bluuebunny/crossref_metadata_2025 huggingface dataset:
Decrease in phenotypic regulatory T cells in subsets of patients with common variable immunodeficiency
Authors: Horn J , Manguiat A , Berglund L J , Knerr V , Tahami F , Grimbacher B , Fulcher D A
Published: February 2009

Common variable immunodeficiencies (CVID) are a heterogeneous group of antibody deficiency disorders complicated by autoimmune, lymphoproliferative and/or granulomatous manifestations, suggesting variations in immunoregulation. We sought to quantify regulatory CD4 T cells (Treg cells) in the blood of CVID patients and to correlate the frequency with clinical manifestations and classification subgroups. Blood samples from 99 CVID patients in Freiburg, London and Sydney, who had been phenotyped clinically and stratified according to their memory B cell phenotype (Freiburg and Paris classification schemes), were analysed for the proportion of Treg cells, defined either as CD25+/forkhead box P3 (FoxP3)+, CD25+/CD127low/FoxP3+ or CD25+/CD127low CD4+ T cells, and results compared with 49 healthy controls. Irrespective of the phenotype used to define them, there was a significant decrease in the Treg cell proportion in patients with granulomatous disease and immune cytopenias. This allowed the definition of a subgroup of CVID patients with abnormally low Treg cells, which had a higher rate of these two manifestations as well as autoimmune disease in general. There was also a significant reduction in the proportion of Treg cells in the Freiburg group Ia compared with other CVID patients and controls, but there were no differences between the Paris groups. The reduction in Treg cells in subsets of CVID patients may be relevant to their clinical manifestations, and may contribute to our understanding of the pathogenesis of CVID complications.
An inhibitor of interleukin-6 trans-signalling, sgp130, contributes to impaired acute phase response in human chronic liver disease
Authors: Lemmers A , Gustot T , Durnez A , Evrard S , Moreno C , Quertinmont E , Vercruysse V , Demetter P , Franchimont D , Le Moine O , Geerts A , Devière J
Published: February 2009

In chronic liver disease, high circulating interleukin (IL)-6 contrasts with a poor acute phase response. We evaluated the impact of liver and circulating IL-6-receptor (IL-6R) forms on IL-6 bioactivity in chronic liver disease. IL-6, soluble IL-6-receptor and sgp130 levels were assayed in plasma from 45 patients with alcoholic liver disease, 84 with hepatitis C virus (HCV) infection undergoing transjugular liver biopsies and 15 healthy subjects. IL-6R mRNA was quantified on liver extracts from 54 patients with alcoholic liver disease with or without cirrhosis and 18 HCV-infected patients. The effect of gp130–Fc on fibrinogen secretion induced by IL-6 trans-signalling was evaluated on hepatocyte cultures. Levels of plasma IL-6 and sgp130, but not soluble IL-6R, increased with the stage of chronic liver disease, and correlated significantly with disease severity. Alcoholic liver disease patients had higher plasma IL-6 levels than hepatitis C, but lower liver IL-6R expression. In alcoholic and HCV-related liver diseases, liver IL-6R expression decreased with advanced fibrosis stage. In vitro, on hepatocytes, gp130–Fc blunted the acute phase response while soluble IL-6R enhanced IL-6 stimulation. In advanced chronic liver disease, high plasma IL-6 is associated with low liver IL-6R expression. This situation enables high plasma sgp130 to act as a major negative regulator of liver IL-6 trans-signalling, as demonstrated functionally here on hepatocytes. This might explain the poor acute phase response induced by IL-6 in chronic liver disease.
Novel mutations of the BSCL2 and AGPAT2 genes in 10 families with Berardinelli–Seip congenital generalized lipodystrophy syndrome
Authors: Miranda Debora M. , Wajchenberg Bernardo L. , Calsolari Maria R. , Aguiar Marcos J. , Silva José M. C. L. , Ribeiro Marcia G. , Fonseca Cristina , Amaral Daniela , Boson Wolfanga L. , Resende Bruna A. , De Marco Luiz
Published: February 2009

Context  Congenital generalized lipodystrophy, or Berardinelli–Seip syndrome, is a rare autosomal recessive disease caused by mutations in either the BSCL2 or AGPAT2 genes. This syndrome is characterized by an almost complete loss of adipose tissue usually diagnosed at birth or early infancy resulting in apparent muscle hypertrophy. Common clinical features are acanthosis nigricans, hepatomegaly with or without splenomegaly and high stature. Acromegaloid features, cardiomyopathy and mental retardation can also be present.

Design  We investigated 11 kindreds from different geographical areas of Brazil (northeast and southeast). All coding regions as well as flanking intronic regions of both genes were examined. Polymerase chain reaction (PCR) amplifications were performed using primers described previously and PCR products were sequenced directly.

Results  Four AGPAT2 and two BSCL2 families harboured the same set of mutations. BSCL2 gene mutations were found in the homozygous form in four kindreds (c.412C>T c.464T>C, c.518–519insA, IVS5‐2A>G), and in two kindreds compound mutations were found (c.1363C>T, c.424A>G). In the other four families, one mutation of the AGPAT2 gene was found (IVS3‐1G>C and c.299G>A).

Conclusions  We have demonstrated four novel mutations of the BSCL2 and AGPAT2 genes responsible for Berardinelli–Seip syndrome and Brunzell syndrome (AGPAT2‐related syndrome).
Markers of insulin sensitivity in placentas and cord serum of intrauterine growth‐restricted newborns
Authors: Street Maria E. , Volta Cecilia , Ziveri Maria A. , Viani Isabella , Bernasconi Sergio
Published: February 2009

Objective  Intrauterine growth restriction (IUGR) has been related to a higher incidence of insulin resistance in adult life, which is associated with low adiponectin and high resistin, insulin and interleukin (IL)‐6 serum concentrations. This study assessed cortisol, insulin, total insulin receptor, resistin, adiponectin and IL‐6 concentrations, as markers of insulin sensitivity, in placental lysates and cord serum of IUGR and appropriate for gestational age (AGA) newborns, to establish relationships among peptides and with growth parameters at birth.

Design and patients  Whole villous tissue and cord serum at birth were collected from 24 AGA and 18 IUGR newborns of comparable gestational age.

Measurements  Hormonal and peptide concentrations were assayed in placental lysates and cord serum using specific commercial kits. Concentrations in lysates were adjusted per mg of total protein content.

Results  Cortisol, insulin and resistin concentrations and the total amount of insulin receptor were similar in both groups. IL‐6 concentration in lysates was significantly higher in IUGR compared with AGA newborns. Adiponectin was significantly lower in lysates from IUGR compared with AGA newborns. Placental insulin and resistin concentrations were positively correlated. Placental adiponectin concentration was positively correlated with the weight of the placenta, birthweight and head circumference. IL‐6 concentration in lysates was negatively correlated with birth length, birthweight and head circumference.

Conclusions  This study evaluated the markers of insulin sensitivity in the placentas of subjects born IUGR, showing new potential roles for adiponectin and IL‐6 in particular, and suggesting a role for the placenta in the programming of these hormones.
The use of thyroid function tests in the diagnosis of hypopituitarism: definition and evaluation of the TSH Index
Authors: Jostel Andreas , Ryder W. David J. , Shalet Stephen M.
Published: February 2009

Background  TSH secretion in hypopituitary patients may be decreased due to TSH deficiency but it also remains under feedback inhibition by free thyroxine (fT4). We propose a TSH index (TSHI), as ‘fT4‐adjusted TSH’, that corrects for any physiological TSH suppression, to provide a true estimate of pituitary thyrotroph function and any pathological pituitary suppression.

Methods  A total of 9519 thyroid function tests (TFTs) (Bayer Immuno‐1®) in 4064 patients of our institution were examined, including 444 patients investigated for hypopituitarism. Based on the physiological log‐linear relationship between fT4 and TSH, we estimated the amount of feedback‐induced change in log TSH per change in fT4, which allowed the extrapolation of log TSH to a fixed fT4 of 0, defining the TSHI. TSHIs were compared with other measures of pituitary function.

Results  Feedback inhibition was estimated to cause a 0·1345 decrease in log TSH (mU/l) for 1 pmol/l increase in fT4 concentration, therefore TSHI = log TSH + 0·1345 × fT4. Patients with lower peak‐stimulated GH and cortisol concentrations had a significantly lower TSHI (P < 0·0001). TSHIs measured before pituitary stimulation tests predicted highly significantly the risk of test failure (P = 0·0002). Of all potential fT4–TSH combinations within the current reference ranges, 21·9% were identified as abnormal on the basis of the TSHI.

Conclusion  The TSHI provides an accurate estimate of the severity of pituitary dysfunction in hypopituitary patients based on simple TFTs. It predicts the probability of pituitary stimulation test failure and extends the diagnosis of TSH deficiency into areas of the normal TFT reference ranges.
Parathyroidectomy is safe and improves symptoms in elderly patients with primary hyperparathyroidism (PHPT)
Authors: Stechman Michael J. , Weisters Mary , Gleeson Fergus V. , Sadler Gregory P. , Mihai Radu
Published: February 2009

Objective  Parathyroidectomy for primary hyperparathyroidism (PHPT) is curative in over 95% of cases. Although PHPT affects up to 2% of the elderly population, whose life expectancy may be a decade or more, such patients may be denied surgery because of perceived risk. This study investigates the outcomes of surgery for PHPT in the elderly.

Design and patients  Consecutive patients with PHPT treated at a tertiary referral centre over 5 years.

Measurements  A prospective database recorded clinical, biochemical and pathological information. Pasieka’s parathyroid symptom scores were obtained pre‐operatively and post‐operatively, from a recent subgroup of 70 consecutive patients. Deaths during follow‐up were identified using the NHS Strategic Tracing Service. Statistical analysis was performed with spss v12.0.

Results  Between November 2002 and October 2007, 224 patients (17–89 years) underwent surgery for PHPT. In the subgroup comprising patients aged >75 years there was a significantly greater proportion of women (47/56 vs. 52/81, P < 0·05). Pre‐operative indices of these patients were similar to younger patients, as were proportions undergoing minimally invasive parathyroidectomy (n = 134) or bilateral neck exploration (n = 90). Patients >75 years had a longer hospital stay (1·6 vs. 0·8 days, P = 0·003). Pasieka’s symptom scores improved significantly at 3–6 months postoperatively in all age groups. During a minimum median follow‐up of 22 months, there were seven patients with persistent/recurrent disease. Median 2‐year survival of those aged 60–74 and those over 75 ranged from 85–90%.

Conclusion  Parathyroidectomy is safe in the elderly and is associated with a significant improvement in symptoms. As survival after operation is similar to younger patients, surgery should be considered in all elderly patients with PHPT.
New and emerging treatments for osteoporosis
Authors: Clarke Bart L.
Published: February 2009

A variety of new treatments for osteoporosis have become available within the last several years, and a number of emerging treatments remain in late clinical stage development. New and emerging treatments include more potent members, or more convenient formulations, of existing classes of therapy, but a number of the emerging treatments are first‐generation compounds addressing specific therapeutic targets based on recent advances in understanding of basic bone biology. These new and emerging treatments include agents with anticatabolic effects, compounds with anabolic effects, and one agent possibly containing both anticatabolic and anabolic effects. The increasing variety of new and emerging treatments increases the possibility that effective therapy will be targeted to the specific needs of the individual patient.
Relationships between cortisol level, mortality and chronic diseases in older persons
Authors: Schoorlemmer R. M. M. , Peeters G. M. E. E. , Van Schoor N. M. , Lips P.
Published: February 2009

Context  High cortisol level is known to be associated with osteoporosis, hypertension, diabetes mellitus (DM), susceptibility to infections and depression and may protect against chronic obstructive pulmonary disease.

Objective  This study assesses the association between cortisol level, 6‐ to 7·5‐year mortality risk and prevalence of chronic diseases.

Design/setting/participants  Subjects were selected from the Longitudinal Aging Study Amsterdam, an ongoing multidisciplinary cohort study in a general population of older persons (≥65 years). Serum cortisol was measured in 1181 men and women in 1995/1996 (second cycle) and salivary cortisol in 998 men and women in 2001/2002 (fourth cycle).

Main outcome measures  Six to seven and a half year mortality and prevalence of chronic diseases.

Results  Men with high salivary morning cortisol had a higher mortality risk than men with low levels [hazard ratio (HR) = 1·63, P = 0·04 for the third vs. the lowest tertile]. Women with high salivary evening cortisol had a higher mortality risk than women with low levels (HR = 1·82, P = 0·04 for the third vs. the lowest tertile). In men, high serum cortisol was independently associated with chronic nonspecific lung disease (CNSLD): odds ratio (OR) = 0·72, P < 0·01; hypertension: OR = 1·38, P < 0·01; DM: OR = 1·38, P = 0·02. In women, high salivary evening cortisol was independently associated with DM: OR = 1·33, P = 0·01 and CNSLD: OR = 0·58, P = 0·02. No independent association between cortisol and number of chronic diseases was found.

Conclusion  High salivary cortisol levels are associated with increased mortality risk in a general older population. High cortisol levels are associated with higher risks of hypertension and DM and lower risk of CNSLD.
Monitoring of acromegaly: what should be performed when GH and IGF‐1 levels are discrepant?
Authors: Freda Pamela U.
Published: February 2009

Monitoring of a patient with acromegaly requires periodic evaluation of levels of GH and IGF‐1, the biochemical markers of this disease. Although the results of these two tests are usually concordant, they can be discrepant and how to proceed when they are can be a challenging clinical problem. In some cases, IGF‐1 levels are normal yet GH suppression after oral glucose is abnormal; this pattern may be due to persistent GH dysregulation despite remission. In other cases, IGF‐1 levels are elevated yet GH suppression appears to be normal; this pattern may be observed if the cutoff for GH suppression is inappropriately high for the GH assay being used. Various conditions known to alter GH and IGF‐1 including malnutrition, thyroid disease and oestrogen use as well as the potential for methodological or normative data issues with the GH and IGF‐1 assays should be considered in the interpretation of discrepant results. When a known cause of the discrepancy other than acromegaly is not identified, a clinical decision about the patient’s therapy needs to be made. We adjust treatment in most patients whose results are discrepant based on the IGF‐1 level, continuing current treatment if it is persistently normal or modifying this if it is elevated. The clinical picture of the patient, however, also needs to be incorporated into this decision. All patients should have continued periodic surveillance of both GH and IGF‐1 levels.
Short‐term temporal changes of bare soil CO2 fluxes after tillage described by first‐order decay models
Authors: La Scala N. , Lopes A. , Spokas K. , Archer D. W. , Reicosky D. C.
Published: February 2009

To further understand the impact of tillage on carbon dioxide (CO2) emission, we compare the performance of two conceptual models that describe CO2 emission after tillage as a function of the non‐tilled emission plus a correction resulting from the tillage disturbance. The models assume that C in the readily decomposable organic matter follows a first‐order reaction kinetics equation as and that soil C‐CO2 emission is proportional to the C decay rate in soil, where Csoil(t) is the available labile soil C (g m−2) at any time (t) and k is the decay constant (time−1). Two possible relationships are derived between non‐tilled (FNT) and tilled (FT) soil fluxes: (model 1) and (model 2), where t is time after tillage. The difference between these two models comes from an assumption related to the k factor of labile C in the tilled plot and its similarity to the k factor of labile C in the non‐till plot. Statistical fit of experimental data to conceptual models showed good agreement between predicted and observed CO2 fluxes based on the index of agreement (d‐index) and with model efficiency as large as 0.97. Comparisons reveal that model 2, where all C pools are assigned the same k factor, produces a better statistical fit than model 1. The advantage of this modelling approach is that temporal variability of tillage‐induced emissions can be described by a simple analytical function that includes the non‐tilled emission plus an exponential term, which is dependent upon tillage and environmental conditions.
Quantifying the relationship between soil organic carbon and soil physical properties using shrinkage modelling
Authors: Boivin P. , Schäffer B. , Sturny W.
Published: February 2009

Changes in soil organic carbon (SOC) may strongly affect soil structure and soil physical properties, which in turn may have feedback effects on the soil microbial activity and SOC dynamics. Such interactions are still not quantitatively described and accounted for in SOC dynamics modelling. The objective of this study was to test the hypothesis that soil shrinkage curve (ShC) analysis allows the establishment of close relationships between soil physical properties and SOC. We sampled a rice‐cropped vertisol, a cambisol under conventional tillage and no‐tillage and a restored cambisol. Soil samples were analysed for clay and SOC content, bulk volume, hydro‐structural stability and plasma and structural pore volumes changes on the full water content range using ShC analysis. Although the soils behaved differently according to their constituents and history, changes in SOC linearly affected most of the soil physical properties, with stronger effects than changes in clay content. The observed effects of increasing SOC, such as increasing hydro‐structural stability, specific bulk volume and water retention, agreed well with previously reported results. However, using ShC measurement and modelling allowed the observation of all these different effects simultaneously for small changes in SOC, and in a single measurement. Moreover, the relation between SOC changes and physical properties could be quantified. ShC analysis may, therefore, be used to account for the effect of changes in SOC on soil physical properties.
Indicator of potential residual carbon in soils after exogenous organic matter application
Authors: Lashermes G. , Nicolardot B. , Parnaudeau V. , Thuriès L. , Chaussod R. , Guillotin M. L. , Linères M. , Mary B. , Metzger L. , Morvan T. , Tricaud A. , Villette C. , Houot S.
Published: February 2009

An indicator to evaluate the proportion of exogenous organic matter (EOM) remaining in soils over the long‐term after application has been developed. A database was constructed with analytical data corresponding to 83 EOMs, including sludges, composts, animal wastes, mulches, plant materials and fertilizers. The data included results of proximal analysis (soluble, SOL, hemicellulose‐, HEM, cellulose‐, CEL, and lignin‐like, LIC, fractions, in g kg−1 total organic matter) and of carbon (C) mineralization during long‐term incubations under laboratory conditions (in g kg−1 exogenous organic C, EOC). The potential residual organic C after EOM application to soil was assessed from the extrapolation of the incubation results. Then, partial least square regression was used to relate EOM characteristics to the proportion of potentially residual organic C previously determined from the incubations. The biochemical fractions of EOM were not predictive enough to develop the indicator. The proportion of organic C mineralized during 3 days of incubation (C3d) was cumulated and appeared to be the most predictive variable of residual organic C. The proposed indicator of residual organic carbon in soils (expressed as g EOC kg−1) was IROC = 445 + 0.5 SOL – 0.2 CEL + 0.7 LIC – 2.3 C3d. The indicator was calculated for the main types of EOM applied to soils. When compared with the few field data of residual C measured in long‐term field experiments, the values provided by the indicator seemed to be over‐estimated (i.e. EOC degradation could be faster under field conditions than during laboratory incubations).
Identification of mesenchymal stem cell (MSC)‐transcription factors by microarray and knockdown analyses, and signature molecule‐marked MSC in bone marrow by immunohistochemistry
Authors: Kubo Hiroshi , Shimizu Masakazu , Taya Yuji , Kawamoto Takeshi , Michida Masahiko , Kaneko Emi , Igarashi Akira , Nishimura Masahiro , Segoshi Kazumi , Shimazu Yoshihito , Tsuji Koichiro , Aoba Takaaki , Kato Yukio
Published: February 2009

Althoughex vivoexpanded mesenchymal stem cells (MSC) have been used in numerous studies, the molecular signature andin vivodistribution status of MSC remain unknown. To address this matter, we identified numerous human MSC‐characteristic genes—including nine transcription factor genes —using DNA microarray and real‐time RT‐PCR analyses: Most of the MSC‐characteristic genes were down‐regulated 24 h after incubation with osteogenesis‐, chondrogenesis‐ or adipogenesis‐induction medium, or 48–72 h after knockdown of the nine transcription factors. Furthermore, knockdowns of ETV1, ETV5, FOXP1, GATA6, HMGA2, SIM2 or SOX11 suppressed the self‐renewal capacity of MSC, whereas those of FOXP1, SOX11, ETV1, SIM2 or PRDM16 reduced the osteogenic‐ and/or adipogenic potential. In addition, immunohistochemistry using antibodies for the MSC characteristic molecules—including GATA6, TRPC4, FLG and TGM2—revealed that MSC‐like cells were present near the endosteum and in the interior of bone marrow of adult mice. These findings indicate that MSC synthesize a set of MSC markersin vitroandin vivo, and that MSC‐characteristic transcription factors are involved in MSC stemness regulation.
Haemoassist™– a hand‐held electronic patient diary for haemophilia home care
Authors: MONDORF W. , SIEGMUND B. , MAHNEL R. , RICHTER H. , WESTFELD M. , GALLER A. , POLLMANN H.
Published: February 2009

Summary.  On‐demand or prophylactic home‐treatment is currently the treatment of choice for haemophilia patients. To allow physicians to monitor the amount of factor concentrates administered, the patients document each factor injection in a paper‐diary. Nevertheless, because of the fact that most patients visit their physicians only two to four times a year, there could be considerable delay in detecting medication problems. The aim of this pilot study was to assess whether an electronic documentation tool could successfully replace traditional paper‐diaries for haemophilia A patients and enable the physician to have a timely overview of the patient’s treatment. An electronic, hand‐held documentation tool, Haemoassist™, was developed. In this study, patients using prophylaxis and on‐demand therapies documented their factor consumption both electronically and on paper‐diaries. Documentations were compared and descriptively evaluated. Patients also completed a survey to evaluate the feasibility and gather their opinions on the Haemoassist™ system. Ten patients from two haemophilia treatment centres in Germany submitted a total of 548 records via hand‐held device during the observation period, from March 2006 to February 2007. Comparison of electronic and paper‐based records showed differing responses among patients with some patients entering more electronic and some others more paper‐based documentations. In the questionnaires on feasibility and usefulness of Haemoassist™, three patients preferred the electronic tool, two patients wanted to continue using paper‐based diaries, and one had no preference. The study shows that an electronic documentation system is feasible for haemophilia patients and provides the physician with the opportunity to more closely monitor patients. However, not all patients seem to be qualified for using an electronic tool, and the tool has to run reliably without major errors for ensuring reliability and acceptability. In the future, Haemoassist™ might support quality assurance in haemophilia treatment and improve guidance in the home‐care setting.
Co‐morbidity in the ageing haemophilia patient: the down side of increased life expectancy
Authors: MAUSER‐BUNSCHOTEN E. P. , FRANSEN VAN DE PUTTE D. E. , SCHUTGENS R. E. G.
Published: February 2009

Summary.  Because of an increased life expectancy, (age‐related) co‐morbidity is becoming a common occurrence in haemophilia patients. In this review, haemophilia‐related and non‐haemophilia‐related medical problems, treatment recommendations and psychosocial consequences in ageing haemophilia patients are discussed. Haemophilic arthropathy is an important cause of pain and disability, and a frequent indication for surgery in haemophilia patients. In addition, many adult patients are infected with hepatitis C or HIV, the consequences and treatment of which can add to physical and mental discomfort. Moreover, inhibitors against factor VIII can also develop in adulthood, especially in patients with mild haemophilia. Hypertension is reported to occur more often in haemophilia patients than in the general population. Other internal problems, like renal abnormalities, overweight, diabetes mellitus and hypercholesterolemia are discussed. Haemophilia seems to protect against cardiovascular disease, although the incidence is increasing. Recommendations are given on dealing with tooth extractions, surgical interventions and sexuality problems in patients with haemophilia. In addition to haemophilia in itself, co‐morbidity has a major psychological impact, and an important effect on quality of life. It can also result in complex treatment regimens, in which coordination between health care workers is essential.
Hypogonadism, ED, metabolic syndrome and obesity: a pathological link supporting cardiovascular diseases
Authors: Corona G. , Mannucci E. , Forti G. , Maggi M.
Published: February 2009

Hypogonadism, erectile dysfunction (ED), visceral adiposity, insulin resistance and metabolic syndrome (MetS) often coexist in the same subjects. This cluster of abnormalities is associated with an increased risk of diabetes and cardiovascular diseases (CVD), affecting not only quality of life but also life expectancy. Longitudinal studies have also demonstrated that ED and male hypogonadism could be considered surrogate markers of incident CVD and MetS. However, how androgens signal fat depots and lessen them is still a matter of active research and whether or not low testosterone could play a pathogenetic role in CVD is still under debate. Hence, pathogenetic mechanisms linking hypogonadism with obesity and insulin resistance appear to be complex and often multi‐directional. Visceral obesity can probably be considered a relevant cause of hypogonadism but at the same time, hypogonadism could be a cause of obesity and insulin resistance, consequently establishing a vicious cycle. To provide a critical analysis of these issues, a comprehensive literary search was carried out to discuss the relationship between insulin resistance ED, visceral adiposity, MetS and hypogonadism focusing on their possible involvement in the development of CVD.
Competency Inventory for Registered Nurses in Macao: instrument validation
Authors: Liu Ming , Yin Lei , Ma Estela , Lo Siuha , Zeng Lingxia
Published: February 2009

Title.  Competency Inventory for Registered Nurses in Macao: instrument validation.

Aim.  This paper is a report of a study to test the reliability and construct validity of the Competency Inventory for Registered Nurses.

Background.  A reliable competency assessment tool is a basic yardstick to assist in assessing the generic competencies of nurses and to evaluate the outcome of various education programmes. The Competency Inventory for Registered Nurses was developed in mainland China. Confirmatory evidence is needed to support its proposed structure, and to further estimate its psychometric properties.

Methods.  A quantitative descriptive design and stratum random sampling method were used to recruit 533 Registered Nurses in Macao in 2007. Internal consistency reliability and stability were estimated by Cronbach’s α and paired t‐test, respectively. Confirmatory factor analysis was employed to test the construct validity of the instrument.

Results.  Internal consistency Cronbach’s α was 0·908 for the overall scale and 0·718–0·903 for subscales. The factor loading value across 55 items ranged from 0·310 to 0·725. Confirmatory factor analysis indicated that the model exhibited acceptable goodness‐of‐fit statistic indices. The 7‐factor structure of the Competency Inventory for Registered Nurses, with 55 items included after deletion of three low loading items, was confirmed.

Conclusion.  The model of Registered Nurses’ competency was confirmed. As the instrument was initially developed in mainland China and successfully validated in this group, it is suggested that this instrument also has the potential for cross‐cultural application.
Use of recommended osteoarthritis pain treatment by older adults
Authors: Merkle Diane , McDonald Deborah Dillon
Published: February 2009

Title.  Use of recommended osteoarthritis pain treatment by older adults.

Aim.  This paper reports on a study conducted to describe what traditional and non‐traditional treatments older adults with osteoarthritis use for pain management, their reported pain relief, and factors associated with use of recommended initial gold standard treatment (acetaminophen/paracetamol or non‐steroidal anti‐inflammatory drugs, and exercise and/or physical therapy) as designated by conventional western medicine.

Background.  Osteoarthritis is characterized by joint pain, stiffness and limited range of motion and has been designated an international health burden by the World Health Organization. Demographic and cultural factors have been shown to affect both traditional and non‐traditional osteoarthritis treatment decisions.

Method.  A descriptive correlational design was used, with secondary analysis of data collected between July 2006 and July 2007 in two randomized controlled studies using the Brief Pain Inventory Short Form and testing older adults’ pain communication.

Results.  The frequency of use of gold standard treatment was 28·0% (n = 128). Both traditional and non‐traditional treatments were used by 46·4% (n = 212) of the participants. Logistic regression revealed that those with higher education (odds ratio 1·56, CI 1·24–1·96, P = 0·001), and non‐White race, regardless of educational level (odds ratio 2·02, CI 1·20–3·40, P = 0·008), were more likely to use gold standard treatment.

Conclusion.  Factors influencing older adults’ use of gold standard treatment for their osteoarthritis pain need to be identified so that greater numbers of older adults can be supported to use recommended treatment to obtain greater pain relief.
Temporal and spatial variations in lice numbers on salmon farms in the Hardanger fjord 2004–06
Authors: Heuch P A , Olsen R S , Malkenes R , Revie C W , Gettinby G , Baillie M , Lees F , Finstad B
Published: February 2009

The long and narrow Hardanger fjord in western Norway has a high density of salmon farms and has had severe salmon lice, Lepeophtheirus salmonis, problems. In the years 2004–06, salmon lice numbers were recorded in selected salmon farms in the fjord as part of a larger research project. Most farm sites participated in a strategic control programme and were deloused between November and January in each year. The aim of the programme was to achieve a mean abundance of <0.3 adult female lice at this time and to minimize the infection pressure on wild smolts in the spring. Dedicated teams carried out detailed counting of lice on farmed fish in April–September each year. Temperature conditions were fairly similar throughout the fjord and amongst years, but wide variations in salinities were observed. The two innermost zones, B and C, had the lowest lice mean abundances, whereas the outermost zones, D and E, consistently had more lice. General linear model analyses showed that differences in adult female lice abundance between the zones were associated with differing levels of salinity and emamectin benzoate treatments strategically administered. Mean fish weight was significantly positively correlated with mean abundance of adult female lice.
Considerations in developing an integrated pest management programme for control of sea lice on farmed salmon in Pacific Canada
Authors: Brooks K M
Published: February 2009

In the development of integrated pest management (IPM) plans for the control of sea lice there are some components that are common to many areas. However, effective plans must be tailored to regionally varying environmental and biological factors affecting the severity of sea lice infections. This paper describes factors that would be involved in the development of an IPM plan for sea lice in the Broughton Archipelago, British Columbia. Temperature, salinity and currents affect the production, dispersion and competence of larvae of sea lice, Lepeophtheirus salmonis (Krøyer), as they develop to the infective copepodid stage. This information can be coupled with oceanographic conditions in the Broughton Archipelago and emerging computer models to define zones of infection where infections of new hosts are most likely. Salinity and temperature depend, in part, on river discharge in estuarine systems. River discharge depends on precipitation, snow pack and ambient temperatures, which can be monitored to help forecast the intensity of sea lice infections associated with both farmed and wild hosts. One of the goals of IPM planning is to reduce reliance on pesticides to avoid development of resistance in targeted parasites and to minimize environmental residues. Recommendations for developing an IPM plan specific to the Broughton Archipelago are provided along with a discussion of the additional information needed to refine IPM plans in this and other areas.
B‐type natriuretic peptide and C‐terminal‐pro‐endothelin‐1 for the prediction of severely impaired peak oxygen consumption
Authors: Maeder M. T. , Brutsche M. H. , Staub D. , Morgenthaler N. G. , Bergmann A. , Noveanu M. , Laule K. , Breidthardt T. , Christ A. , Klima T. , Reichlin T. , Potocki M. , Mueller C.
Published: February 2009

Objective.  To assess the utility of B‐type natriuretic peptide (BNP) and C‐terminal‐pro‐endothelin‐1 (CT‐proET‐1) to predict a severely impaired peak oxygen consumption (peak VO2, < 14 mL kg−1 min−1) in patients referred for cardiopulmonary exercise testing.

Design.  Cross‐sectional study.

Setting.  Tertiary care center.

Methods.  Peak VO2, BNP and CT‐proET‐1 were assessed in 141 consecutive patients referred for cardiopulmonary exercise testing.

Results.  B‐type natriuretic peptide [median (interquartile range) 48 (38–319) vs. 33 (15–86) pg mL−1; P = 0.002] and CT‐proET‐1 [87 (76–95) vs. 60 (52–74) pmol L−1; P < 0.001] were higher in patients with a peak VO2 < 14 mL kg−1 min−1 (n = 30) than in those with a peak VO2 ≥ 14 mL kg−1 min−1 (n = 111). CT‐pro‐ET‐1 had a higher area under the receiver‐operator‐characteristics curve (AUC) to predict a peak VO2 < 14 mL kg−1 min−1 than BNP (0.79 vs. 0.68; P = 0.04). The optimal BNP cut‐off of 37.2 pg mL−1 had a sensitivity of 80% and a specificity of 56%. The optimal CT‐proET‐1 cut‐off of 74.4 pmol L−1 had a sensitivity of 80% and specificity of 76%. A five‐item score composed of body mass index, diabetes, forced expiratory volume within the first second, alveolo–arterial oxygen pressure difference, and BNP had an AUC of 0.88 to predict a peak VO2 < 14 mL kg−1 min−1. Adding CT‐proET‐1 to the score resulted in an AUC of 0.92.

Conclusions.  C‐terminal‐pro‐endothelin‐1 is superior to BNP for the prediction of a peak VO2 < 14 mL kg−1 min−1 in patients referred for CPET. A score incorporating body mass index, diabetes status, spirometry, blood gases, BNP and CT‐proET‐1 improves the prediction of a peak VO2 < 14 mL kg−1 min−1 based on single biomarkers.
Effects of coronary artery disease and percutaneous intervention on the cardiac metabolism of nonesterified fatty acids and insulin: Implications of diabetes mellitus
Authors: Jaumdally R. J. , Lip G. Y. H. , Patel J. V. , MacFadyen R. J. , Varma C.
Published: February 2009

Background.  Nonesterified fatty acids (NEFA) and insulin have been implicated in the pathogenesis of diabetes mellitus (Type 2 diabetes) and coronary artery disease (CAD). We hypothesized that intracardiac levels of insulin and NEFA within the aortic root, coronary sinus and systemic venous levels would be different in patients with coronary atherosclerosis and/or diabetes. We also studied the metabolic cardiac response following percutaneous coronary intervention (PCI).

Methods.  A total of 67 subjects (42 males; mean age 60 ± 11 years) were recruited, of which three groups were identified: Group I – those with no CAD or Type 2 diabetes (n = 17); Group II – those with CAD but no Type 2 diabetes (n = 40); and Group III – patients with Type 2 diabetes and CAD (n = 10). Of the whole cohort, 34 patients (51%) proceeded to PCI. NEFA and insulin levels were analysed using enzymatic colorimetric and a monoclonal immuno‐autoanalyser techniques, respectively. Subsequently, fractional extraction (FFE) of both variables was calculated.

Results.  Nonesterified fatty acids and insulin concentrations were lower in the aortic root versus coronary sinus (both P < 0.05). FFE of NEFA was 2× higher in Group I (P < 0.01) with a sevenfold reduction in insulin FFE in Group III. Following PCI, systemic NEFA levels increased significantly (P < 0.05) with no significant change seen within the coronary sinus (P = NS), whilst a reduction in insulin concentrations at all three sites was observed (all P < 0.01). No significant difference in FFE of NEFA was seen after PCI when comparing Groups II and III. There was a drop in insulin extraction in Group II (nondiabetic subjects, from 12% to −4%, P = 0.04), compared with an increase seen in Group III (Type 2 diabetes patients, from −4% to 3%, P = 0.03).

Conclusion.  There is an intracardiac gradient of NEFA and insulin in Groups I–III. Cardiac NEFA metabolism was higher in those with mild CAD compared with those with obstructive CAD whereas intracardiac insulin extraction was lower in Group III (diabetic) patients. PCI was associated with a systemic rise in NEFA, with a reduction in insulin levels and cardiac utilization, but these effects were blunted in diabetic patients.
Sex Differences and the Roles of Sex Steroids in Apoptosis of Sexually Dimorphic Nuclei of the Preoptic Area in Postnatal Rats
Authors: Tsukahara S.
Published: February 2009

The brain contains several sexually dimorphic nuclei that exhibit sex differences with respect to cell number. It is likely that the control of cell number by apoptotic cell death in the developing brain contributes to creating sex differences in cell number in sexually dimorphic nuclei, although the mechanisms responsible for this have not been determined completely. The milieu of sex steroids in the developing brain affects sexual differentiation in the brain. The preoptic region of rats has two sexually dimorphic nuclei. The sexually dimorphic nucleus of the preoptic area (SDN‐POA) has more neurones in males, whereas the anteroventral periventricular nucleus (AVPV) has a higher cell density in females. Sex differences in apoptotic cell number arise in the SDN‐POA and AVPV of rats in the early postnatal period, and an inverse correlation exists between sex differences in apoptotic cell number and the number of living cells in the mature period. The SDN‐POA of postnatal male rats exhibits a higher expression of anti‐apoptotic Bcl‐2 and lower expression of pro‐apoptotic Bax compared to that in females and, as a potential result, apoptotic cell death via caspase‐3 activation more frequently occurs in the SDN‐POA of females. The patterns of expression of Bcl‐2 and Bax in the SDN‐POA of postnatal female rats are changed to male‐typical ones by treatment with oestrogen, which is normally synthesised from testicular androgen and affects the developing brain in males. In the AVPV of postnatal rats, apoptotic regulation also differs between the sexes, although Bcl‐2 expression is increased and Bax expression and caspase‐3 activity are decreased in females. The mechanisms of apoptosis possibly contributing to the creation of sex differences in cell number and the roles of sex steroids in apoptosis are discussed.
Tissue engineering: state of the art in oral rehabilitation
Authors: SCHELLER E. L. , KREBSBACH P. H. , KOHN D. H.
Published: February 2009

Summary More than 85% of the global population requires repair or replacement of a craniofacial structure. These defects range from simple tooth decay to radical oncologic craniofacial resection. Regeneration of oral and craniofacial tissues presents a formidable challenge that requires synthesis of basic science, clinical science and engineering technology. Identification of appropriate scaffolds, cell sources and spatial and temporal signals (the tissue engineering triad) is necessary to optimize development of a single tissue, hybrid organ or interface. Furthermore, combining the understanding of the interactions between molecules of the extracellular matrix and attached cells with an understanding of the gene expression needed to induce differentiation and tissue growth will provide the design basis for translating basic science into rationally developed components of this tissue engineering triad. Dental tissue engineers are interested in regeneration of teeth, oral mucosa, salivary glands, bone and periodontium. Many of these oral structures are hybrid tissues. For example, engineering the periodontium requires growth of alveolar bone, cementum and the periodontal ligament. Recapitulation of biological development of hybrid tissues and interfaces presents a challenge that exceeds that of engineering just a single tissue. Advances made in dental interface engineering will allow these tissues to serve as model systems for engineering other tissues or organs of the body. This review will begin by covering basic tissue engineering principles and strategic design of functional biomaterials. We will then explore the impact of biomaterials design on the status of craniofacial tissue engineering and current challenges and opportunities in dental tissue engineering.
Pharmacokinetics of lidocaine in serum and milk of mature Holstein cows
Authors: SELLERS G. , LIN H. C. , RIDDELL M. G. , RAVIS W. R. , DURAN S. H. , GIVENS M. D.
Published: February 2009

The purpose of this study was to evaluate the pharmacokinetics of lidocaine in mature Holstein cows following an inverted L and caudal epidural nerve block. Plasma and milk concentrations were determined using high‐performance liquid chromatography assay. Pharmacokinetic parameters were estimated using a noncompartmental method. Following administration via inverted L nerve block, serum Tmaxwas 0.521 ± 0.226 h and serum Cmaxwas 572 ± 207 ng/mL. Serum AUC was 1348 ± 335 ng·h/mL. Apparent serum t½βwas 4.19 ± 1.69 h and MRT was 5.13 ± 2.33 h with clearance uncorrected for the extent of absorption of 2.75 ± 0.68 L/kg/h. The last measurable time of lidocaine detection in serum was 8.5 ± 1.4 h with a mean concentration of 51 ± 30 ng/mL. Milk Tmaxwas detected at 1.75 ± 0.46 h with Cmaxof 300 ± 139 ng/mL. Milk AUC till the last time was 1869 ± 450 ng·h/mL with the mean AUC milk to AUC serum ratio of 1.439 ± 0.374. The last measurable time of lidocaine detection in milk was 32.5 ± 16.2 h with a mean concentration of 46 ± 30 ng/mL. There was no detectable lidocaine concentration in any samples following caudal epidural administration.
Involvement of GRP78 in inhibition of HBV secretion by Boehmeria nivea extract in human HepG2 2.2.15 cells
Authors: Huang K.‐L. , Lai Y.‐K. , Lin C.‐C. , Chang J.‐M.
Published: February 2009

Summary.  Previous studies showed that the root extract of Boehmeria nivea (BNE) can significantly suppress the production of hepatitis B virus (HBV) in vitro and in vivo. In this study, viral core and large‐surface proteins accompanied with their encapsidated viral DNA were observed to accumulate within the cells. Notably, 78‐kDa glucose‐regulated protein (GRP78) was found to be suppressed by BNE, and stimulation of the GRP78 expression by thapsigargin could rescue virus production initially inhibited by BNE. The antiviral effect of BNE was reversible, which also coincided with the level of GRP78. Furthermore, we synthesized the GRP78 siRNA to knockdown the expression of GRP78 protein, and the production of supernatant HBV DNA was reduced simultaneously. Moreover, combined treatment of BNE and 3TC exhibited an additive anti‐hepatitis B virus effect. In conclusion, the inhibitory effect of BNE on blocking assembled virion secretion might be via the reduction of GRP78.
Inferring recent migration rates from individual genotypes
Authors: BROQUET THOMAS , YEARSLEY JONATHAN , HIRZEL ALEXANDRE H. , GOUDET JÉRÔME , PERRIN NICOLAS
Published: February 2009

We present a novel and straightforward method for estimating recent migration rates between discrete populations using multilocus genotype data. The approach builds upon a two‐step sampling design, where individual genotypes are sampled before and after dispersal. We develop a model that estimates all pairwise backwards migration rates (mij, the probability that an individual sampled in populationiis a migrant from populationj) between a set of populations. The method is validated with simulated data and compared with the methods of BayesAss and Structure. First, we use data for an island model and then we consider more realistic data simulations for a metapopulation of the greater white‐toothed shrew (Crocidura russula). We show that the precision and bias of estimates primarily depend upon the proportion of individuals sampled in each population. Weak sampling designs may particularly affect the quality of the coverage provided by 95% highest posterior density intervals. We further show that it is relatively insensitive to the number of loci sampled and the overall strength of genetic structure. The method can easily be extended and makes fewer assumptions about the underlying demographic and genetic processes than currently available methods. It allows backwards migration rates to be estimated across a wide range of realistic conditions.