bluuebunny/crossref_metadata_2025 huggingface dataset:
Examination of mortality rates in a retrospective cohort of patients treated with oral or implant naltrexone for problematic opiate use
Authors: Kelty Erin , Hulse Gary
Published: April 2012

Aims  To examine and compare mortality rates in patients treated with oral and implant naltrexone.

Design  A retrospective cohort study.

Setting  A community not‐for‐profit drug treatment clinic.

Participants  Patients treated with oral naltrexone (n = 2155, 17 207 patient‐years) and implant naltrexone (n = 2389, 11 678 patient‐years) for problematic opiate use between August 1997 and December 2009.

Measurements  Crude gender, age, treatment period and cause‐specific mortality rates were calculated using data obtained from the National Death Index.

Findings  Crude mortality rates for patients treated with oral naltrexone [8.78 deaths per 1000 patient‐years (ptpy), 95% confidence interval (CI): 7.38–10.17] were significantly different to those treated with implant naltrexone (6.59 ptpy, 95% CI: 5.13–8.06) (P = 0.0339). During the first 4 months following treatment, differences in the two groups were particularly apparent, with a mortality rate of 26.28 ptpy in patients treated with oral naltrexone compared to 7.34 ptpy in patients treated with implant naltrexone (P = 0.0003). Differences in initial mortality rates following treatment were associated predominantly with high rates of opiate overdoses in oral naltrexone patients during the first 4 months following treatment (17.22 ptpy compared with 0.67 ptpy in implant naltrexone patients) (P < 0.0001).

Conclusions  The use of implant naltrexone can reduce all‐cause mortality and opiate overdose during the first 4 months following treatment compared with patients treated with oral naltrexone.
Does forest restoration using taungya foster tree species diversity? The case of Afram Headwaters Forest Reserve in Ghana
Authors: Boakye Emmanuel A. , van Gils Hein , Osei Edward M. , Asare Veronica N. A.
Published: April 2012

The taungya agro‐forestry system is an under‐researched means of forest restoration that may result in high tree diversity. Within a forest reserve in Ghana, the forest core and its surrounding Teak‐ and Cedrela‐taungya on logged, cropped and burned land were mapped with ALOS satellite imagery. Native trees, seedlings and saplings were enumerated in 70 random, nested plots, equally divided between forest and taungya. The native tree regeneration was assessed by species richness (SR), Shannon‐Wiener Index (SWI), Shannon Evenness Index (SEI) and species density (SeD) for seedlings, saplings and trees separately and combined and subsequently correlated with canopy covers (CC) in taungya. As anticipated, the taungya diversity was lower than the forest diversity but higher than reported from nontaungya exotic plantations. In the forest, the diversity of native trees increased from seedlings through saplings to trees. The reverse was found in the taungya. Taungya seedling diversity was not significantly different from the forest, while the sapling and tree diversity were significantly lower. Weak correlations of CC with SR, SWI, SEI and SeD were found. Our results suggest the need for treatment to maintain the tree diversity beyond the seedling stage in the taungya.
High TPMT enzyme activity does not explain drug resistance due to preferential 6‐methylmercaptopurine production in patients on thiopurine treatment
Authors: van Egmond R. , Chin P. , Zhang M. , Sies C. W. , Barclay M. L.
Published: April 2012

Background

Up to 20% of patients on thiopurine therapy fail to achieve adequate drug response. Many of these patients preferentially produce the toxic 6‐methylmercaptopurine metabolites (6‐MMP) rather than the active 6‐thioguanine nucleotides (6‐TGN) resulting in a high 6‐MMP/6‐TGN ratio (>20) and increased risk of hepatotoxicity.

Aim

To determine the prevalence of preferential 6‐MMP producers and define the relationships between 6‐TGN, 6‐MMP and thiopurine methyltransferase (TPMT).

Methods

The database of 6‐TGN, 6‐MMP and TPMT measurements from patients throughout New Zealand was used to calculate patients’ 6‐MMP/6‐TGN ratios and identify those with high (>20) or normal ratio (≤20).The TPMT enzyme activity was compared amongst the groups.

Results

Of 1879 patients with TPMT, 6‐TGN and 6‐MMP results, 349 (19%) had a 6‐MMP/6‐TGN ratio >20. The mean TPMT enzyme activity was slightly lower for those with a 6‐MMP/6‐TGN ratio ≤20 vs. >20, which achieved statistical significance (12.2 vs. 13.2; P < 0.001). However, the distributions of TPMT enzyme activity were similar, with 97% of TPMT results falling between 5.0 and 17.6 IU/mL for both groups. In all, 17% of those with 6‐MMP/6‐TGN ratio ≤20 were intermediate TPMT metabolisers (TPMT 5.0–9.2 IU/mL) vs. 7% in those with a ratio >20.

Conclusions

In this patient population with measured 6‐MMP/6‐TGN ratios, 19% of patients were preferential 6‐MMP producers. The results show that high TPMT enzyme activity is not the major reason for preferential 6‐MMP production in most patients with a high metabolite ratio. This suggests that there are one or more important alternative mechanisms for preferentially producing 6‐MMP.
Effect of long‐term swine‐manure application on soil hydraulic properties and heavy metal behaviour
Authors: Asada K. , Yabushita Y. , Saito H. , Nishimura T.
Published: April 2012

This study evaluated the effect of 13 years of swine‐manure application on the changes in soil hydraulic properties, and as associated physicochemical properties, with a focus on heavy metal mobility. Various soil hydraulic properties were measured, including soil water retention (SWR), saturated field hydraulic conductivity (Kfs) and unsaturated field hydraulic conductivity (Kfunsat) using a disc infiltrometer. Heavy metal mobility was evaluated with a sequential extraction procedure. At 0–30 cm soil depth in the heavily manured plot (SMhigh plot), SWR at 0 to −100 kPa was significantly larger than in plots amended with a standard amount of manure (SMstd plot) or with chemical fertilizer (CF plot). Kfs and Kfunsat values in both manure‐amended plots were less than in the CF plot under dry soil conditions but greater than those of the CF plot under wet soil conditions. Furthermore, Kfs and Kfunsat did not necessarily increase with manure application rates. On the other hand, high‐mobility metal fractions, such as the exchangeable fraction of Zn, and the CH3CO2Na‐extractable fraction of Zn and Mn, and the metal–organic complex fractions of Zn, Cu and Mn, increased with the greater manure application rate. In addition, low‐mobility metal fractions, the organically bound fractions of Zn, Cu and Mn in the high SM plot and the easily reducible metal oxide fraction of Mn in both manure‐amended plots were probably affected and released into high‐mobility fractions. This indicated that manure application changed the soil redox conditions by improving the soil structure, depending on the water content of soil pores. Despite the reduction of Kfs and Kfunsat by heavy manure application, the transport of high‐mobility metal fractions with either surface water flow or infiltration water flow could be controlled by soil water content at the beginning of a rain or irrigation event.
Comparison of enzyme‐assisted and ultrasound‐assisted extraction of vitamin C and phenolic compounds from acerola (Malpighia emarginata DC.) fruit
Authors: Le Hong Van , Le Van Viet Man
Published: April 2012

This article describes a comparative study of enzyme and ultrasound techniques for the simultaneous extraction of vitamin C and phenolic compounds from acerola fruit. Ultrasound‐assisted extraction (UAE) took only 6 min to achieve the highest level of vitamin C and phenolic compounds as well as antioxidant activity of acerola juice, while enzyme‐assisted extraction (EAE) took up to 120 min to obtain the maximal values. On the basis of kinetic model of second‐order extraction, the extraction rate constant of vitamin C and phenolics in UAE increased approximately 3.1 and 2.7 times, respectively, in comparison with that in EAE. In addition, the maximal level of vitamin C, phenolics and the antioxidant activity evaluated by 1,1‐diphenyl‐2‐picrylhydrazyl (DPPH), and 2,2′‐azinobis‐(3‐ethylbenzothiazoline‐6‐sulphonic acid) (ABTS) methods in UAE was 4.6%, 3.5%, 4.6% and 3.3%, respectively, higher than those in EAE. Obviously, UAE is a useful method for the extraction of antioxidants from plant materials.
Production of total polyphenol from fermented soybean curd residue by Lentinus edodes
Authors: Shi Min , Yang Yingnan , Wang Qinghong , Zhang Ying , Wang Yuepeng , Zhang Zhenya
Published: April 2012

The effects of fermented conditions on the production of total polyphenol from Lentinus edodes using soybean curd residue (SCR) were investigated in solid‐state cultures. Based on the results of single factor, inoculum size, moisture content and fermented time were optimised using central composite design in response surface methodology. As a result, the optimal fermented condition of total polyphenol production was determined as following: 12.13% inoculum size, 76.96% moisture content for 24 days incubation. Compared with unfermented SCR, the total polyphenol yield increased from 3.12 ± 0.02 to 22.93 ± 0.41 mg gallic acid equivalent per gram, and polysaccharides, protein and various amino acid of fermented SCR were increased significantly. Therefore, a nutritious functional food or food additives could be produced using fermented SCR.
Cereal‐based fermented foods in developing countries: ancient foods for modern research
Authors: Guyot Jean‐Pierre
Published: April 2012

Cereal‐based fermented foods are major contributors to energy intake in developing countries (DC). Their microbiota is dominated by lactic acid bacteria and has been extensively investigated. Diversity studies have been facilitated by molecular methods enabling genotyping of isolates; the rapid development of ‘omics’ approaches should facilitate more comprehensive studies to describe the relation between microbial diversity, cell physiology and product characteristics. Also, the link between the food microbiota and health benefits, in particular in nutrition, should be investigated. There is a need to encourage researches in the field of DC cereal‐based foods in direction of more mechanistic approaches.
Unsound kernel identification using linear colour charge‐coupled device
Authors: Chen Fengnong , Luo Yan , Cheng Fang
Published: April 2012

Wheat is one of the most consumed grains in the world. The identification of wheat based on surface characteristics is important for the market. This study is aimed at identifying unsound kernels (Triticum durum Desf), including 710 black germ kernels, 627 broken kernels and 1169 sound kernels from several seed distributors in China. The system is mainly composed of a liner charge‐coupled device for image capture and a software package for extracting various morphological, colour and texture features. The models built by partial least squares discriminate analysis, support vector machine discrimination analysis (SVMDA) and principal component analysis‐artificial neural networks for identifying the unsound kernels have been explored. After comparisons of these three methods, it has been found that SVMDA got the best accuracy: 95.1%, 96.0% and 98.3% (black germ kernels, broken kernels and sound kernels). Obviously, the experimental results have shown that SVMDA is the most feasible and effective choice for the identification.
Characteristics of fibre‐rich powder and antioxidant activity of pitaya (Hylocereus undatus) peels
Authors: Zhuang Yongliang , Zhang Yufeng , Sun Liping
Published: April 2012

The contents of total dietary fibre (TDF), soluble dietary fibre (SDF), insoluble dietary fibre (IDF) and functional properties of fibre‐rich powders (FRP) from pitaya peels with different particle size (FRP80, FRP140 and FRP250) were determined. Results showed that FRP140 had higher TDF (79.37%) and SDF (33.07%) with a balanced ratio of SDF/IDF (1:1.32) and higher water‐holding capacity (54.20 g g−1), swelling capacity (50.63 mL g−1), oil‐holding capacity (2.65 g g−1) and glucose dialysis retardation index (62.83% at 60 min), compared with FRP80 and FRP250. Therefore, physiochemical properties of FRP140 were further investigated. SDF of FRP140 mainly contained rhamnose (4.95%) and galactose (1.98%), with 9.45% galacturonic acid, while IDF dominantly contained xylose (4.76%) and galactose (3.42%), with 18.54% klason lignin. Total phenolic content was 7.75 mg g−1 and mainly composed of salicylic acid (0.98 mg g−1) and protocatechuic acid (0.45 mg g−1). Furthermore, FRP140 showed significant reducing power, DPPH‐scavenging activity and nitrite‐scavenging ability.
Classification of moroccan olive cultivars by linear discriminant analysis applied to ATR–FTIR spectra of endocarps
Authors: De Luca Michele , Terouzi Wafa , Kzaiber Fouzia , Ioele Giuseppina , Oussama Abdelkhalek , Ragno Gaetano
Published: April 2012

The potential of FTIR combined with chemometrics was studied to classify five Moroccan varieties of olives by analysis on the endocarps. Attenuated total reflectance (ATR) enabled the samples to be examined directly in the solid state. The spectral data were subjected to a preliminary derivative elaboration based on the Norris gap algorithm to reduce the noise and extract larger analytical information. Linear discriminant analysis (LDA) was adopted as classification method, and Principle component analysis (PCA) was employed to compress the original data set into a reduced new set of variables before LDA. The calibration set was built by using the IR data from seventy‐five samples scanned in reflectance mode, and the ranges 3000–2400 and 2300–600 cm−1 were selected because furnishing the most useful analytical information. PCA allowed clustering the samples in five classes by using the first two principal components with an explained variance of 98.16%. Application of LDA on an external test set of twenty‐five samples enabled to classify them into five variety groups with a correct classification of 92.0%.
Chemical and sensory changes of different dairy products during storage in packages containing nanocrystallised TiO2
Authors: Peter Anca , Nicula Camelia , Mihaly‐Cozmuta Anca , Mihaly‐Cozmuta Leonard , Indrea Emil
Published: April 2012

The chemical changes of three types of cheese, yoghurt and kefir were evaluated during storage in packages containing TiO2 with two different compositions of the mixed anatase–rutile phase. The influence of TiO2 packaging during storage on titratable acidity and fat content and on the external aspect was investigated. Fourier Transformed Infrared Spectroscopy (FTIR) analyses were performed to establish whether the TiO2 penetrated the food during storage. The results showed that the TiO2 nanoparticles deposited on polyethylene surface significantly decreased acidity and fat content of the investigated cheese and yoghurt types. During storage in TiO2 nanopackages, the change in chemical parameters is accentuated as the content of rutile grows from 2.8% to 6.9%. The sensory evaluation revealed that the dairy products stored for 11 days in TiO2 nanopackages present similar colour, texture and flavour with that of the references; the samples stored in polyethylene film were found to be unacceptable.
Pharmacokinetics of ceftiofur crystalline free acid after single and multiple subcutaneous administrations in healthy alpacas (Vicugna pacos)
Authors: DECHANT J. E. , ROWE J. D. , BYRNE B. A. , WETZLICH S. E. , KIEU H. T. , TELL L. A.
Published: April 2012

Dechant, J. E., Rowe, J. D., Byrne, B. A., Wetzlich, S. E., Kieu, H. T., Tell, L. A. Pharmacokinetics of ceftiofur crystalline free acid after single and multiple subcutaneous administrations in healthy alpacas (Vicugna pacos). J. vet. Pharmacol. Therap. 36, 122–129.

Six adult male alpacas received one subcutaneous administration of ceftiofur crystalline free acid (CCFA) at a dosage of 6.6 mg/kg. After a washout period, the same alpacas received three subcutaneous doses of 6.6 mg/kg CCFA at 5‐day intervals. Blood samples collected from the jugular vein before and at multiple time points after each CCFA administration were assayed for ceftiofur‐ and desfuroylceftiofur‐related metabolite concentrations using high‐performance liquid chromatography. Pharmacokinetic disposition of CCFA was analyzed by a noncompartmental approach. Mean pharmacokinetic parameters (±SD) following single‐dose administration of CCFA were Cmax (2.7 ± 0.9 μg/mL); Tmax (36 ± 0 h); area under the curve AUC0→∞ (199.2 ± 42.1 μg·h/mL); terminal phase rate constant λz (0.02 ± 0.003/h); and terminal phase rate constant half‐life t1/2λz (44.7 h; harmonic). Mean terminal pharmacokinetic parameters (±SD) following three administrations of CCFA were Cmax (2.0 ± 0.4 μg/mL); Tmax (17.3 ± 16.3 h); AUC0→∞ (216.8 ± 84.5 μg·h/mL); λz (0.01 ± 0.003/h); and t1/2λz (65.9 h; harmonic). The terminal phase rate constant and the Tmax were significantly different between single and multiple administrations. Local reactions were noted in two alpacas following multiple CCFA administrations.
Early HIV viral load determination after initiating first‐line antiretroviral therapy for indentifying patients with high risk of developing virological failure: data from a cohort study in a resource‐limited setting
Authors: Alvarez‐Uria Gerardo , Naik Praveen Kumar , Pakam Rhagavakalyan , Midde Manoranjan
Published: April 2012

Objectives  To evaluate the performance of a single determination of HIV viral load (VL) 6–12 months after starting antiretroviral therapy (ART) for identifying patients who will subsequently develop virological failure.

Methods  We selected HIV‐infected patients with at least two VL determinations after 6 months of ART from an HIV cohort study in India. Patients were divided in two groups depending on whether the first VL was below (Group 1) or above (Group 2) 1000 copies/ml. Cut‐off for virological failure was defined according to World Health Organization recommendation (>5000 copies/ml).

Results  The study included 584 patients and 560.1 person‐years of follow‐up. Of all virological failures, 83% were diagnosed at the first VL determination. The cumulative incidence of virological failure after 1 and 2 years since the first VL was 0.9% [95% confidence interval (CI), 0.3–2.7] and 1.7% (95% CI, 0.6–5), respectively, for Group 1, and 58.2% (95% CI, 47–69.7) and 63.1% (95% CI, 49.8–76.4), respectively, for Group 2. Compared with Group 1, patients from Group 2 had a hazard ratio for virological failure of 78.3 (95% CI, 27.8–220.2).

Conclusions  A single VL determination after 6 months of ART was able to identify patients with high risk of virological failure.
Patterns of male fitness conform to predictions of evolutionary models of late life
Authors: SHAHRESTANI P. , TRAN X. , MUELLER L. D.
Published: April 2012

We studied lifetime male virility, a male fitness component, in five populations of Drosophila melanogaster. Virility was measured as the number of females, of eight total, that a male could fertilize in 24 h. Individual males were measured at weekly intervals until they died. Virility declined in an approximately linear fashion for the first 3 weeks of adult life. It then stayed low but relatively constant for another 3 weeks, exhibiting a clear plateau. These observations are consistent with the evolutionary theories of late life. The results were not consistent with a simple heterogeneity theory of late life. This is the first demonstration of a late‐life plateau for a male fitness component. We also found that the virility of males that were within 7 days of death was significantly lower than that of similarly aged males that were not about to die. This rapid deterioration of virility prior to death, or death spiral, is similar to a decline in fecundity that we had previously documented.
Group adaptation, formal darwinism and contextual analysis
Authors: OKASHA S. , PATERNOTTE C.
Published: April 2012

We consider the question: under what circumstances can the concept of adaptation be applied to groups, rather than individuals? Gardner and Grafen (2009, J. Evol. Biol.22: 659–671) develop a novel approach to this question, building on Grafen's ‘formal Darwinism’ project, which defines adaptation in terms of links between evolutionary dynamics and optimization. They conclude that only clonal groups, and to a lesser extent groups in which reproductive competition is repressed, can be considered as adaptive units. We re‐examine the conditions under which the selection–optimization links hold at the group level. We focus on an important distinction between two ways of understanding the links, which have different implications regarding group adaptationism. We show how the formal Darwinism approach can be reconciled with G.C. Williams’ famous analysis of group adaptation, and we consider the relationships between group adaptation, the Price equation approach to multi‐level selection, and the alternative approach based on contextual analysis.
Water Deficit during the Reproductive Period of Grass Pea (Lathyrus sativus L.) Reduced Grain Yield but Maintained Seed Size
Authors: Gusmao M. , Siddique K. H. M. , Flower K. , Nesbitt H. , Veneklaas E. J.
Published: April 2012

The grain legume grass pea (Lathyrus sativus L.) is adapted to drought‐prone environments, but the extent and mechanisms of its tolerance are not well understood. In a pot experiment, water deficit was imposed on plants by withholding water from first flowering until predawn leaf water potential (LWPpd) was −3.12 MPa. Water deficit reduced dry matter, seed yield, harvest index and water use efficiency by 60 %, 87 %, 67 % and 75 %, respectively, when compared with the controls. Flower production stopped when LWPpd fell to −1.8 MPa. At LWPpd−1.5 MPa, only 25 % of flowers resulted in filled pods (compared with 95 % filled pods in the control) with the rest aborted as flowers (48 %) or pods (27 %). Filled pods had more aborted ovules than controls, resulting in 29 % less seeds per pod. Water deficit reduced pollen viability, germination and the number of pollen tubes reaching the ovary by 13 %, 25 % and 31 %, respectively. Emergence from seeds produced from water‐deficient plants was 21 % less than controls, but seedling shoot dry mass was 18 % higher, in accordance with the 19 % higher seed mass. The sensitivity of flowering to drought limited pod numbers but enabled plants to retain existing pods and develop near‐normal seeds with low β‐N‐oxalyl‐l‐α‐β‐diaminopropionic acid toxin concentrations. This trait is useful for farming systems reliant on harvested seed for the next crop and in cases where seed size influences the value of the product.
Concentrations of haptoglobin in bovine plasma determined by ELISA or a colorimetric method based on peroxidase activity
Authors: Cooke R. F. , Arthington J. D.
Published: April 2012

The objective was to compare different procedures for determination of haptoglobin in bovine plasma. Nine Angus steers were vaccinated againstMannheimia haemolyticato stimulate an acute‐phase response. Blood samples were collected immediately prior to vaccination (day 0), and on days 1, 3, 5, 7 and 10. Plasma samples were frozen in duplicates at −80 °C. One set of the duplicates was analysed for haptoglobin concentrations using a commercial ELISA kit. A day effect was detected (p < 0.01) because haptoglobin peaked on day 3 and returned to baseline on day 7 relative to vaccination. The second duplicate was analysed using a procedure that measures haptoglobin–haemoglobin complexing by estimating differences in peroxidase activity (CPPA) with results expressed as optical density. Further, based on the ELISA results, the plasma sample with the greatest haptoglobin concentration was also serially diluted into a plasma sample with negligible haptoglobin concentration from the same steer (1:1 through 1:1024 dilution). These dilutions were used within the CPPA method to generate a standard curve and estimate plasma haptoglobin concentrations (CPPA + STD). A linear standard curve was generated (r2 = 0.99). A day effect similar to the ELISA method was detected for the CPPA and CPPA + STD methods (p < 0.01). Results obtained from CPPA and ELISA methods were positively correlated (r = 0.97; p < 0.01). The values generated by the CPPA + STD procedure were similar (p = 0.38) compared to the values generated by the ELISA method. In conclusion, assessing concentrations of haptoglobin in bovine plasma using the CPPA and CPPA + STD methods generate highly correlated or similar results, respectively, compared to ELISA. Therefore, the CPPA + STD and CPPA methods can be used as a less expensive alternative to ELISA to determine concentrations or monitor changes in plasma haptoglobin in bovine samples.
Rapid death after admission to palliative care
Authors: Paratz E. D. , Flynn E.
Published: April 2012

Background:  Palliative care units provide non‐curative treatment and support to patients with terminal illness. Brief end‐of‐life admissions are disruptive for patients and their families, and increase staff stress. Extremely rapid deaths (survival <24 h from admission) are particularly challenging for all involved. From 1 January 2010 to 23 August 2011, 256 patients died on the Palliative Care Unit (Caritas Christi) at St Vincent's Hospital Melbourne. Forty‐two died within 24 h (16%), while 214 survived beyond 24 h (84%).

Aims:  A retrospective chart audit was conducted, aiming to identify factors characterising those patients who died within 24 h.

Methods:  Groups were compared for age, gender, country of birth, preferred language, ward of origin, primary pathology, time trends, whether an emergency code was called, Palliative Care Outcomes Collaboration (PCOC) phase, modified Karnofsky score and commencement of a syringe driver for medication.

Results:  Results showed that admission from neurosurgery (P= 0.0001), a vascular or infective pathology (P= 0.0001), PCOC phase ≥3 (P= 0.0001), modified Karnofsky score ≤20% (P= 0.0001), and commencement of a syringe driver prior to or at admission (P= 0.0001) were all significantly associated with death within 24 h of admission. On binary logistic regression, the only independent predictor of patients likely to die in <24 h from admission was PCOC phase ≥3 (P= 0.002).

Conclusions:  This study is designed to help clinicians identify patients likely to deteriorate rapidly. Alternative options could include earlier transfer to the palliative care unit or palliation on their home ward with palliative care consultation.
Recent trends in Victorian risk‐adjusted in‐hospital mortality: 1999–2009
Authors: Duke G. , Barker A. , Santamaria J. , Graco M.
Published: April 2012

Background

The background of the study is a comparison of risk‐adjusted mortality across hospitals from different jurisdictions is now common worldwide.

Aim

To examine temporal trends in risk‐adjusted mortality in Victoria over the last decade.

Methods

Retrospective cohort study of 6.89 million adult (>14 years) patient episodes from 23 major Victorian public hospitals between 1999 and 2009. The primary outcome was in‐hospital death. Three measures were calculated: the crude mortality rate, risk‐adjusted mortality rate and standardised mortality ratio (SMR). The Hospital Outcome Prediction Equation (HOPE) was applied to generate estimates of predicted mortality that were used to compute the SMR and risk‐adjusted mortality rates. The HOPE model includes 26 exogenous risk factors for which providers have no influence. The model was calibrated using the 2004–2005 data. Temporal mortality trends from 1999–2009 were evaluated using negative binomial regression for crude mortality and SMR estimates and random‐intercept hierarchical logistic regression for risk‐adjusted mortality.

Results

The study population included 84 423 in‐hospital deaths (1.2%). Crude mortality risk declined from 1.5% in 2000 to 1.1% in 2005–2009 (incidence rate ratio (IRR): 0.96; 95% confidence interval (CI): 0.95–0.97; P < 0.001). There were 1.39 million episodes in the HOPE calibration cohort. Between 1999 and 2009, the SMR decreased from 1.4 to 0.9 (IRR = 0.91; 95% CI: 0.90–0.97; P < 0.001) and adjusted mortality risk declined from 2.1% to 0.9% (odds ratio = 0.94, 95% CI: 0.94–0.94, P < 0.001). Declining mortality trends were evident in the tertiary, metropolitan and regional peer groups (P < 0.001).

Conclusion

Analysis of in‐hospital risk‐adjusted mortality trends using the HOPE model indicates significant improvement in patient outcomes in the State of Victoria over the past decade.
Sleep‐dependent consolidation of procedural motor memories in children and adults: the pre‐sleep level of performance matters
Authors: Wilhelm Ines , Metzkow‐Mészàros Maila , Knapp Susanne , Born Jan
Published: April 2012

In striking contrast to adults, in children sleep following training a motor task did not induce the expected (offline) gain in motor skill performance in previous studies. Children normally perform at distinctly lower levels than adults. Moreover, evidence in adults suggests that sleep dependent offline gains in skill essentially depend on the pre‐sleep level of performance. Against this background, we asked whether improving children’s performance on a motor sequence learning task by extended training to levels approaching those of adults would enable sleep‐associated gains in motor skill in this age group also. Children (4–6 years) and adults (18–35 years) performed on the motor sequence learning task (button‐box task) before and after ∼2‐hour retention intervals including either sleep (midday nap) or wakefulness. Whereas one group of children and adults, respectively, received the standard amount of 10 blocks of training before retention intervals of sleep or wakefulness, a further group of children received an extended training on 30 blocks (distributed across 3 days). A further group of adults received a restricted training on only two blocks before the retention intervals. Children after standard training reached lowest performance levels, whereas in adults performance after standard training was highest. Children with extended training and adults after reduced training reached intermediate performance levels. Only at these intermediate performance levels did sleep induce significant gains in motor sequence skill, whereas performance did not benefit from sleep in the low‐performing children or in the high‐performing adults. Spindle counts in the post‐training nap were correlated with performance gains at retrieval only in the adults benefitting from sleep. We conclude that, across age groups, sleep induces the most robust gain in motor skill at an intermediate pre‐sleep performance level. In low‐performing children sleep‐dependent improvements in skill may be revealed only after enhancing the pre‐sleep performance level by extended training.
Confucian dynamism work values and team performance: A multiple‐level analysis
Authors: Huang Min‐Ping , Liang Wei‐Chun , Hsin Chih‐Ning
Published: April 2012

In this study we clarified the multiple‐level effects of Confucian‐related work values, including self‐discipline and interpersonal ethics, on the performance of individuals and the team. Empirical data of 70 work teams with 472 team members from Taiwanese enterprises were collected to test our hypotheses. Results showed that, at the group level, shared team values of interpersonal ethics were positively related to team performance through the partial mediation of team cooperation. For cross‐level effect, shared team values of interpersonal ethics and individual member's self‐discipline values were both positively related to individual performance. The implications of Confucian dynamism work values on contemporary organizational management and indigenous Chinese team theories were provided.
THE TRIPLISM OF PRACTICAL REASON
Authors: Skorupski John
Published: April 2012

There can be reasons for belief, for action, and for feeling. In each case, knowledge of such reasons requires non‐empirical knowledge of some truths about them: these will be truths about what there is reason to believe, to feel, or to do – either outright or on condition of certain facts obtaining. Call these a priori truths about reasons, ‘norms’. Norms are a priori true propositions about reasons.

It's an epistemic norm that if something's a good explanation that's a reason to believe it. It's an evaluative norm that if someone's cheated you that's a reason to be annoyed with them. There are many evaluative norms, relating to a variety of feelings. Equally, there may be various epistemic norms, even though in this case they all relate to belief. My concern here, however, is with practical norms: a priori truths about what there is reason to do.

I have a suggestion about what fundamental practical norms there are, which I would like to describe and explain. It is that there are just three distinct kinds of practical norm governing what there is reason to do – three categories or generic sources of practical normativity, one may say. I call them the Bridge principle, the principle of Good, and the Demand principle – Bridge, Good and Demand for short. I have said more about them in my book, The Domain of Reasons;1 here my aim is simply to set them out and sketch some questions to which this ‘triplism of practical reason’2 gives rise. In particular, since these norms are about practical reasons, not about morality, a question I'll touch on is how moral obligation comes onto the scene.
IRIS MURDOCH AND THE BORDERS OF ANALYTIC PHILOSOPHY
Authors: Milligan Tony
Published: April 2012

Iris Murdoch's philosophical texts depart significantly from familiar analytic discursive norms. (Such as the norms concerning argument structure and the minimization of rhetoric.) This may lead us to adopt one of two strategies. On the one hand an assimilation strategy that involves translation of Murdoch's claims into the more familiar terms of property‐realism (the terminology of ethical naturalism and non‐naturalism). On the other hand, there is the option of adopting a crossover strategy and reading Murdoch as (in some sense) a philosopher who belongs more properly to the continental tradition. The following article argues that if familiar Quinean claims about ontological commitment and Murdoch's account of metaphor are both broadly correct then the assimilation strategy must fail to produce a faithful translation. Nonetheless, Murdoch's connection to the analytic tradition is more than genealogical, it is more than a matter of her writing (initially) in response to analytic contemporaries before branching off in a more continental direction. While she departs from familiar analytic discursive norms, she continues to accept most of the epistemic values (such as clarity and simplicity) that the norms embody.
Norwegian Euroscepticism: Values, Identity or Interest*
Authors: SKINNER MARIANNE SUNDLISÆTER
Published: April 2012

This article presents a new theory – the VCR (Values, political Culture and Rural society) model – to clarify what Norwegian Euroscepticism is really about and explain why so many Norwegians do not want their country to be a member of the European Union. It argues that at the centre of Norwegian Euroscepticism is a concern for post‐materialist values, political culture and rural society, and that values (the desire to make Norway and the world a better place) is a much more potent explanation for Norwegian Euroscepticism than economic interest (the desire to make Norway a richer place) or perceived threat to Norwegian national identity. The VCR theory finds support in the empirical study conducted: a thematic analysis of newspaper debates in a major Norwegian newspaper from the 1960s, 1970s and 1990s. The findings also indicate that the Euroscepticism found in Norway in the 1990s is extremely similar to that which was formed during the first membership debates in the 1960s and 1970s. In addition to contributing towards the literature on Norway and the EU, the article makes a contribution to the general study of Euroscepticism by putting forward a new approach to studying and comparing the subject across time and across countries.
Using life‐history traits of New Zealand sea lions, Auckland Islands to clarify potential causes of decline
Authors: Chilvers B. L.
Published: April 2012

Annual censuses of New Zealand (NZ) sea lions Phocarctos hookeri at the subantarctic Auckland Islands have indicated a decline in pup production of over 40% during the first decade of the 2000s. With this significant decline and likely decline in the population as a whole, population ecology theory hypothesizes that life‐history traits such as reproduction rate, survival or growth should improve, particularly if density‐dependency is playing a significant role in the population. This research examined whether changes in NZ sea lion pup production were associated with changes in adult abundance or population life‐history traits in an attempt to clarify potential causes of decline. Since 1998/1999, daily surveys of Sandy Bay, Enderby Island, were undertaken during the NZ sea lion breeding season (December–February). These surveys confirm that the number of adults at the breeding area has significantly declined during the period of pup production decline. There was no difference between years in mean pup birth date, but the ratio of pups to females ashore during peak pupping varied significantly. The sex ratio of pups at birth also varied from year to year, but with no significant variation overall. Pup mortality varied significantly only during years of epizootic events (1997/1998, 2001/2002 and 2002/2003). Pup birth mass showed little variation between 2000/2001 and 2006/2007, increasing slightly in the last 3 years of study. Pup mass at 3 weeks, although highly variable, showed no trend during the period of decline. Despite the significant decrease in pup production and breeding animals, not all life‐history traits relating to pup mass and survival or female fecundity improved. Research suggests that indirect fishing‐related pressures may influence some of these traits and that the NZ sea lion population was unlikely to have been influenced by density‐dependent factors or to have been at or near carrying capacity before the decline.
Calcitonin Gene‐Related Peptide and Size of the Atrial Septal Defect in New‐Onset Migraine After Transcatheter Closure: Results of a Preliminary Study
Authors: Wei Shu‐Hao , Fan Pi‐Chuan , Kuo Ping‐Hung , Chiou Lih‐Chu , Wang Jou‐Kou
Published: April 2012

Background.— New‐onset migraine headache attacks (MHAs) can occur after atrial septal device implantation in patients without previous migraine. Plasma calcitonin gene‐related peptide (CGRP), which plays a crucial role in migraine pathophysiology, has shown to be released from specific cardiac tissues.

Methods and Results.— We prospectively collected patients before and after closure and measured plasma CGRP levels using enzyme‐linked immunosorbent assay. Forty atrial septal defect (ASD) patients who had no migraine previously were enrolled. Four (23.5%) of the 17 consecutive patients whose CGRP levels were checked before ASD closure had new‐onset MHAs. The patients with MHAs had bigger ASD size (20 ± 0.9 vs 16 ± 1 mm, P = .009) and lower CGRP levels before closure (21.1 ± 3.9 vs 90.1 ± 27.1 pg/mL, P = .042) than those without. Among the 5 patients with blood samplings both during and between attacks, a paired comparison revealed a significantly increased level during attack (257.2 ± 45.5 vs 45.6 ± 25.5 pg/mL, P = .03).

Conclusion.— Bigger ASD size and lower plasma CGRP levels before closure can be a potential predictor of new‐onset MHAs. Furthermore, a significant increase of CGRP levels during migraine attack implies that the occurrences of new‐onset MHAs after ASD closure correlate with the release of CGRP. This suggests CGRP sensitization from a lower baseline may be involved in the occurrence of new‐onset MHAs after ASD closure.
Alcohol Exposure Rate Control Through Physiologically Based Pharmacokinetic Modeling
Authors: Plawecki Martin H. , Zimmermann Ulrich S. , Vitvitskiy Victor , Doerschuk Peter C. , Crabb David , O'Connor Sean
Published: April 2012

Background

The instantaneous rate of change of alcohol exposure (slope) may contribute to changes in measures of brain function following administration of alcohol that are usually attributed to breath alcohol concentration (BrAC) acting alone. To test this proposition, a 2‐session experiment was designed in which carefully prescribed, constant‐slope trajectories of BrAC intersected at the same exposure level and time since the exposure began. This paper presents the methods and limitations of the experimental design.

Methods

Individualized intravenous infusion rate profiles of 6% ethanol (EtOH) that achieved the constant‐slope trajectories for an individual were precomputed using a physiologically based pharmacokinetic model. Adjusting the parameters of the model allowed each infusion profile to account for the subject's EtOH distribution and elimination kinetics. Sessions were conducted in randomized order and made no use of feedback of BrAC measurements obtained during the session to modify the precalculated infusion profiles. In one session, an individual's time course of exposure, BrAC(t), was prescribed to rise at a constant rate of 6.0 mg% per minute until it reached 68 mg% and then descend at −1.0 mg% per minute; in the other, to rise at a rate of 3.0 mg% per minute. The 2 exposure trajectories were designed to intersect at a BrAC (t = 20 minutes) = 60 mg% at an experimental time of 20 minutes.

Results

Intersection points for 54 of 61 subjects were within prescribed deviations (range of ±3 mg% and ±4 minutes from the nominal intersection point).

Conclusions

Results confirmed the feasibility of applying the novel methods for achieving the intended time courses of the BrAC, with technical problems limiting success to 90% of the individuals tested.
Evaluate, assess, treat: development and evaluation of the EAT framework to increase effective communication regarding sensitive oral‐systemic health issues
Authors: DeBate R. D. , Cragun D. , Gallentine A. A. , Severson H. H. , Shaw T. , Cantwell C. , Christiansen S. , Koerber A. , Hendricson W. , Tomar S. L. , McCormack Brown K. , Tedesco L. A.
Published: April 2012

Oral healthcare providers are likely to encounter a number of sensitive oral/systemic health issues whilst interacting with patients. The purpose of the current study was to develop and evaluate a framework aimed at oral healthcare providers to engage in active secondary prevention of eating disorders (i.e. early detection of oral manifestations of disordered eating behaviours, patient approach and communication, patient‐specific oral treatment, and referral to care) for patients presenting with signs of disordered eating behaviours. The EAT Framework was developed based on the Brief Motivational Interviewing (B‐MI) conceptual framework and comprises three continuous steps: Evaluating, Assessing, and Treating. Using a group‐randomized control design, 11 dental hygiene (DH) and seven dental (D) classes from eight institutions were randomized to either the intervention or control conditions. Both groups completed pre‐ and post‐intervention assessments. Hierarchical linear models were conducted to measure the effects of the intervention whilst controlling for baseline levels. Statistically significant improvements from pre‐ to post‐intervention were observed in the Intervention group compared with the Control group on knowledge of eating disorders and oral findings, skills‐based knowledge, and self‐efficacy (all P < 0.01). Effect sizes ranged from 0.57 to 0.95. No statistically significant differences in outcomes were observed by type of student. Although the EAT Framework was developed as part of a larger study on secondary prevention of eating disorders, the procedures and skills presented can be applied to other sensitive oral/systemic health issues. Because the EAT Framework was developed by translating B‐MI principles and procedures, the framework can be easily adopted as a non‐confrontational method for patient communication.
Growth and differentiation factors for periodontal regeneration: a review on factors with clinical testing
Authors: Stavropoulos A. , Wikesjö U. M. E.
Published: April 2012

Stavropoulos A, Wikesjö UME. Growth and differentiation factors for periodontal regeneration: a review on factors with clinical testing. J Periodont Res 2012; 47: 545–553. © 2012 John Wiley & Sons A/S

Background and Objective:  A large body of evidence implies that growth and differentiation factors, based on their ability to regulate various functions of cells originating in the periodontal tissues, may support periodontal wound healing/regeneration, creating an environment conducive to and/or immediately inducing de novo tissue formation. This study presents a short systematic overview on growth and differentiation factor technologies evaluated in the clinic for their potential to enhance periodontal wound healing/regeneration.

Material and Methods:  Reports on growth and differentiation factor technologies evaluated in the clinic for their potential to enhance periodontal wound healing/regeneration were selected for review.

Results:  Growth and differentiation factor technologies intended for periodontal wound healing/regeneration and evaluated clinically included platelet‐derived growth factor, insulin‐like growth factor‐I and ‐II, basic fibroblast growth factor, bone morphogenetic protein‐3 and growth differentiation factor‐5; platelet‐derived growth factor was the only Food and Drug Administration‐approved commercially available growth and differentiation factor technology. In general, enhanced periodontal regeneration was observed in sites receiving growth and differentiation factors compared with control(s). However, improvements of relatively limited clinical magnitude have been shown thus far.

Conclusion:  Although growth and differentiation factors project considerable appeal as candidate technologies in support of periodontal wound healing/regeneration, current candidate and commercially available technologies enhance treatment outcomes only to a limited extent in clinical settings.
Laparostomy management using the ABThera™ open abdomen negative pressure therapy system in a grade IV open abdomen secondary to acute pancreatitis
Authors: Fitzgerald James EF , Gupta Shradha , Masterson Sarah , Sigurdsson Helgi H
Published: April 2012

Wound control in laparostomy for the treatment of intra‐abdominal hypertension remains challenging and numerous techniques have been described. We report the first UK experience with a new commercially available device specifically designed to facilitate management of the open abdomen. A 44‐year‐old gentleman presented with a 3‐day history of constant severe epigastric pain and associated vomiting. Amylase was markedly elevated and he was admitted for supportive management of pancreatitis, with subsequent transfer to intensive care due to severe systemic inflammatory syndrome. The patient decompensated, developing intra‐abdominal hypertension with renal and respiratory failure. This was successfully managed by performing a laparostomy and using an ABThera™ Open Abdomen Negative Pressure Therapy System (KCI, San Antonio, TX). We describe its use to facilitate wound control, including enteroatmospheric fistula, allowing granulation and eventual restoration of gastrointestinal continuity 383‐days after admission. We found the ABThera™ System proved to be a useful treatment adjunct, protecting intra‐abdominal contents while removing large volumes of exudate and infected material from within the abdominal cavity. Complex cases such as this remain infrequent and this article provides a summary of our experience, including a review of indications for laparostomy and the underlying basic science in this difficult area.