bluuebunny/crossref_metadata_2025 huggingface dataset:
Aetiology, microbiology and therapy of periapical lesions around oral implants: a retrospective analysis
Authors: Lefever David , Van Assche Nele , Temmerman Andy , Teughels Wim , Quirynen Marc
Published: November 2012

Objective

The aim of this study was: (i) to evaluate whether an endodontic pathology on the extracted tooth or adjacent teeth of an implant site has an influence on the emergence of a periapical lesion, (ii) to retrospectively analyse the outcome of different treatment strategies, (iii) to determine which bacteria were present in periapical lesions.

Methods

The endodontic status of the tooth at the implant site and the adjacent teeth was explored and linked to the periapical status of the implant. For all the lesions treated since 2000, their survival was assessed. Finally, microbial samples (culturing) from the periapical lesions, were analysed.

Results

If an endodontic treatment or a periapical lesion at the apex of a tooth is present, a periapical lesion around the implant can be detected in 8.2% up to 13.6% (OR 7.2). For periapical pathology at the adjacent teeth, the percentage rises to 25% (OR 8.0). The best treatment option could not be found. Bacteria were found in 9/21 lesions. The most prominent species was P. gingivalis.

Conclusions

When an endodontic pathology is present on the extracted or neighbouring teeth, it is significantly more likely that a periapical lesion will develop around a future implant.
‘Sustaining Place’ – a grounded theory of how informal carers of people with dementia manage alterations to relationships within their social worlds
Authors: Daly Louise , McCarron Mary , Higgins Agnes , McCallion Philip
Published: November 2012

Aims and objectives

This paper presents a theory explaining the processes used by informal carers of people with dementia to mange alterations to their, and people with dementias' relationships with and places within their social worlds.

Background

Informal carers provide the majority of care to people with dementia. A great deal of international informal dementia care research is available, much of which elucidates the content, impacts and consequences of the informal caring role and the coping mechanisms that carers use. However, the socially situated experiences and processes integral to informal caring in dementia have not yet been robustly accounted for.

Design

A classic grounded theory approach was used as it is designed for research enquiries that aim to generate theory illustrating social patterns of action used to address an identified problem.

Methods

Thirty interviews were conducted with 31 participants between 2006–2008. The theory was conceptualised from the data using the concurrent methods of theoretical sampling, constant comparative analysis, memo writing and theoretical sensitivity.

Results

Informal carers' main concern was identified as ‘Living on the fringes’, which was stimulated by dementia‐related stigma and living a different life. The theory of ‘Sustaining Place’ explains the social pattern of actions employed by informal carers to manage this problem on behalf of themselves and the person with dementia.

Conclusions

The theory of ‘Sustaining Place’ identifies an imperative for nurses, other formal carers and society to engage in actions to support and enable social connectedness, social inclusion and citizenship for informal carers and people with dementia.

Relevance to clinical practice

‘Sustaining Place’ facilitates enhanced understanding of the complex and socially situated nature of informal dementia care through its portrayal of informal carers as social agents and can be used to guide nurses to better support those who live with dementia.
Adherence to treatment among adolescents in a psychiatric ward
Authors: Timlin Ulla , Riala Kaisa , Kyngäs Helvi
Published: November 2012

Aims and objectives

To examine the adolescent's adherence in psychiatric inpatient care that includes both medication and non‐pharmacological treatment.

Background

Adolescents can deny having a problem or being in need of treatment and are therefore prone to defying attempts to engage them in a collaborative treatment process. There is still little information in the literature concerning adherence to psychiatric inpatient treatment among mentally ill adolescents, especially focusing on the entire treatment period and all forms of treatment.

Design

This is a retrospective, mixed‐method study.

Methods

Data were collected from discharge reports written by doctors (n = 72) and were subjected to inductive content analysis. Adherence to all forms of treatment was considered, over the entirety of the treatment period rather than focusing on a single specific time point.

Results

Three main adherence‐related content categories were identified: non‐adherence to treatment, adherence to treatment and challenges of adherence. The last of these categories contains information on factors that affect adolescent treatment adherence.

Conclusions

We found that adherent adolescents are cooperative, willing to receive treatment and participate actively in therapies aimed at relieving their mental symptoms or illness.

Relevance to clinical practice

The findings presented herein are likely to be informative in the context of inpatient treatment, and it is expected that the results presented herein will help to improve adolescents' quality of treatment.
Is Perception of Sucrose and Caffeine Affected by Training or Experience? Monitoring Training Effects in Female Subjects over a Half‐Year Period
Authors: Hoehl Karolin , Schoenberger Gesa U. , Schwarz Karin , Busch‐Stockfisch Mechthild
Published: November 2012

The study focuses on potential differences between trained and untrained female subjects with regard to their ability to recognize sweet and bitter. Seventy‐six European female students (mean age 22.1) were recruited. They were randomly classified into a control group (n = 35) and an intervention group (n = 41), who were trained. Matching test, intensity testing, and threshold measurements were conducted for all and quantified at t0 (baseline), t1 (after intervention), and t2 (6 months after intervention). The intervention group's performance was enhanced after training: Panelists tended to match more taste samples correctly. Bitter samples were matched better at t1 in comparison with t0. Intensity of sweet and bitter samples was rated higher after intervention, too. The performance was reproduced at t2. Threshold results were ambiguous. Intervention increased the ability to detect tastes. However, in the control group, the recognition thresholds were improved during repeated testing (t1 and t2). The intervention group's performance in perception of sweet and bitter increased because of training. The performance in the control group also improved while the subjects gained experience over the course of the three testing sessions.

Practical Applications

The study offers new insight into the effects of sensory training or sensory experiences on the perception of the basic tastes, sweet and bitter. Because many sensory laboratories follow the advice of the International Organization for Standardization (ISO) when conducting sensory training or developing special test designs, the study design was geared to the specifications given in ISO 8586‐1 (Sensory analysis – General guidance for the selection, training and monitoring of assessors), and in ISO 3972 (Sensory analysis – Methodology – Method of investigating sensitivity of taste). Of special interest may be the fact that the study focuses on monitoring the effects of training in women over a period of half a year to show how long training effects can last. Training and monitoring of sensory panelists is time consuming and expensive. Simplifying the procedures would be advantageous for panel leaders as well as for the panelists themselves.
Participatory action research: moving beyond the mental health ‘service user’ identity
Authors: HUTCHINSON A. , LOVELL A.
Published: November 2012

Accessible summary

The pervasive impact of mental illness on identity is generally held as negative. Contemporary Models of involvement within statutory services pay little regard to the identity of individuals beyond the “service user” label and in doing so unwittingly perpetuate and sustain the negative impact of mental illness.

This aim of this paper is to discuss the process of working alongside people who use statutory mental health services as co‐researchers. It highlights the perspective of those involved as researchers on both the process and the impact of this type of involvement on them considering a move beyond the illness identity.

This three year participatory action research study was facilitated within community mental health services. 6 people, currently using statutory mental health services were recruited as co‐researchers. The study required that they undertook a series of interviews with service users in relation to their life stories. The transcripts were mapped and analysed by the researchers using interpretative phenomenological analysis (IPA). In order that the people were enabled to undertake these roles the study included a process of interviewing and appointing service user researchers followed by a programme of training workshops, supervision and discussion group/peer support throughout.

The study reveals the importance of key aspects within the process of user involvement emphasizing the potential for transformation: connection, creditable definitions of self and reciprocity. It discusses implications for service user involvement within the statutory mental health service, acknowledging potential for transformation at both an individual and collective level.

Contemporary models of involvement within statutory services pay little regard to the identity of individuals beyond the ‘service user’ label and in doing so unwittingly perpetuate and sustain the negative impact of mental illness. The aim of this paper is to discuss the process of a 3‐year participatory action research study facilitated by a mental health nurse. It highlights the perspective of those involved as co‐researchers, all having experience of accessing statutory mental health services. It identifies both the process and the impact of this type of involvement on them illustrating their move beyond an illness identity. The study involved them undertaking a series of interviews with other service users in relation to their life stories. They subsequently mapped and analysed the transcripts. In order that the people were enabled to undertake these roles the study included a process of interviewing and appointing service user researchers followed by a programme of training workshops, supervision and discussion group/peer support. The accounts provided reflect the six researchers' attempts to make sense of their experience and reveal the path of transformation through collaboration.
Prolonged wakefulness alters neuronal responsiveness to local electrical stimulation of the neocortex in awake rats
Authors: Vyazovskiy Vladyslav V. , Olcese Umberto , Cirelli Chiara , Tononi Giulio
Published: November 2012

Prolonged wakefulness or a lack of sleep lead to cognitive deficits, but little is known about the underlying cellular mechanisms. We recently found that sleep deprivation affects spontaneous neuronal activity in the neocortex of sleeping and awake rats. While it is well known that synaptic responses are modulated by ongoing cortical activity, it remains unclear whether prolonged waking affects responsiveness of cortical neurons to incoming stimuli. By applying local electrical microstimulation to the frontal area of the neocortex, we found that after a 4 h period of waking the initial neuronal response in the contralateral frontal cortex was stronger and more synchronous, and was followed by a more profound inhibition of neuronal spiking as compared with the control condition. These changes in evoked activity suggest increased neuronal excitability and indicate that, after staying awake, cortical neurons become transiently bistable. We propose that some of the detrimental effects of sleep deprivation may be a result of altered neuronal responsiveness to incoming intrinsic and extrinsic inputs.
Working memory performance of older adults with insomnia
Authors: Lovato Nicole , Lack Leon , Wright Helen , Cant Megan , Humphreys Joanne
Published: November 2012

Older individuals suffering insomnia typically report declines in their cognitive performance beyond what they consider to be normal changes due to the aging process. Recent neuro‐imaging studies have demonstrated frontal lobe hypo‐activation among insomniac populations when compared with healthy, good sleepers. However, research is yet to confirm whether frontal lobe hypo‐activation translates into objective declines when performing tasks hypothesized to draw upon this brain region. This study aimed to investigate whether older insomnia sufferers demonstrate significantly impaired performance on a challenging working memory task when compared with age‐matched good sleepers. Forty‐nine older individuals (mean age = 69.43 years, SD = 4.83) suffering from sleep maintenance insomnia were compared with 49 age‐matched good sleepers. Cognitive performance was assessed using the Double Span Memory Task, a computer‐based working memory task that requires participants to indicate the names and/or spatial locations of increasingly longer sequences of visually presented objects. After controlling for general intelligence, the individuals suffering from insomnia did not perform differently when compared with the good sleepers on either the simpler or more cognitively demanding components of the task. Older individuals with insomnia did not display an observable impairment of working memory in this study relative to good sleepers. Despite the mixed results from previous research, this study adds weight to the absence of objective impairment in insomniacs, at least while performing short‐term demanding cognitive tasks.
Serum Lipocalin2 is a potential biomarker of liver irradiation damage
Authors: Sultan Sadaf , Cameron Silke , Ahmad Shakil , Malik Ihtzaz A. , Schultze Frank C. , Hielscher Ruth , Rave‐Fränk Margret , Hess Clemens F. , Ramadori Giuliano , Christiansen Hans
Published: November 2012

Background/Aim

IL‐6 – IL‐1– lipocalin2 (LCN2) – liver irradiation – oxidative stress – TNF‐a Lipocalin2 (LCN2) is an acute phase protein. The source of its increased serum level in oxidative stress conditions (ROS) remains still unknown. We prospectively evaluate the serum LCN2 increase after single dose liver irradiation along with hepatic LCN2 gene and protein expression.

Methods

A single dose of 25 Gray was administered percutaneously to the liver of randomly paired rats after a planning CT scan. Male Wistar rats were sacrificed 1, 3, 6, 12, 24 and 48 h after irradiation along with sham‐irradiated controls. ELISA, RT‐PCR, Western blot and immunofluorescence staining was performed. Furthermore, hepatocytes, myofibroblasts and Kupffer cells were isolated from the liver of healthy rats and irradiated ex‐vivo.

Results

After liver irradiation, LCN2 serum levels increased significantly up to 2.7 μg/ml within 6 h and stayed elevated over 24 h. LCN2 specific transcripts increased significantly up to 552 ± 109‐fold at 24 h after liver irradiation, which was further confirmed at protein level. α2‐macroglobulin and hemoxygenase‐1 also showed an increase, but the magnitude was less as compared to LCN2. LCN2+ granulocytes were detected within 1 h after irradiation around central and portal fields and remained high during the course of study. Ex‐vivo irradiated hepatocytes (2.4 ± 0.6‐fold) showed a higher LCN2 gene expression as compared to myofibroblasts and Kupffer cells. IL‐1β treatment further increased LCN2 gene expression in cultured hepatocytes.

Conclusions

Single dose liver irradiation induces a significant increase in LCN2 serum levels, comparable to the induction of acute phase proteins. We suggest LCN2 as marker for the early phase of radiation‐induced tissue damage.
Nutrition in pregnancy and early childhood and associations with obesity in developing countries
Authors: Yang Zhenyu , Huffman Sandra L.
Published: November 2012

Concerns about the increasing rates of obesity in developing countries have led many policy makers to question the impacts of maternal and early child nutrition on risk of later obesity. The purposes of the review are to summarise the studies on the associations between nutrition during pregnancy and infant feeding practices with later obesity from childhood through adulthood and to identify potential ways for preventing obesity in developing countries. As few studies were identified in developing countries, key studies in developed countries were included in the review.

Poor prenatal dietary intakes of energy, protein and micronutrients were shown to be associated with increased risk of adult obesity in offspring. Female offspring seem to be more vulnerable than male offspring when their mothers receive insufficient energy during pregnancy.

By influencing birthweight, optimal prenatal nutrition might reduce the risk of obesity in adults. While normal birthweights (2500–3999 g) were associated with higher body mass index (BMI) as adults, they generally were associated with higher fat‐free mass and lower fat mass compared with low birthweights (<2500 g). Low birthweight was associated with higher risk of metabolic syndrome and central obesity in adults.

Breastfeeding and timely introduction of complementary foods were shown to protect against obesity later in life in observational studies. High‐protein intake during early childhood however was associated with higher body fat mass and obesity in adulthood.

In developed countries, increased weight gain during the first 2 years of life was associated with a higher BMI in adulthood. However, recent studies in developing countries showed that higher BMI was more related to greater lean body mass than fat mass. It appears that increased length at 2 years of age was positively associated with height, weight and fat‐free mass, and was only weakly associated with fat mass.

The protective associations between breastfeeding and obesity may differ in developing countries compared to developed countries because many studies in developed countries used formula feeding as a control. Future research on the relationship between breastfeeding, timely introduction of complementary feeding or rapid weight gain and obesity are warranted in developing countries.

The focus of interventions to reduce risk of obesity in later life in developing countries could include:

improving maternal nutritional status during pregnancy to reduce low birthweight;

enhancing breastfeeding (including durations of exclusive and total breastfeeding);

timely introduction of high‐quality complementary foods (containing micronutrients and essential fats) but not excessive in protein;

further evidence is needed to understand the extent of weight gain and length gain during early childhood are related to body composition in later life.
Telomere length and dynamics predict mortality in a wild longitudinal study
Authors: Barrett Emma L. B. , Burke Terry A. , Hammers Martijn , Komdeur Jan , Richardson David S.
Published: November 2012

Explaining variation in life expectancy between individuals of the same age is fundamental to our understanding of population ecology and life history evolution. Variation in the length and rate of loss of the protective telomere chromosome caps has been linked to cellular lifespan. Yet, the extent to which telomere length and dynamics predict organismal lifespan in nature is still contentious. Using longitudinal samples taken from a closed population ofAcrocephalus sechellensis(Seychelles warblers) studied for over 20 years, we describe the first study into life‐long adult telomere dynamics (1–17 years) and their relationship to mortality under natural conditions (n = 204 individuals). We show that telomeres shorten with increasing age and body mass, and that shorter telomeres and greater rates of telomere shortening predicted future mortality. Our results provide the first clear and unambiguous evidence of a relationship between telomere length and mortality in the wild, and substantiate the prediction that telomere length and shortening rate can act as an indicator of biological age further to chronological age when exploring life history questions in natural conditions.
Changes in residents’ opportunities for experiential learning over time
Authors: Peets Adam D , Stelfox Henry T
Published: November 2012

Medical Education 2012: 46: 1189–1193

Context  Learning in the clinical environment is believed to be a crucial component of residency training. However, it remains unclear whether recent changes to postgraduate medical education, including the implementation of work hour limitations, have significantly impacted opportunities for experiential learning. Therefore, we sought to quantify opportunities to gain clinical experience within medical‐surgical intensive care units (ICUs) over time.

Methods  Data on the numbers of patients admitted and invasive procedures performed per day between 1 July 2001 and 30 June 2010 within three academic medical‐surgical ICUs in Calgary, Alberta, Canada were obtained from electronic medical records. These data were matched to resident doctor on‐call schedules and residents’ opportunities to admit patients and participate in procedures were calculated and compared over time using Spearman’s rho.

Results  We found that over a 9‐year period, the opportunities afforded to residents (n = 1156) to admit patients (n = 17 189) and perform procedures (n = 52 827) during ICU rotations decreased by 32% (p < 0.001) and 34% (p < 0.001), respectively.

Conclusions  Our results suggest that there has been a significant decrease in residents’ clinical experiences in the ICU over time. Further investigations to better understand these changes and how they may impact on performance as residents become independent practising doctors are warranted.
How core competencies are taught during clinical supervision: participatory action research in family medicine
Authors: Saucier Danielle , Paré Line , Côté Luc , Baillargeon Lucie
Published: November 2012

Medical Education 2012: 46: 1194–1205

Objectives  The development of professional competence is the main goal of residency training. Clinical supervision is the most commonly used teaching and learning method for the development of core competencies (CCs). The literature provides little information on how to encourage the learning of CCs through supervision. We undertook an exploratory study to describe if and how CCs were addressed during supervision in a family medicine residency programme.

Methods  We selected a participatory action research design to engage participants in exploring their precepting practices. Eleven volunteer faculty staff and six residents from a large family medicine residency programme took part in a 9‐month process which included three focus group encounters alternating with data gathering during supervision. We used mostly qualitative methods for data collection and analysis, with thematic content analysis, triangulation of sources and of researchers, and member checking.

Results  Participants realised that they addressed all CCs listed as programme outcomes during clinical supervision, albeit implicitly and intuitively, and often unconsciously and superficially. We identified a series of factors that influenced the discussion of CCs: (i) CCs must be both known and valued; (ii) discussion of CCs occurs in a constant adaptation to numerous contextual factors, such as residents’ characteristics; (iii) the teaching and learning of CCs is influenced by six challenges in the preceptor–resident interaction, such as residents’ active engagement, and (iv) coherence with other curricular elements contributes to learning about CCs. Differences between residents’ and preceptors’ perspectives are discussed.

Conclusions  This is the first descriptive study focusing on the teaching of CCs during clinical supervision, as experienced in a family medicine residency programme. Content and process issues were equally influential on the discussion of CCs. Our findings led to a representation of factors determining the teaching and learning of CCs in supervision, and suggest directions for research, for faculty development, and for interventions with learners.
Mapping as a learning strategy in health professions education: a critical analysis
Authors: Pudelko Beatrice , Young Meredith , Vincent‐Lamarre Philippe , Charlin Bernard
Published: November 2012

Medical Education 2012: 46: 1215–1225

Context  Mapping is a means of representing knowledge in a visual network and is becoming more commonly used as a learning strategy in medical education. The assumption driving the development and use of concept mapping is that it supports and furthers meaningful learning.

Objectives  The goal of this paper was to examine the effectiveness of concept mapping as a learning strategy in health professions education.

Methods  The authors conducted a critical analysis of recent literature on the use of concept mapping as a learning strategy in the area of health professions education.

Results  Among the 65 studies identified, 63% were classified as empirical work, the majority (76%) of which used pre‐experimental designs. Only 24% of empirical studies assessed the impact of mapping on meaningful learning. Results of the analysis do not support the hypothesis that mapping per se furthers and supports meaningful learning, memorisation or factual recall. When documented improvements in learning were found, they often occurred when mapping was used in concert with other strategies, such as collaborative learning or instructor modelling, scaffolding and feedback.

Conclusions  Current empirical research on mapping as a learning strategy presents methodological shortcomings that limit its internal and external validity. The results of our analysis indicate that mapping strategies that make use of feedback and scaffolding have beneficial effects on learning. Accordingly, we see a need to expand the process of reflection on the characteristics of representational guidance as it is provided by mapping techniques and tools based on field of knowledge, instructional objectives, and the characteristics of learners in health professions education.
Power, leadership and transformation: the doctor’s potential for influence
Authors: Gabel Stewart
Published: November 2012

Medical Education 2012: 46: 1152–1160

Context  Power and leadership are concepts that are linked. Both are studied too infrequently in medical and health care settings, given the responsibilities and opportunities doctors and other health care personnel have to exert leadership and power appropriately to foster patient‐centred and health care organisational goals.

Methods  This paper reviews Raven’s concept of power, clarifies the bases of power that are available to doctors in different roles and provides illustrations of the application of the bases of power in medical practice. The relationship between power and leadership is explored, with an emphasis on how power and leadership are linked through the personal characteristics and competencies of the leader.

Results  Transformational leadership illustrates the incorporation and elaboration of power strategies into a principles‐driven, relationship‐oriented and empirically grounded form of leadership. Illustrations of the appropriate and inappropriate use of power and leadership in health care settings are provided.

Conclusions  The study of power, the study of leadership and their linkage should be incorporated to a greater degree into medical education at all levels. Strategies to achieve this end are suggested.
Development of knowledge in basic sciences: a comparison of two medical curricula
Authors: Nouns Zineb , Schauber Stefan , Witt Claudia , Kingreen Halina , Schüttpelz‐Brauns Katrin
Published: November 2012

Medical Education 2012: 46: 1206–1214

Context  Basic medical sciences education differs among medicine courses, especially as traditional and integrated problem‐based learning (PBL) curricula teach basic sciences in very different ways. The literature shows no clear differences in the performance of students of these different educational philosophies. The Charité Medical University of Berlin (Charité Universitätsmedizin Berlin) teaches both a traditional medical curriculum (TMC) and a PBL reformed medical curriculum (RMC). Both curricula conduct the Progress Test in Medicine (PTM), which examines competence in the basic and clinical sciences from the first to the last semester.

Objectives  The aim of this study was to compare the development and retention of knowledge in the basic medical sciences between students on the traditional and reformed undergraduate medical curricula, respectively.

Methods  For each student and single PTM, relative frequencies of correct answers were computed for basic sciences items only and for the whole curriculum. Frequencies were averaged and grouped by semester and curriculum. Analyses of variance (anovas) were performed at all measurement points with a Bonferroni‐corrected p‐value at the level of p < 0.005. Eta‐squared (η2) was used to classify effect size.

Results  In the first three semesters, RMC students slightly outperform TMC students in the basic sciences, although TMC students receive more systematic teaching. After this, TMC students develop a peak of knowledge in basic sciences and overtake RMC students. The knowledge of TMC students then decreases over time, but despite this, they perform better in the final semester. Students on the RMC show constant progress throughout their undergraduate studies. Overall, the development of medical knowledge is consistent in both curricula. There is no significant difference in this outcome between the traditional and PBL courses.

Conclusions  Progress testing as a longitudinal method allows us to better understand the development of knowledge during formal undergraduate education. The main difference between traditional and problem‐based medical education seems to be provoked by the high‐stakes national examination undertaken in the traditional course (the Physikum).
Waking up the next morning: surgeons’ emotional reactions to adverse events
Authors: Luu Shelly , Patel Priyanka , St‐Martin Laurent , Leung Annie SO , Regehr Glenn , Murnaghan M Lucas , Gallinger Steven , Moulton Carol‐anne
Published: November 2012

Medical Education 2012: 46: 1179–1188

Context  The adverse patient event is an inherent component of surgical practice, but many surgeons are unprepared for the profound emotional responses these events can evoke. This study explored surgeons’ reactions to adverse events and their impact on subsequent judgement and decision making.

Methods  Using a constructivist grounded theory approach, we conducted 20 semi‐structured, 60‐minute interviews with surgeons across subspecialties, experience levels, and sexes to explore surgeons’ recollections of reactions to adverse events. Further interviews were conducted with six general surgeons to explore more immediate reactions after 28 adverse events. Data coding was both inductive, developing a new framework based on emergent themes, and deductive, using an existing framework for care providers’ reactions to adverse events.

Results  Surgeons expressed feeling unique and alone in the depths of their reactions to adverse events and consistently described four phases of response, each containing cognitive and emotive components, following such events. The initial phase (the kick) involved feelings of failure (‘Am I good enough?’) experienced with a significant physiological response. This was shortly followed by a second phase (the fall), during which the surgeon experienced a sense of chaos and assessed the extent of his or her contribution to the event (‘Was it my fault?’). During the third phase (the recovery), the surgeon reflected on the adverse event (‘What can I learn?’) and experienced a sense of ‘moving on’. In the fourth phase (the long‐term impact), the surgeon experienced the prolonged and cumulative effects of these reactions on his or her own personal and professional identities. Surgeons also described an effect on their clinical judgement, both for the case in question (minimisation) and future cases (overcompensation).

Conclusions  Surgeons progress through a series of four phases following adverse events that are potentially caused by or directly linked to surgeon error. The framework provided by this study has implications for teaching, surgeon wellness and surgeon error.
Mutational analysis of MukE reveals its role in focal subcellular localization of MukBEF
Authors: She Weifeng , Mordukhova Elena , Zhao Hang , Petrushenko Zoya M. , Rybenkov Valentin V.
Published: November 2012

Bacterial condensin MukBEF is essential for global folding of the Escherichia coli chromosome. MukB, a SMC (structural maintenance of chromosome) protein, comprises the core of this complex and is responsible for its ATP‐modulated DNA binding and reshaping activities. MukF serves as a kleisin that modulates MukB–DNA interactions and links MukBs into macromolecular assemblies. Little is known about the function of MukE. Using random mutagenesis, we generated six loss‐of‐function point mutations in MukE. The surface mutations clustered in two places. One of them was at or close to the interface with MukF while the other was away from the known interactions of the protein. All loss‐of‐function mutations affected focal localization of MukBEF in live cells. In vitro, however, only some of them interfered with the assembly of MukBEF into a complex or the ability of MukEF to disrupt MukB–DNA interactions. Moreover, some MukE mutants were able to join intracellular foci formed by endogenous MukBEF and most of the mutants were efficiently incorporated into MukBEF even in the presence of endogenous MukE. These data reveal that focal localization of MukBEF involves other activities besides DNA binding and that MukE plays a central role in them.
Role of iron homeostasis in the virulence of phytopathogenic bacteria: an ‘à la carte’ menu
Authors: Franza Thierry , Expert Dominique
Published: November 2012

The interaction between pathogenic microbes and their hosts is determined by survival strategies on both sides. As a result of its redox properties, iron is vital for the growth and proliferation of nearly all organisms, including pathogenic bacteria. In bacteria–vertebrate interactions, competition for this essential metal is critical for the outcome of the infection. The role of iron in the virulence of plant pathogenic bacteria has only been explored in a few pathosystems in the past. However, in the last 5 years, intensive research has provided new insights into the mechanisms of iron homeostasis in phytopathogenic bacteria that are involved in virulence. This review, which includes important plant pathosystems, discusses the recent advances in the understanding of iron transport and homeostasis during plant pathogenesis. By summarizing the recent progress, we wish to provide an updated view clarifying the various roles played by this metal in the virulence of bacterial phytopathogens as a nutritional and regulatory element. The complex intertwining of iron metabolism and oxidative stress during infection is emphasized.
Posaconazole after previous antifungal therapy with voriconazole for therapy of invasive aspergillus disease, a retrospective analysis
Authors: Heinz Werner J. , Egerer Gerlinde , Lellek Heinrich , Boehme Angelika , Greiner Jochen
Published: November 2012

Invasive aspergillosis is an important cause of morbidity and mortality in haematological patients. Current guidelines recommend voriconazole as first‐line therapy. A change in class of antifungal agent is generally recommended for salvage therapy. The focus of this analysis was to assess if posaconazole is suitable for salvage therapy following voriconazole treatment. This was a retrospective investigation on patients with sequential antifungal therapy of posaconazole after voriconazole identified at four German hospitals. Response rates at 30 and 60 days following start of posaconazole application and toxicity of azoles by comparing liver enzymes and cholestasis parameters were evaluated. Data were analysed by descriptive statistics. Overall, the success rate was 72.2% [15 of 36 patients showed complete response (41.7%), 11 patients partial response (30.6%) at any time point], eight patients failed treatment and two were not evaluable. Mean laboratory values increased during voriconazole and decreased during posaconazole treatment: aspartate aminotransferase (increase: 31.9 U l−1 vs. decrease: 19.6 U l−1), alanine aminotransferase (32.4 U l−1 vs. 19.8 U l−1), gamma‐glutamyl transferase (124.2 U l−1 vs. 152.3 U l−1) and alkaline phosphatase (71.5 U l−1 vs. 40.3 U l−1) respectively. No patient discontinued posaconazole therapy due to an adverse event. In this analysis posaconazole was a safe and effective antifungal salvage therapy in patients with prior administration of another triazole.
Review: Experimental manipulations of microglia in mouse models of Alzheimer's pathology: activation reduces amyloid but hastens tau pathology
Authors: Lee D. C. , Rizer J. , Hunt J. B. , Selenica M.‐L. B. , Gordon M. N. , Morgan D.
Published: November 2012

The inflammation hypothesis of Alzheimer's pathogenesis has directed much scientific effort towards ameliorating this disease. The development of mouse models of amyloid deposition permitted direct tests of the proposal that amyloid‐activated microglia could cause neurodegeneration in vivo. Many approaches to manipulating microglial activation have been applied to these mouse models, and are the subject of this review. In general, these results do not support a direct neuricidal action of microglia in mouse amyloid models under any activation state. Some of the manipulations cause both a reduction in pathology and a reduction in microglial activation. However, at least for agents like ibuprofen, this outcome may result from a direct action on amyloid production, and a reduction in the microglial‐provoking amyloid deposits, rather than from reduced microglial activation leading to a decline in amyloid deposition. Instead, a surprising number of the experimental manipulations which increase microglial activation lead to enhanced clearance of the amyloid deposits. Both the literature and new data presented here suggest that either classical or alternative activation of microglia can lead to enhanced amyloid clearance. However, a limited number of studies comparing the same treatments in amyloid‐depositing vs. tau‐depositing mice find the opposite effects. Treatments that benefit amyloid pathology accelerate tau pathology. This observation argues strongly that potential treatments be tested for impact on both amyloid and tau pathology before consideration of testing in humans.
National identity during periods of controversy: celebrating Cinco de Mayo in Phoenix, Arizona
Authors: Kaftan Joanna
Published: November 2012

Cinco de Mayo, celebrated by Mexican Americans as well as Americans of other ethnicities, provides an opportunity to examine the influence of ethnic festivals on broader US identity. Given the recent controversy over the immigration bill, State Bill 1070, passed in Arizona in 2010, the themes presented in newspaper articles concerning the celebration of the holiday in Phoenix, Arizona (2006–11) and the public response to these articles are examined. This examination reveals the intense contestation associated with the presentation of symbols and themes of national identity during periods of political controversy. It also illustrates that ordinary people have strong, long‐standing opinions about the future of the nation and national identity and will express their opinions when an outlet is provided to them
Visceral and somatic sensory function in functional dyspepsia
Authors: Li X. , Cao Y , Wong R. K. M , Ho K. Y , Wilder‐Smith C. H
Published: November 2012

Background  Visceral hypersensitivity is one of the proposed underlying mechanisms in functional dyspepsia (FD). It is not clear whether visceral hypersensitivity in FD is a manifestation of a central sensitization also encompassing somatic sensitization. Transient receptor potential vanilloid‐1 (TRPV1) pathways are involved in gastric mechanosensory physiology and the TRPV1 receptor agonist, capsaicin, has been used as a chemical stimulant.

Methods  In this double‐blind, randomized study we evaluated both visceral and somatic sensory function in 34 FD patients and 42 healthy controls using quantitative sensory testing. Visceral pain sensitivity was assessed using a validated gastric pain model with oral capsaicin capsule titration and somatic pain sensitivity was determined by foot heat and hand electric stimulation.

Key Results  The median capsaicin dose required to attain moderate pain was 0.5mg in FD and 1mg in controls (P = 0.03). At these doses, mean pain intensities on a 0–100 visual analog scale were greater for FD than controls [56.9 (95% confidence intervals, 52.2–61.5) vs 45.1 (41.6–48.6), resp.] (P = 0.005). Overall, mean somatic sensory and pain thresholds were similar in FD and control groups, but in a subgroup of FD pain hypersensitivity was seen on the hand and on the foot at different stimulation thresholds.

Conclusions & Inferences  A majority of patients with FD have visceral chemo‐hypersensitivity involving TRPV1 pathways. A substantial subgroup also has somatic hypersensitivity as evidence of central sensitization.
Four 13‐lipoxygenases contribute to rapid jasmonate synthesis in wounded Arabidopsis thaliana leaves: a role for lipoxygenase 6 in responses to long‐distance wound signals
Authors: Chauvin Adeline , Caldelari Daniela , Wolfender Jean‐Luc , Farmer Edward E.
Published: November 2012

Damage‐inducible defenses in plants are controlled in part by jasmonates, fatty acid‐derived regulators that start to accumulate within 30 s of wounding a leaf.

Using liquid chromatography–tandem mass spectrometry, we sought to identify the 13‐lipoxygenases (13‐LOXs) that initiate wound‐induced jasmonate synthesis within a 190‐s timeframe in Arabidopsis thaliana in 19 single, double, triple and quadruple mutant combinations derived from the four 13‐LOX genes in this plant.

All four 13‐LOXs were found to contribute to jasmonate synthesis in wounded leaves: among them LOX6 showed a unique behavior. The relative contribution of LOX6 to jasmonate synthesis increased with distance from a leaf tip wound, and LOX6 was the only 13‐LOX necessary for the initiation of early jasmonate synthesis in leaves distal to the wounded leaf.

Herbivory assays that compared Spodoptera littoralis feeding on the lox2‐1 lox3B lox4A lox6A quadruple mutant and the lox2‐1 lox3B lox4A triple mutant revealed a role for LOX6 in defense of the shoot apical meristem. Consistent with this, we found that LOX6 promoter activity was strong in the apical region of rosettes. The LOX6 promoter was active in and near developing xylem cells and in expression domains we term subtrichomal mounds.
Elevated CO2 does not offset greater water stress predicted under climate change for native and exotic riparian plants
Authors: Perry Laura G. , Shafroth Patrick B. , Blumenthal Dana M. , Morgan Jack A. , LeCain Daniel R.
Published: November 2012

In semiarid western North American riparian ecosystems, increased drought and lower streamflows under climate change may reduce plant growth and recruitment, and favor drought‐tolerant exotic species over mesic native species. We tested whether elevated atmospheric CO2 might ameliorate these effects by improving plant water‐use efficiency.

We examined the effects of CO2 and water availability on seedlings of two native (Populus deltoides spp. monilifera, Salix exigua) and three exotic (Elaeagnus angustifolia, Tamarix spp., Ulmus pumila) western North American riparian species in a CO2‐controlled glasshouse, using 1‐m‐deep pots with different water‐table decline rates.

Low water availability reduced seedling biomass by 70–97%, and hindered the native species more than the exotics. Elevated CO2 increased biomass by 15%, with similar effects on natives and exotics. Elevated CO2 increased intrinsic water‐use efficiency (Δ13Cleaf), but did not increase biomass more in drier treatments than wetter treatments.

The moderate positive effects of elevated CO2 on riparian seedlings are unlikely to counteract the large negative effects of increased aridity projected under climate change. Our results suggest that increased aridity will reduce riparian seedling growth despite elevated CO2, and will reduce growth more for native Salix and Populus than for drought‐tolerant exotic species.
The possibility of regulating for obesity prevention–understanding regulation in theCommonwealthGovernment
Authors: Crammond B. , Van C. , Allender S. , Peeters A. , Lawrence M. , Sacks G. , Mavoa H. , Swinburn B. A. , Loff B.
Published: November 2012

A complex regulatory package is likely to be necessary to effectively reduce obesity prevalence in developed countries. This study investigated the barriers and facilitators to implementing regulatory interventions to prevent obesity within the executive arm of theAustralianCommonwealthGovernment. Policy reviews were conducted on nine government departments to understand their roles and interests in obesity. From this process we identified regulatory review carried out by theOffice ofBestPracticeRegulation as possibly posing a barrier to law reform for obesity prevention, along with the complexity of the food policymaking structures. The policy reviews informed subsequent in‐depth semi‐structured interviews with seniorCommonwealth government officers (n = 13) focused on refining our understanding of the barriers to enacting obesity prevention policy. In addition to the two barriers already identified, interviewees identified a lack of evidence for interventions, which would reduce obesity prevalence, and the influence of politicians on executive decisions as posing obstacles. Most interviewees believed that the barriers to regulating to prevent obesity were strong and that intervention by elected politicians would be the most likely method of implementing obesity prevention policy.
Off‐axis partial coherence interferometry in myopes and emmetropes
Authors: Ehsaei Asieh , Chisholm Catharine M , Pacey Ian E , Mallen Edward AH
Published: November 2012

Purpose

This study describes the axial and peripheral dimensions of myopic and emmetropic eyes in a wide range of retinal locations using a non‐contact optical biometer (Zeiss IOLMaster) based upon the principle of partial coherence interferometry. Understanding the optical properties of the peripheral eye may provide insight into myopia development and the possible effects on off‐axis visual performance.

Methods

Fifty‐two myopes (spherical equivalent between −2.00 and −9.62 D) and 27 emmetropes (spherical equivalent between −0.50 and +0.50 D) with astigmatism less than 0.75 D, participated in this study. Axial length and peripheral cornea to retina lengths were measured using partial coherence interferometry at the fovea and up to ±30° eccentricity along the horizontal and vertical meridian in 10° steps. Relative cornea to retina length was calculated by subtracting the axial length from that obtained at each peripheral location.

Results

Our results showed significant differences between refractive groups for both horizontal (p < 0.001) and vertical (p < 0.001) meridians, illustrating that the retinal shape profile is significantly different between myopes and emmetropes. Myopic eyes exhibited a greater rate of change in cornea to retina lengths with increasing eccentricity than emmetropic eyes, with the temporal portion of the retina exhibiting the steepest shift. In addition, significant nasal‐temporal asymmetry was observed, which was more pronounced in myopic eyes.

Conclusions

Axial and peripheral cornea to retina dimension measurements, using partial coherence interferometry, suggest that myopic eyes tend toward an ellipsoid shape compared to the spherical emmetropic eyes.