thailand (2–5 per MI). Surprisingly, all six patients from Thailand and six of eight from Malawi contained related haplotypes, and haplotypes were more similar within- than between-infections. These results argue against a simple superinfection model. Instead, the observed kinship patterns may be explained by inoculation of multiple related haploid sporozoites from single mosquito bites, by immune suppression of parasite subpopulations within infections, and serial transmission of related parasites between people. That relatedness is maintained in endemic areas in the face of repeated bites from infected mosquitoes has profound implications for understanding malaria transmission, immunity and intra-host dynamics of co-infecting parasite genotypes.
A hydrothermal seep on the Costa Rica margin: middle ground in a continuum of reducing ecosystems
Authors: Levin Lisa A. , Orphan Victoria J. , Rouse Greg W. , Rathburn Anthony E. , Ussler William , Cook Geoffrey S. , Goffredi Shana K. , Perez Elena M. , Waren Anders , Grupe Benjamin M. , Chadwick Grayson , Strickrott Bruce
Published: March 2012

Upon their initial discovery, hydrothermal vents and methane seeps were considered to be related but distinct ecosystems, with different distributions, geomorphology, temperatures, geochemical properties and mostly different species. However, subsequently discovered vents and seep systems have blurred this distinction. Here, we report on a composite, hydrothermal seep ecosystem at a subducting seamount on the convergent Costa Rica margin that represents an intermediate between vent and seep ecosystems. Diffuse flow of shimmering, warm fluids with high methane concentrations supports a mixture of microbes, animal species, assemblages and trophic pathways with vent and seep affinities. Their coexistence reinforces the continuity of reducing environments and exemplifies a setting conducive to interactive evolution of vent and seep biota.
OsMYB2P-1, an R2R3 MYB Transcription Factor, Is Involved in the Regulation of Phosphate-Starvation Responses and Root Architecture in Rice
Authors: Dai Xiaoyan , Wang Yuanyuan , Yang An , Zhang Wen-Hao
Published: March 2012

An R2R3 MYB transcription factor, OsMYB2P-1, was identified from microarray data by monitoring the expression profile of rice (Oryza sativa ssp. japonica) seedlings exposed to phosphate (Pi)-deficient medium. Expression of OsMYB2P-1 was induced by Pi starvation. OsMYB2P-1 was localized in the nuclei and exhibited transcriptional activation activity. Overexpression of OsMYB2P-1 in Arabidopsis (Arabidopsis thaliana) and rice enhanced tolerance to Pi starvation, while suppression of OsMYB2P-1 by RNA interference in rice rendered the transgenic rice more sensitive to Pi deficiency. Furthermore, primary roots of OsMYB2P-1-overexpressing plants were shorter than those in wild-type plants under Pi-sufficient conditions, while primary roots and adventitious roots of OsMYB2P-1-overexpressing plants were longer than those of wild-type plants under Pi-deficient conditions. These results suggest that OsMYB2P-1 may also be associated with the regulation of root system architecture. Overexpression of OsMYB2P-1 led to greater expression of Pi-responsive genes such as Oryza sativa UDP-sulfoquinovose synthase, OsIPS1, OsPAP10, OsmiR399a, and OsmiR399j. In contrast, overexpression of OsMYB2P-1 suppressed the expression of OsPHO2 under both Pi-sufficient and Pi-deficient conditions. Moreover, expression of OsPT2, which encodes a low-affinity Pi transporter, was up-regulated in OsMYB2P-1-overexpressing plants under Pi-sufficient conditions, whereas expression of the high-affinity Pi transporters OsPT6, OsPT8, and OsPT10 was up-regulated by overexpression of OsMYB2P-1 under Pi-deficient conditions, suggesting that OsMYB2P-1 may act as a Pi-dependent regulator in controlling the expression of Pi transporters. These findings demonstrate that OsMYB2P-1 is a novel R2R3 MYB transcriptional factor associated with Pi starvation signaling in rice.
6-Bromoindigo dye
Authors: Szalda David J. , Ramig Keith , Lavinda Olga , Koren Zvi C. , Massa Lou
Published: March 2012

6-Bromoindigo (MBI) [systematic name: 6-bromo-2-(3-oxo-2,3-dihydro-1H-indol-2-ylidene)-2,3-dihydro-1H-indol-3-one], C16H9BrN2O2, crystallizes with one disordered molecule in the asymmetric unit about a pseudo-inversion center, as shown by the Br-atom disorder of 0.682 (3):0.318 (3). The 18 indigo ring atoms occupy two sites which are displaced by 0.34 Å from each other as a result of this packing disorder. This difference in occupancy factors results in each atom in the reported model used to represent the two disordered sites being 0.08 Å from the higher-occupancy site and 0.26 Å from the lower-occupancy site. Thus, as a result of the disorder, the C—Br bond lengths in the disordered components are 0.08 and 0.26 Å shorter than those found in 6,6′-dibromoindigo (DBI) [Süsse & Krampe (1979).Naturwissenschaften,66, 110], although the distances within the indigo ring are similar to those found in DBI. The crystals are also twinned by merohedry. Stacking interactions and hydrogen bonds are similar to those found in the structures of indigo and DBI. In MBI, an interaction of the type C—Br...C replaces the C—Br...Br interactions found in DBI. The interactions in MBI were calculated quantum mechanically using density functional theory and the quantum theory of atoms in molecules.
Novel anti‐acne actions of nadifloxacin and clindamycin that inhibit the production of sebum, prostaglandin E2 and promatrix metalloproteinase‐2 in hamster sebocytes
Authors: SATO Takashi , SHIRANE Tatsuhiko , NOGUCHI Norihisa , SASATSU Masanori , ITO Akira
Published: March 2012

Acne vulgaris is characteristic of excess sebum production and the induction of inflammatory reactions, for example, the augmentation of cytokine, prostaglandin (PG) and matrix metalloproteinase (MMP) production in sebaceous glands and pilosebaceous units. As Propionibacterium acnes is considered to be involved in the aggravation of acne vulgaris, antimicrobial agents have been found to be effective for treating acne leading to the remission of inflammation. However, it is not fully understood whether antimicrobial agents influence sebum production and/or the inflammatory reactions in sebaceous gland cells (sebocytes). In the present study, topical antimicrobial agents such as nadifloxacin (NDFX) and clindamycin (CLDM) decreased the production of triacylglycerols (TG), which are a major component of sebum in insulin‐differentiated hamster sebocytes. These antibiotics also suppressed insulin‐augmented gene expression and the production of perilipin, by which intracellular lipid droplet formation was concomitantly inhibited. On the other hand, peptidoglycan (PGN) from Gram‐positive bacteria dose‐dependently increased TG production in hamster sebocytes. The augmented TG production was decreased by treating NDFX or CLDM. Furthermore, NDFX and CLDM inhibited the PGN‐augmented PGE2 production in the sebocytes. Moreover, NDFX, but not CLDM, suppressed the PGN‐augmented gene expression and production of pro‐MMP‐2/progelatinase A in hamster sebocytes. Therefore, these results provide novel evidence that NDFX and CLDM exhibit anti‐lipogenesis and anti‐inflammatory activities against insulin‐ or PGN‐activated sebocytes which at least partly mimic acne pathology in vitro. Moreover, NDFX for acne therapy is likely to be effective in not only inhibiting microbial proliferation but also in preventing the onset of acne scar formation.
Single‐nucleotide polymorphisms in the promoter of the growth hormone‐releasing hormone receptor gene are associated with growth and reproduction traits in chickens
Authors: Liu W. , Yu Y. , Li G. , Tang S. , Zhang Y. , Wang Y. , Zhang S. , Zhang Y.
Published: March 2012

Growth hormone‐releasing hormone receptor (GHRHR) plays a critical role in growth hormone (GH) synthesis, release and regulation in animals. The objective of this study was to investigate variations of the chicken GHRHR gene and their associations with growth and reproduction traits in 768 Beijing You chickens. Results revealed three single nucleotide polymorphisms (SNPs) in the promoter region of the gene (g.‐1654A>G, g.‐1411A>G and g.‐142T>C). Association analysis revealed that the novel SNP g.‐1654A>G had significant effects on chicken body weight at 7, 9, 11, 13, 17 weeks of age and the age of first egg as well as egg number at 32, 36 and 40 weeks. Significant association was also observed between g.‐1411A>G and g.‐142T>C with EN24. Moreover, the age of first egg was distinctly related with g.‐142T>C (P < 0.05). Although significant statistical difference was not detected in GHRHR mRNA levels among genotypes of the SNPs (P > 0.05), strong expression variations of the gene were found between the ages 17 and 20 weeks in the population (P < 0.05). These results suggest that the three SNPs in the GHRHR promoter could be used as potential genetic markers to improve the growth and reproductive traits in chickens.
Association of leptin genotypes with beef cattle characteristics
Authors: Woronuk G. N. , Marquess F. L. , James S. T. , Palmer J. , Berryere T. , Deobald H. , Howie S. , Kononoff P. J.
Published: March 2012

A single nucleotide polymorphism (C/T) in bovine leptin, resulting in an arginine to cysteine amino acid substitution (p.Arg25Cys), has previously been shown to have an impact on carcass characteristics. Given the significant energetic relationship between fat and animal efficiency, further evaluation of this SNP across larger animal populations is warranted. Of the total number of 136 286 genotyped cattle in this study, 92 112 and 53 189 were analysed for backfat and body weight measurements, respectively. Results showed a significant positive relationship (P < 0.0001) between the T allele frequency and animal backfat, with TT, CT and CC animals having estimates of 6.79 ± 0.02, 6.49 ± 0.01 and 6.28 ± 0.01 mm, respectively. Calculations using rate of backfat accretion showed that animals with CC genotypes would require more days to reach 12 mm of backfat (45 days) than animals with CT (42 days) and TT (38 days) genotypes. Animal weight was also shown to be positively associated (P < 0.0001) with genotype, as animals of the TT, CT and CC genotypes weighed 484.2 ± 0.7, 488.0 ± 0.5 and 487.3 ± 0.6 kg, respectively, further underscoring the effects of this SNP on key market cattle characteristics.
Safety profile of enantiomers vs. racemic mixtures: it's the same?
Authors: Caillet Céline , Chauvelot‐Moachon Laurence , Montastruc Jean‐Louis , Bagheri Haleh ,   French Association of Regional Pharmacovigilance Centers
Published: March 2012

WHAT IS ALREADY KNOWN ABOUT THIS SUBJECT

• The physicochemical properties of racemates and stereoisomers of medicines can differ significantly, and this may affect the side‐effect profile in addition to the pharmacokinetics and intended pharmacology.

WHAT THIS STUDY ADDS

• This is a study to investigate the profile of adverse drug reactions of racemic and enantiomeric forms of drugs. Our data suggest differences in the safety profile for ofloxacin and omeprazole.

• This area requires more work to investigate this for other compounds.

AIMS The objective was to investigate the safety profile of four drugs marketed as racemic and enantiomeric forms in France.

METHODS Data from the French PharmacoVigilance Data Base (January 2005 to June 2010) were analysed for four pairs of racemic/isomeric drugs. A case–noncase approach was used to measure the disproportionality of combination between adverse drug reaction (ADR) and exposure to drug.

RESULTS No significant difference in the number of ADRs was observed between Rac‐cetirizine/(R)‐cetirizine or Rac‐citalopram/(S)‐citalopram pairs. (S)‐Omeprazole induced more haematological effects than Rac‐omeprazole. Rac‐Ofloxacin induced more haematological, renal and neuropsychiatric ADRs than (S)‐ofloxacin, whereas levofloxacin was associated with more reports of musculoskeletal ADRs.

CONCLUSIONS The profile of ADRs could differ for some drugs marketed as racemic and enantiomeric forms. Further studies would be necessary to confirm these data.
Groundwater seepage stimulates the growth of aquatic macrophytes
Authors: FRANDSEN METTE , NILSSON BERTEL , ENGESGAARD PETER , PEDERSEN OLE
Published: March 2012

1. The impact of groundwater seepage on the growth of submerged macrophytes was investigated in experiments on the isoetid Littorella uniflora and the elodeid Myriophyllum alterniflorum both in the laboratory and in the field. Isoetids rely mostly on sediment‐derived CO2 and nutrients via root uptake, whereas elodeids acquire their inorganic carbon and nutrients from the water column. We thus hypothesised that L. uniflora would respond positively to seeping ground water as it should improve both CO2 and nutrient supply.

2. Laboratory experiments were conducted by percolating vegetated cores containing natural sediment or technical sand with artificial ground water of high CO2 concentrations and with either high or low levels of nutrients. Field experiments were conducted in the oligotrophic Lake Hampen, Denmark, with custom‐built seepage‐growth chambers that permitted a near‐natural flow‐through of seeping ground water. Chambers with a solid bottom, and thus no flow‐through of seeping ground water, served as controls in both laboratory and field experiments. In the field, seepage chambers were installed at a site with relatively high seepage fluxes (ground water from forest catchment), at a site with much lower seepage fluxes but with higher nutrient concentrations (ground water from agricultural catchment) and at a reference site with no net discharge or recharge of ground water.

3. Positive growth responses were observed in the field at transects with high groundwater discharge compared to the control chambers with no seepage. No growth response was observed at the reference transect with low or alternating direction of groundwater seepage. The growth rates of L. uniflora in the field were significantly higher in seepage treatments compared to control treatments, and final plant mass was up to 70% higher than that for plants where seepage was excluded. In areas with high groundwater discharge, a strong positive correlation was found between groundwater seepage fluxes, growth rates, and final plant mass for L. uniflora, while there was no such relationship at the reference transect. The growth of M. alterniflorum was also significantly affected by groundwater seepage, but to a lesser degree than L. uniflora. Laboratory experiments generally showed the same trend for both L. uniflora and M. alterniflorum, and the positive influence of seeping ground water was apparently related to increased inorganic carbon supply and, to a lesser degree, improved nutrient availability.

4. Groundwater discharge results in enhanced growth of isoetids and to some extent elodeids inhabiting a groundwater‐fed softwater lake. We propose that the shallow dense vegetation present where most of the discharge takes place acts as a biological filter that retains nutrients that otherwise would end up in the water column and could result in increased algal growth.
Managing the impacts of nutrient enrichment on river systems: dealing with complex uncertainties in risk analyses
Authors: PAGE T. , HEATHWAITE A. L. , MOSS B. , REYNOLDS C. , BEVEN K. J. , POPE L. , WILLOWS R.
Published: March 2012

1. Rivers and their catchments are complex, dynamic and non‐equilibrium systems. Although the general functioning of these ecosystems is familiar, the characteristics of particular sites are often poorly known and accurate prediction of future behaviour to inform management decisions is extremely difficult.

2. Simple relationships between river nutrient concentrations and the health of river ecosystems do not exist. Natural variability and practical and technical constraints reduce our ability to set nutrient targets to protect river ecosystems. Particularly challenging is the use of simple dose–response relationships as regulatory threshold targets, whereby sections of river are classified as either passing or failing to meet good ecological status.

3. Ecologically meaningful frameworks are needed that take account of the epistemic uncertainty associated with our predictions. Such frameworks should have clearly defined goals; be holistic; allow for natural variability; help to define ecologically acceptable environmental regimes; recognise that significant uncertainties mean that we will often be using indices rather than absolute measures; and use measures that explicitly include uncertainty estimates. Such approaches allow those outside the decision‐making process to understand the level of environmental precaution included in the management of complex systems.
How river structure and biological traits influence gene flow: a population genetic study of two stream invertebrates with differing dispersal abilities
Authors: ALP MARIA , KELLER IRENE , WESTRAM ANJA MARIE , ROBINSON CHRISTOPHER T.
Published: March 2012

1. Determined by landscape structure as well as dispersal‐related traits of species, connectivity influences various key aspects of population biology, ranging from population persistence to genetic structure and diversity. Here, we investigated differences in small‐scale connectivity in terms of gene flow between populations of two ecologically important invertebrates with contrasting dispersal‐related traits: an amphipod (Gammarus fossarum) with a purely aquatic life cycle and a mayfly (Baetis rhodani) with a terrestrial adult stage.

2. We used highly polymorphic markers to estimate genetic differentiation between populations of both species within a Swiss pre‐alpine catchment and compared these results to the broader‐scale genetic structure within the Rhine drainage. Landscape genetic approaches were used to test for correlations of genetic and geographical structures and in‐stream barrier effects.

3. We found overall very weak genetic structure in populations of B. rhodani. In contrast, G. fossarum showed strong genetic differentiation, even at spatial scales of a few kilometres, and a clear pattern of isolation by distance. Genetic diversity decreased from downstream towards upstream populations of G. fossarum, suggesting asymmetric gene flow. Correlation of genetic structure with landscape topography was more pronounced in the amphipod. Our study also indicates that G. fossarum might be capable of dispersing overland in headwater regions and of crossing small in‐stream barriers.

4. We speculate that differences in dispersal capacity but also habitat specialisation and potentially the extent of local adaptation could be responsible for the differences in genetic differentiation found between the two species. These results highlight the importance of taking into account dispersal‐related traits when planning management and conservation strategies.
Meteorological drivers of the dynamics of autotrophic picoplankton
Authors: PELTOMAA ELINA , OJALA ANNE
Published: March 2012

1. The tiny non‐motile autotrophic picoplankton (APP; size range 0.2–2 μm) occur in all types of aquatic habitats and are comprised of prokaryotic as well as eukaryotic taxa. In the Boreal Zone, the majority of lakes have high concentrations of coloured humic substances that can adversely affect lake light climate and cause steep summertime stratification resulting in epilimnetic nutrient depletion. APP are more effective in nutrient and light acquisition than larger phytoplankton and thus should be competitive in humic lakes.

2. Most lacustrine APP studies have been based on short sampling periods, and thus, interannual variation and its drivers are still unclear. We studied APP in the small, boreal, humic Lake Valkea‐Kotinen during five open‐water periods in 2002–06 to determine interannual variation and the importance of meteorological drivers for APP dynamics.

3. Total APP showed a bimodal annual pattern, but the timing and vertical location of the two maxima varied during the study. In general, APP thrived in warm water and the most important abiotic factor controlling APP was stability of the water column (Ns). On average, 82% of APP were found in the epilimnion or metalimnion during summertime stratification.

4. There was niche separation of APP and larger phytoplankton in the lake because, with only one exception, APP maxima occurred separately from the maxima of larger phytoplankton.

5. Two groups, solitary eukaryotic APP and colonial picocyanobacteria (Merismopedia warmingiana), responded differently to the abiotic factors. Solitary APP preferred high water colour and low pH, both of which occurred after heavy rain, whereas colonial APP did not fare well when water colour was high. Our findings suggest that when future climate change‐related processes increase incoming allocthonous organic matter load from the catchment, solitary eukaryotic APP will be favoured.
Effects of burial on leaf litter quality, microbial conditioning and palatability to three shredder taxa
Authors: DANGER MICHAEL , CORNUT JULIEN , ELGER ARNAUD , CHAUVET ERIC
Published: March 2012

Summary 1. Heterotrophic microorganisms are crucial for mineralising leaf litter and rendering it more palatable to leaf‐shredding invertebrates. A substantial part of leaf litter entering running waters may be buried in the streambed and thus be exposed to the constraining conditions prevailing in the hyporheic zone. The fate of this buried organic matter and particularly the role of microbial conditioning in this habitat remain largely unexplored.

2. The aim of this study was to determine how the location of leaf litter within the streambed (i.e. at the surface or buried), as well as the leaf litter burial history, may affect the leaf‐associated aquatic hyphomycete communities and therefore leaf consumption by invertebrate detritivores. We tested the hypotheses that (i) burial of leaf litter would result in lower decomposition rates associated with changes in microbial assemblages compared with leaf litter at the surface and (ii) altered microbial conditioning of buried leaf litter would lead to decreased quality and palatability to their consumers, translating into lower growth rates of detritivores.

3. These hypotheses were tested experimentally in a second‐order stream where leaf‐associated microbial communities, as well as leaf litter decomposition rates, elemental composition and toughness, were compared across controlled treatments differing by their location within the streambed. We examined the effects of the diverse conditioning treatments on decaying leaf palatability to consumers through feeding trials on three shredder taxa including a freshwater amphipod, of which we also determined the growth rate.

4. Microbial leaf litter decomposition, fungal biomass and sporulation rates were reduced when leaf litter was buried in the hyporheic zone. While the total species richness of fungal assemblages was similar among treatments, the composition of fungal assemblages was affected by leaf litter burial in sediment.

5. Leaf litter burial markedly affected the food quality (especially P content) of leaf material, probably due to the changes in microbial conditioning. Leaf litter palatability to shredders was highest for leaves exposed at the sediment surface and tended to be negatively related to leaf litter toughness and C/P ratio. In addition, burial of leaf litter led to lower amphipod growth rates, which were positively correlated with leaf litter P content.

6. These results emphasise the importance of leaf colonisation by aquatic fungi in the hyporheic zone of headwater streams, where fungal conditioning of leaf litter appears particularly critical for nutrient and energy transfer to higher trophic levels.
Perceptual shifts of priority: a qualitative study bringing emotional intelligence to the foreground for nurses in talk‐based therapy roles
Authors: HURLEY J.
Published: March 2012

Accessible summary

Emotional intelligence capabilities have been associated with the identity of mental health nurses and as being desired attributes by users of mental health services. Simultaneously, the nursing profession is increasing its delivery of talk‐based therapies, with policy‐driven preparation for such roles prioritizing therapy approaches rather than intrapersonal capability.

This paper adds the voiced experiences of mental health nurses who construct a truth that a shifting of priorities toward developing emotionally intelligent capabilities is necessary for mental health nurses to successfully deliver talk‐based therapies.

This paper presents the findings of a qualitative study conceptually framed by social constructionism that explored the experiences of mental health nurses engaging in talk‐based therapy roles. Constructions from the participants' narratives are shown to have a powerful resonance with the construct of emotional intelligence, a resonance also echoed from the literature, and policies from the UK identified within the paper. Forwarded is that rather than prioritizing the development of technical approaches of specific therapies, nurses should equally be prepared for talk‐based therapy roles through developing their emotionally intelligence capabilities.
The orphan histidine protein kinase SgmT is a c‐di‐GMP receptor and regulates composition of the extracellular matrix together with the orphan DNA binding response regulator DigR in Myxococcus xanthus
Authors: Petters Tobias , Zhang Xin , Nesper Jutta , Treuner‐Lange Anke , Gomez‐Santos Nuria , Hoppert Michael , Jenal Urs , Søgaard‐Andersen Lotte
Published: March 2012

In Myxococcus xanthus the extracellular matrix is essential for type IV pili‐dependent motility and starvation‐induced fruiting body formation. Proteins of two‐component systems including the orphan DNA binding response regulator DigR are essential in regulating the composition of the extracellular matrix. We identify the orphan hybrid histidine kinase SgmT as the partner kinase of DigR. In addition to kinase and receiver domains, SgmT consists of an N‐terminal GAF domain and a C‐terminal GGDEF domain. The GAF domain is the primary sensor domain. The GGDEF domain binds the second messenger bis‐(3′‐5′)‐cyclic‐dimeric‐GMP (c‐di‐GMP) and functions as a c‐di‐GMP receptor to spatially sequester SgmT. We identify the DigR binding site in the promoter of the fibA gene, which encodes an abundant extracellular matrix metalloprotease. Whole‐genome expression profiling experiments in combination with the identified DigR binding site allowed the identification of the DigR regulon and suggests that SgmT/DigR regulates the expression of genes for secreted proteins and enzymes involved in secondary metabolite synthesis. We suggest that SgmT/DigR regulates extracellular matrix composition and that SgmT activity is regulated by two sensor domains with ligand binding to the GAF domain resulting in SgmT activation and c‐di‐GMP binding to the GGDEF domain resulting in spatial sequestration of SgmT.
Red blood cell storage and cell morphology
Authors: Blasi B. , D’Alessandro A. , Ramundo N. , Zolla L.
Published: March 2012

Aim: In this study, we performed weekly assessment of morphology‐related parameters through monitoring of CPD‐SAGM leuco‐filtered erythrocyte concentrates from blood withdrawal until the 42nd day of storage.

Background: Liquid storage of red blood cells (RBCs) delivers a blood‐derived therapeutic, which is safe, available, effective and affordable for most patients who need transfusion therapy in developed countries. However, a growing body of accumulating controversial evidences, from either biochemical or retrospective clinical studies, prompted safety concerns about longer stored RBCs.

Methods: Statistical image analysis through scanning electron microscope was coupled to osmotic fragility and erythrocyte sedimentation rate.

Results: We could observe that by day 21 more than 50% of RBCs displayed non‐discocyte phenotypes. This observation was related to an increase in osmotic fragility, which was totally overlapped in day 0 controls and day 7 RBCs while only slightly augmented in day 14 samples. Cation dysregulation (pH internal/external alteration and potassium) might both reflect and trigger a negative feedback loop with metabolic fluxes and membrane cation pumps.

Conclusion: Morphology parameters suggest that significant alterations to RBC morphology over storage duration occur soon after the 14th day of storage, as to become significant enough within the 21st day.
Assessment of pain in sedated and mechanically ventilated patients: an observational study
Authors: JEITZINER M. ‐M. , SCHWENDIMANN R. , HAMERS J. P. H. , ROHRER O. , HANTIKAINEN V. , JAKOB S. M.
Published: March 2012

Background

Critically ill patients often undergo unpleasant procedures. We quantified the effects of an unpleasant stimulus on physiological and behavioral parameters and evaluated how they are modified by sedation and analgesia.

Methods

A 6‐month study in the 30‐bed intensive care unit (ICU) of a university hospital examined 21 sedated patients from various diagnostic groups. Hemodynamic and respiratory parameters, pupil size, facial expression, muscle tone, body movement, and the Richmond Agitation‐Sedation Scale (RASS) score were measured before and during intratracheal suctioning, first in sedated patients, after sedation was stopped, and after an opioid bolus.

Results

Before intratracheal suctioning, patients had RASS scores of −1.8 ± 1.2 (mean ± standard deviation; sedation), −0.6 ± 1.7 (sedation stop), and −0.9 ± 1.4 (analgesia) (P = 0.014). Intratracheal suctioning significantly increased RASS during both sedation (to −0.6 ± 1.7) and sedation stop (to 1.0 ± 1.5) (both P < 0.01), but not during analgesia. Systolic blood pressure increased during sedation (by 9 ± 10 mmHg), during sedation stop (by 15 ± 17 mmHg) and during analgesia (by 9 ± 4 mmHg; all P < 0.01), but diastolic pressure only during sedation and sedation stop (both P < 0.01). Facial expression, body movement, and muscle tone changed significantly during the episodes of intratracheal suctioning. Heart rate, tidal volume, and pupil size remained stable under all conditions.

Conclusions

Intratracheal suctioning evoked significant changes in some physiological and behavioral parameters. Some physiological changes were suppressed by analgesia, but at our ICU's standard doses, neither analgesia nor sedation attenuated changes in behavioral parameters at the intensity tested.
Effect of the menstrual cycle phase on post‐operative pain perception and analgesic requirements
Authors: AHMED A. , KHAN F. , ALI M. , HAQNAWAZ F. , HUSSAIN A. , AZAM S. I.
Published: March 2012

Background

Research has shown that menstrual cycle phase may affect pain sensitivity. There is a lack of studies evaluating this effect on post‐operative pain and analgesic needs.

Methods

In this prospective cohort study, we determined the effect of menstrual cycle phase on pain perception and analgesic requirements following total abdominal hysterectomy. Sixty women with regular menstrual cycles undergoing elective surgery were recruited and divided into ‘follicular’ and ‘luteal’ groups according to their menstrual history. Post‐operative pain was managed with intravenous patient‐controlled analgesia using tramadol. Intravenous morphine was used for rescue analgesia, and pain was assessed for 24 h.

Results

Pain scores in the recovery room and ward six and 24 h post‐operatively were similar in the groups at rest and on coughing. Pain scores at rest 12 h post‐operatively were significantly higher in the luteal group (P = 0.043), while they were similar on coughing. There was no significant difference in the total tramadol requirement. Number of patients requiring rescue analgesia and the amount of morphine used was also similar.

Conclusion

There was no difference in pain scores or analgesic requirements between the two groups except for rest pain at 12 h, which was significantly higher in the luteal group. As pain was assessed at 13 different time points, a significant difference seen only at one point could be due to random chance. We suggest that future research should concentrate on studying this issue in patients of relatively younger age groups with more pronounced hormonal variations during the cycle.
Effects of propofol with hyperthermia in a rat model of endotoxemic shock
Authors: MUKAWA C. , TANIGUCHI T.
Published: March 2012

Background

We aimed to investigate the effects of active mild hyperthermia and the effects of active mild hyperthermia with propofol on mortality and inflammatory responses during endotoxin‐induced shock in rats.

Methods

Intravenous Escherichia coli endotoxin (15 mg/kg over 2 min) was injected in 48 rats. The animals were randomly allocated to one of the following four groups (n = 12 per group): normothermia group (group N), rectal temperature maintained between 36 °C and 38 °C; hyperthermia group (group H), rectal temperature was moderate and maintained between 39 °C and 40 °C; propofol with normothermia group (group PN), propofol (10 mg/kg/h) was administered, and temperature was between 36 °C and 38 °C; Propofol with hyperthermia group (group PH), propofol (10 mg/kg/h) administrated, and temperatures were maintained between 39 °C and 40 °C. The primary outcome was mortality 8 h after endotoxin injection. Secondary outcomes included changes in haemodynamics, arterial blood gases and plasma cytokine concentrations for the 8‐h observation period.

Results

Mortality rates 8 h after endotoxin injection were 92%, 100%, 68% and 50% for N, H, PN and PH groups, respectively. There was no difference in hypotension, acidosis, and increase in plasma cytokine concentrations between N and H groups, but these parameters were attenuated in group PH.

Conclusion

The mortality rates in the present study were extremely high; further hypotension and elevations in plasma pro‐inflammatory and anti‐inflammatory cytokine concentrations after endotoxin injection were not attenuated by mild hyperthermia between 39 °C and 40 °C, but they were attenuated by propofol with mild hyperthermia.
New hypothesis of chronic back pain: low pH promotes nerve ingrowth into damaged intervertebral disks
Authors: LIANG C. , LI H. , TAO Y. , SHEN C. , LI F. , SHI Z. , HAN B. , CHEN Q.
Published: March 2012

The pathogenesis of low back pain is still elusive. Here, we proposed a new hypothesis that low pH is a possible cause of the development and progression of low back pain. We propose that low pH promotes the production of the inflammatory mediators and the depletion of proteoglycan in the damaged intervertebral disk. The inflammation response, evoked by the dorsal root ganglia, changes the delicate nutrient balance in the nucleus, resulting in a vicious cycle and leading to choronic back pain. Our hypothesis may explain many of the available clinical and experimental data on low back pain, thus it may help elucidate the pathogenesis of low back pain and improve clinical management.
A clinical assessment tool for ultrasound‐guided axillary brachial plexus block
Authors: SULTAN S. F. , IOHOM G. , SAUNDERS J. , SHORTEN G.
Published: March 2012

Background

Competency in anesthesia traditionally has been determined subjectively in practice. Optimal training in procedural skills requires valid and reliable forms of assessment. The objective was to examine a procedure‐specific clinical assessment tool for ultrasound‐guided axillary brachial plexus block for inter‐rater reliability and construct validity in a clinical setting.

Method

This was a prospective observational study. Using prior work at our institution, the clinical assessment tool was developed consisting of a 63‐point task‐specific checklist and a global rating scale. The anesthesiologists were assigned to three groups based on prior experience of performing an axillary block: group 1 (‘novices’) < 10 procedures, group 2 (‘intermediates’) 50–80 procedures and group 3 (‘experts’) > 100 procedures. Each participant performed two consecutive blocks that were videotaped. Two blinded independent experts trained in the marking of the tool evaluated the videotapes.

Results

There were five participants per group. The inter‐rater reliability between assessors was 0.842 and 0.795 for the checklist and global rating scale, respectively. There was a consistent difference between (each pair of) the three groups in terms of both the checklist and global rating scale (P < 0.05). For the checklist, expert vs. intermediate group P = 0.023, expert vs. novice group P < 0.001 and intermediate vs. novice group P = 0.019. For the global rating scale, expert vs. intermediate group P < 0.001, expert vs. novice group gave P < 0.001 and intermediate vs. novice group P = 0.023.

Conclusion

The objective of task‐specific checklist and global rating scale are reliable and valid measures of axillary block performance between different levels of expertise.
Survey of injury sources for a trampoline with equipment hazards designed out
Authors: Eager David , Scarrott Carl , Nixon Jim , Alexander Keith
Published: March 2012

Aim:  In Australia, trampolines contribute approximately one‐quarter of all childhood play‐equipment injuries. The purpose of this study was to gather and evaluate injury data from a nontraditional, ‘soft‐edged’, consumer trampoline in which the equipment injury sources have been designed out.

Methods:  A survey was undertaken in Queensland and New South Wales. The manufacturer of the nontraditional trampoline provided the University of Technology, Sydney, with their Australian customer database. Injury data were gathered in a pilot study by phone interview, then in a full study through an email survey. Results from 3817 respondents were compared with earlier Australian and US data from traditional trampolines gathered from emergency departments.

Results:  A significantly lower proportion of the injuries caused by falling off or striking the equipment was found for this new design when compared with traditional trampolines both in Australia and in the USA. The age of children being injured on trampolines in Australia was found to be markedly lower than in North America.

Conclusions:  This research indicates that with appropriate design the more severe injuries on traditional trampolines can be significantly reduced.
Evaluation of the North Star Ambulatory Assessment scale and cardiac abnormalities in ambulant boys with Duchenne muscular dystrophy
Authors: Ergul Yakup , Ekici Baris , Nisli Kemal , Tatli Burak , Binboga Fatih , Acar Gonul , Ozmen Meral , Omeroglu Rukiye Eker
Published: March 2012

Aim  We evaluated ambulatory patients with Duchenne muscular dystrophy from the cardiovascular standpoint and studied the correlation between the results of electrocardiographic (ECG) findings, left ventricular ejection fraction (LVEF), troponin T and N‐terminal pro‐brain natriuretic peptide (NT‐proBNP) levels and patients' North Star Ambulatory Assessment scores.

Methods:  Fifty patients of ages 6–12 (8.9 ± 2.8) were enrolled in this cross‐sectional study. Cardiac evaluation included electrocardiography, echocardiography and cardiac enzyme tests.

Results  North Star scores ranged from 6/34 to 34/34. Twenty‐eight patients (56%) had ECG changes. The most frequently seen ECG abnormalities were short PR interval (14%, n= 7), right ventricular hypertrophy (16%, n= 8), prolonged QTc interval (10%, n= 5), prominent Q wave (10%, n= 5) and T wave inversion (44%, n= 22). In 10 patients (20%), LVEF was below 55%, troponin T and NT‐proBNP levels were significantly elevated (P= 0.003 and P < 0.001, respectively). When North Star scores were compared to patients' age, enzyme levels, ECG and echocardiographic results, we discovered negative correlation with age (P < 0.001) and troponin T levels (P= 0.02) and positive correlation with LVEF (P= 0.02).

Conclusion  Patients with North Star scores of ≤16 are more at risk of developing cardiomyopathies. Troponin T is a cardiac index that can be used for evaluating myopathic patients and it seems to be correlated with the proBNP levels and LVEF values.
Incidence, aetiology and resistance of late‐onset neonatal sepsis: A five‐year prospective study
Authors: Hammoud Majeda S , Al‐Taiar Abdullah , Thalib Lukman , Al‐Sweih Noura , Pathan Seema , Isaacs David
Published: March 2012

Aim:  Investigate the incidence, etiological pattern and the antimicrobial resistance of late‐onset neonatal infections over a period of 5 years.

Methods:  Longitudinal audit of neonatal sepsis from January 2005 to December 2009, in the main maternity hospital in Kuwait. Late‐onset neonatal infection was defined as the culture of a single potentially pathogenic organism from blood or cerebrospinal fluid from an infant older than 6 days in association with clinical or laboratory findings consistent with infection.

Results:  The overall incidence was 16.9 (95% confidence interval: 15.8–18.0) episodes per 1000 live births. The commonest pathogen was coagulase‐negative Staphylococcus, 339 (35.7%), while Klebsiella was the most common gram‐negative infection, 178 (18.8%). Escherichia coli, Enterococcus and Enterobacter spp were each responsible for 6% of all infections. Candida caused 104 (11.0%) infections. The general pattern of infection remained unchanged over the study period. Case fatality was 11.7% (95% confidence interval: 9.7–13.9%) and was high for Pseudomonas (18.4%) and Candida (22.1%) infections. Approximately 24 and 20% of Klebsiella infections were resistant to cefotaxime and gentamicin, respectively, while 28 and 24% of Escherichia coli infections were resistant to cefotaxime and gentamicin, respectively.

Conclusion:  The incidence of late‐onset infection in Kuwait is high, resembling that in resource‐poor countries. The high incidence coupled with low case fatality provides an example for settings where tertiary care is introduced without strict measures against nosocomial infections. Prevention against nosocomial infections in neonatal units has the potential to further reduce neonatal mortality in these settings.
What paediatricians should know about eating disorders in children and young people
Authors: Hudson Lee D , Court Andrew J
Published: March 2012

Any health professional working with children and young people may become involved in the care of a child or young person with an eating disorder. Morbidity and mortality can be high, and paediatricians have an important role to play. There are broadly two aspects of underweight that the paediatrician may face – acute medical instability and a more chronic underweight which can impact greatly upon growth and development. Ultimate weight restoration means an adequate nutritional status to allow appropriate growth and development. Key to success is a team approach with paediatric and mental health and dietetic expertise combined. This paper provides an overview of eating disorders and explores current best practice, written in collaboration by a paediatrician and child and adolescent psychiatrist.