bluuebunny/crossref_metadata_2025 huggingface dataset:
Molecular diversity of the foregut bacteria community in the dromedary camel (Camelus dromedarius)
Authors: Samsudin Anjas A. , Evans Paul N. , Wright André‐Denis G. , Al Jassim Rafat
Published: September 2011

The molecular diversity of the foregut bacterial community in the dromedary camel (Camelus dromedarius) in Central Australia was investigated through comparative analyses of 16S rRNA gene sequences prepared from the foregut contents of 12 adult feral camels fed on native vegetation. A total of 267 full‐length 16S rRNA gene clones were examined, with 151 operational taxonomic units (OTUs) identified at a 99% species‐level identity cut‐off criterion. The prediction of actual diversity in the foregut of the dromedary camel using the Chaol approach was 238 OTUs, while the richness and evenness of the diversity estimated using Shannon index was 4.84. The majority of bacteria in the current study were affiliated with the bacterial phylum Firmicutes (67% of total clones) and were related to the classes Clostridia, Bacilli and Mollicutes, followed by the Bacteroidetes (25%) that were mostly represented by the family Prevotellaceae. The remaining phyla were represented by Actinobacteria, Chloroflexi, Cynophyta, Lentisphaerae, Planctomycetes, Proteobacteria and Sphirochaetes. Moreover, 11 clones of cultivated bacteria were identified as Brevundimonas sp., Butyrivibrio fibrisolvens, Prevotella sp. and Ruminococcus flavefaciens. The novelty in this foregut environment is remarkable where 97% of the OTUs were distantly related to any known sequence in the public database.
Microanatomy of the anterior uveoscleral outflow pathway in normal and primary open‐angle glaucomatous dogs
Authors: Samuelson Don , Streit Alison
Published: September 2011

Objective  To compare the morphology of the uveoscleral (US) outflow pathway in normal and glaucomatous canines.

Animals studied  10 normal beagles, 10 beagles with inherited primary open‐angle glaucoma, 4 cocker spaniels with spontaneous glaucoma.

Procedures  Formalin‐preserved globes were sectioned tangentially and sagittally and treated with H&E, Masson’s trichrome, or elastin stains or analyzed by immunohistochemistry to visualize smooth muscle actin. Tissues associated with the US pathway were observed and compared using light microscopy.

Results  Tangentially oriented sections clearly revealed spaces for the transport of aqueous humor at the junction of the posterior iridocorneal angle (ICA) and anterior ciliary body musculature (CBM). Within the external anterior‐most of the US pathway, the supraciliary space, distinct connective tissue cords and smooth muscle pegs fastened the ciliary body to the adjacent sclera. Compared to normal controls, glaucomatous eyes developed a robust scleral elastic sheath at the junction between the posterior ICA and the anterior CBM. In advanced glaucomatous beagles and cocker spaniels, a large amount of melanophores were seen in the US pathway and surrounding vasculature. Within the C8M of glaucomatous specimens, the smooth muscle bundles appeared fewer and separated by elastic‐rich ECM. Structures of the US pathway changed little with age.

Conclusions  The anterior portion of the canine US pathway is well defined and appears to be altered little with age. However with glaucoma, changes of the US pathway were associated with its the elastic components, as well as the accumulation of melanophores. Collectively, these changes may have an effect on US outflow and, subsequently, aqueous humor dynamics.
The Vitis vinifera C‐repeat binding protein 4 (VvCBF4) transcriptional factor enhances freezing tolerance in wine grape
Authors: Tillett Richard L. , Wheatley Matthew D. , Tattersall Elizabeth A. R. , Schlauch Karen A. , Cramer Grant R. , Cushman John C.
Published: September 2011

Chilling and freezing can reduce significantly vine survival and fruit set in Vitis vinifera wine grape. To overcome such production losses, a recently identified grapevine C‐repeat binding factor (CBF) gene, VvCBF4, was overexpressed in grape vine cv. ‘Freedom’ and found to improve freezing survival and reduced freezing‐induced electrolyte leakage by up to 2 °C in non‐cold‐acclimated vines. In addition, overexpression of this transgene caused a reduced growth phenotype similar to that observed for CBF overexpression in Arabidopsis and other species. Both freezing tolerance and reduced growth phenotypes were manifested in a transgene dose‐dependent manner. To understand the mechanistic basis of VvCBF4 transgene action, one transgenic line (9–12) was genotyped using microarray‐based mRNA expression profiling. Forty‐seven and 12 genes were identified in unstressed transgenic shoots with either a >1.5‐fold increase or decrease in mRNA abundance, respectively. Comparison of mRNA changes with characterized CBF regulons in woody and herbaceous species revealed partial overlaps, suggesting that CBF‐mediated cold acclimation responses are widely conserved. Putative VvCBF4‐regulon targets included genes with functions in cell wall structure, lipid metabolism, epicuticular wax formation and stress‐responses suggesting that the observed cold tolerance and dwarf phenotypes are the result of a complex network of diverse functional determinants.
Going Global: The Transnationalization of Care
Authors: Yeates Nicola
Published: September 2011

This article critically examines the contours of ‘care transnationalization’ as an ongoing social process and a field of enquiry. Care transnationalization scholarship combines structural understandings of global power relations with an emphasis on social interactions between defined actors in ways that keep sight of human agency, material welfare and wider social development. It has, however, tended to privilege particular forms, dynamics and sites of care transnationalization over others. The body of research on care labour migration, which is otherwise the most developed literature on care transnationalization to date, contains a number of biases and omissions in its coverage of border‐spanning relations and their mediation across country contexts. At the same time, other significant forms of care transnationalization, such as those involving consumer‐based care migration, corporate restructuring and the formation of care policy, have suffered from comparative neglect. Working towards an integrated agenda that addresses these diverse expressions of care transnationalization and how they ‘touch down’ in a range of sectoral, social and country contexts is of prime importance to policy research agendas directed at understanding the wider development impacts of processes of social and economic restructuring.
The Good, the Bad and the Confusing: The Political Economy of Social Care Expansion in South Korea
Authors: Peng Ito
Published: September 2011

Recent social policy reforms in South Korea indicate a progressive shift by a conservative government to modify the familialistic male breadwinner model that informs its welfare regime. The Korean government has demonstrated support for women through an increase in the provision, regulation and coordination of childcare and workplace support programmes for working parents. At the same time, labour market reforms have also created more pressures on women to seek and maintain paid work outside the home. Conflicting social and economic policy objectives have resulted in a confusing mix of policies, advancing and impeding gender equality at the same time. This contribution examines the recent family–work reconciliation policy reforms in Korea and discusses why these reforms may be good politics but a bad deal for women.
THE EVOLUTIONARY GAME OF POVERTY TRAPS*
Authors: ACCINELLI ELVIO , SANCHEZ CARRERA EDGAR J.
Published: September 2011

We study a coordination game, between a leader population and a follower population. Each individual of each population follows an imitative behavior in order to decide between being a high‐ or low‐type economic agent. We show that individual behavior driven by imitation can lead to an economy that is either in a low‐level equilibrium—a poverty trap—or a high‐level equilibrium. We analyze how possible it is for an economy placed in the basin of attraction of the poverty trap to overcome it through the strategic action (limited on time) of a benevolent central planner.
tPA for stroke – Are we ready to remove the barriers?
Authors: Martin‐Schild Sheryl
Published: September 2011

Click here to view the accompanying paper in this issue.
Early neurological outcomes according to CHADS2 score in stroke patients with non‐valvular atrial fibrillation
Authors: Hong H. J. , Kim Y. D. , Cha M.‐J. , Kim J. , Lee D. H. , Lee H. S. , Nam C. M. , Nam H. S. , Heo J. H.
Published: September 2011

Background and purpose:  A higher CHADS2 score or CHA2DS2‐VASc score is associated with an increased risk of ischaemic stroke in patients with non‐valvular atrial fibrillation (NVAF). However, there are no data regarding early neurological outcomes after stroke according to the risk levels.

Methods:  In this study, a total of 649 stroke patients with NVAF were enrolled and categorized into three groups: low‐risk (CHADS2 score of 0–1), moderate‐risk (CHADS2 score 2–3), or high‐risk group (CHADS2 score ≥4). CHA2DS2‐VASc score was divided into four groups including 0–1, 2–3, 4–5, and ≥6. We investigated whether there were differences in initial stroke severity, early neurological outcome, and infarct size according to CHADS2 score or CHA2DS2‐VASc score in stroke patients with NVAF.

Results:  The initial National Institutes of Health Stroke Scale (NIHSS) score was highest in high‐risk group [9.5, interquartile range (IQR) 4–18], followed by moderate‐risk (8, IQR 2–17) and low‐risk group (6, IQR 2–15) (P = 0.012). Likewise, initial stroke severity increased in a positive fashion with increasing the CHA2DS2‐VASc score. During hospitalization, those in the high‐risk group or higher CHA2DS2‐VASc score had less improvement in their NIHSS score. Furthermore, early neurological deterioration (END) developed more frequently as CHADS2 score or CHA2DS2‐VASc score increased. Multivariate analysis showed being in the high‐risk group was independently associated with END (OR 2.129, 95% CI 1.013–4.477).

Conclusions:  Our data indicate that patients with NVAF and higher CHADS2 score or CHA2DS2‐VASc score are more likely to develop severe stroke and a worse clinical course is expected in these patients after stroke presentation.
The Internationalization of Chinese Firms: A Critical Review and Future Research*
Authors: Deng Ping
Published: September 2011

The important phenomenon that the internationalization of Chinese firms (ICF) represents has attracted increasing interest from scholars from multiple fields over the past 20 years (1991–2010). Although this proliferation of research has the potential to significantly improve understanding of Chinese multinational enterprises (MNEs), the necessary step of consolidating and integrating extant knowledge is absent. This paper reviews the scholarship on the ICF and offers insights into the specific areas in critical need of further development. By focusing on articles published in major scholarly journals during the period 1991–2010, the authors develop a coherent framework to organize and review conceptual and empirical findings from disciplines as far ranging as management, international business, cross‐culture and area studies. Within the reviewed literature, three primary streams of enquiry are identified which focus on the antecedents, processes and outcomes of the ICF. Achievements within each of the three research streams are carefully reviewed using content analysis, whereby a number of important issues are identified which have remained consistently untouched, and recommendations are provided for future research, aimed at developing a more integrated research agenda on the ICF for management and international business scholars.
Sentinel lymph node mapping in cervical cancer: the future?
Authors: Eiriksson LR , Covens A
Published: September 2011

Please cite this paper as: Eiriksson L, Covens A. Sentinel lymph node mapping in cervical cancer: the future? BJOG 2012;119:129–133.
Simvastatin enhances the antihypertensive effect of ramipril in hypertensive hypercholesterolemic animals and patients. Possible role of nitric oxide, oxidative stress, and high sensitivity C‐reactive protein
Authors: Abdel‐Zaher Ahmed O. , Elkoussi Alaa Eldin A. , Abudahab Lotfy H. , Elbakry Mohammed H. , Elsayed Elsayed Abu‐Elwafa
Published: September 2011

In this study, the effects of simvastatin on the blood pressure and on the antihypertensive activity of ramipril in hypertensive hypercholesterolemic animals and patients were evaluated. In hypertensive hypercholesterolemic animals, repeated administration of simvastatin slightly but significantly decreased the systolic blood pressure, enhanced its progressive reductions induced by repeated administration of ramipril and corrected the compromised lipid profile. Concomitantly, repeated administration of simvastatin, ramipril or simvastatin in combination with ramipril to these animals, increased nitric oxide (NO) production and decreased the elevated serum malondialdehyde (MDA) and high sensitivity C‐reactive protein (hs‐CRP) levels. The effects of combined treatment were greater than those of simvastatin or ramipril alone. In hypertensive hypercholesterolemic patients, repeated administration of ramipril decreased systolic and diastolic blood pressure, increased NO production, and decreased the elevated serum MDA and hs‐CRP levels. Addition of simvastatin to ramipril therapy enhanced these effects and corrected the compromised lipid profile. Simvastatin but not ramipril inhibited the contractile responses of isolated aortic rings induced by angiotensin 11. l‐arginine and acetylcholine enhanced, while l‐NAME inhibited effects of simvastatin, and simvastatin in combination with ramipril on these contractile responses. These findings suggest that simvastatin exerts antihypertensive effect and enhances the antihypertensive effect of ramipril in hypertensive hypercholesterolemic animals and patients. In addition to its cholesterol‐lowering effect, the ability of simvastatin to ameliorate endothelial dysfunction through increasing NO bioavailability and through suppression of oxidative stress and vascular inflammation and its ability to enhance the effect of ramipril on these parameters may play a pivotal role in these effects.
Levofloxacin‐induced rhabdomyolysis in a hemodialysis patient
Authors: Gupta Ankur , Guron Nita , Harris Michael , Bell Robert
Published: September 2011

Rhabdomyolysis is a well‐known complication of various drug therapies. We report a case of levofloxacin‐induced rhabdomyolysis requiring hospitalization in a hemodialysis patient. Physicians should be aware of the risk of this potentially severe adverse drug reaction.
How Salts Affect the Rheological Behavior of an Aluminum Titanate‐Based Ceramic Paste
Authors: DeRosa Michael E. , Lockhart Mark J. , Wu Lung‐Ming , Dasher David
Published: September 2011

This article describes how eight different salts impact the rheological behavior of an aluminum titanate‐based ceramic paste. A capillary rheometer was used to measure the thermal phase transition temperature of a hydroxypropyl methylcellose binder in the paste. The transition of the binder causes the paste to increase in viscosity and the temperature at which this occurs is defined as the stiffening onset temperature (Tonset). The Tonset was found to be a linear function of salt concentration and the slope of this relationship is called the salt strength. Four of the five salts behaved as “salt‐out” salts and depressed Tonset while three showed “salt‐in” behavior and raised Tonset. The salt strength occurred in a regular order based on the anion type consistent with the Hofmeister series. In addition, the specific mixing energy of the paste during plasticization was also affected by the ion type present in the batch and was consistent with the Hofmeister series. The results show how the presence of salts can influence the interaction between the binder and water in a highly filled system and illustrate how this interaction can impact batch thermorheological behavior of ceramic pastes during the forming process.
The definition of a haemodynamic significant duct in randomized controlled trials: a systematic literature review
Authors: Zonnenberg Inge , de Waal Koert
Published: September 2011

Aim:  A patent ductus arteriosus (PDA) is associated with morbidity in preterm infants. Treatment is prescribed for a haemodynamically significant duct (HSDA), but its definition varies. We systematically reviewed the clinical and ultrasound criteria used for the definition of an HSDA.

Methods:  PubMed and the Cochrane library were searched for randomized trials evaluating ductal treatment. The included studies were explored, and we categorized clinical and ultrasound criteria used to define an HSDA.

Results:  Sixty‐seven trials were included in our review. Forty‐two were placebo‐controlled trials, and 25 were comparative trials. The diagnosis of the PDA was made by clinical examination, followed by ultrasound in most trials. Most trials used clinical and ultrasound criteria to define an HSDA, but there was a wide variety in criteria and cut‐offs used. Of the clinical criteria, a murmur or hyperdynamic circulation was most used, and of the ultrasound criteria, the left‐atrium‐to‐aorta ratio (LA/Ao ratio) was most used.

Conclusion:  We found a wide variety in the definition of an HSDA. This finding implies that comparison of studies is difficult. International consensus should be reached on the definition of an HSDA, which will make future studies more comparable.
Oral status in home‐dwelling elderly dependent on moderate or substantial supportive care for daily living: prevalence of edentulous subjects, caries and periodontal disease
Authors: Holmén Anette , Strömberg Ella , Hagman‐Gustafsson Marie‐Louise , Wårdh Inger , Gabre Pia
Published: September 2011

doi: 10.1111/j.1741‐2358.2011.00507.x

Oral status in home‐dwelling elderly dependent on moderate or substantial supportive care for daily living: prevalence of edentulous subjects, caries and periodontal disease

Objectives:  The aim of this study was to compare the prevalence of edentulous subjects, caries and periodontal disease among the home‐dwelling elderly with moderate and substantial needs of support for daily living.

Materials and method:  A sample of 302 randomly selected elderly with moderate or substantial needs of supportive care were examined in Sweden. Several oral clinical variables were registered: number of teeth, dentures, caries, probing pocket depth, gingival bleeding and Eichner’s index.

Results:  Both in general and in oral health, the differences were small when comparing elderly with moderate and substantial care needs for daily living. Those with substantial needs had more caries lesions (p < 0.01) and more gingival bleeding (p < 0.05), while the number of teeth and prevalence of edentulous subjects did not differ in relation to the need of daily support. The elderly had, on average, 9.8–11.7 teeth, one‐third of whom had no natural teeth. According to Eichner’s index, half of the elderly in both groups had no opposing tooth contacts. Fifty‐five per cent used dentures.

Conclusions:  Elderly people with needs of supportive care have lost many teeth before they become dependent. Health promotion should be a priority in early ageing populations to prevent oral diseases and tooth loss.
The PTPN22*R620W polymorphism does not confer genetic susceptibility to antiphospholipid syndrome in the Spanish population
Authors: Castro‐Marrero J. , Balada E. , Vilardell‐Tarrés M. , Ordi‐Ros J.
Published: September 2011

In this work, we proposed to determine the association of the PTPN22*R620W SNP with primary antiphospholipid syndrome (PAPS) in a case–control association study of Spanish Caucasian individuals. A total of 81 PAPS patients were compared with 81 blood‐donor healthy control subjects. PTPN22 SNP (R620W) genotyping was performed by using a polymerase chain reaction–restricted fragment length polymorphism assay. No statistically significant differences were found between control subjects and PAPS patients for the PTPN22*R620W genotypes (P = 0.214). No statistically significant differences were found according to either the presence or absence of antiphospholipid antibodies or the clinical manifestations associated to PAPS. Our results indicate that this functional PTPN22*R620W polymorphism is not associated to PAPS; it seems not to be a risk factor in our Spanish population. The effect of the PTPN22 SNP on clinical manifestations and presence of antiphospholipid antibodies in APS warrants further investigations.
Development of a Methodology for the Assessment of Vulnerability Related to Wildland Fires Using a Multi‐Criteria Evaluation
Authors: GALIANA‐MARTÍN LUIS , KARLSSON OSKAR
Published: September 2011

In the geography of risk, vulnerability may be defined as a physical characteristic that describes the tendency of a territory to suffer damage as a result of the occurrence of certain phenomena. According to this synthetic definition, there are two main components of vulnerability in the context of wildland fires. The first is internal, and is related to the effects of fires on the value of the affected assets affected and their capacity for recovery. The second is external, and is related to the characteristics of fires and the ability of society to deal with the hazards of wildland fires. The aim of the present study is to develop an assessment of spatial vulnerability in the context of wildland fires, at a scale appropriate for planning (1/25 000), in a mountainous region of the Spanish Mediterranean coast (Sierra Calderona). The proposed methodology entailed the definition of a synthetic index associated with the management of the risk of wildland fires, which was made up of significant factors such as the difficulty of extinction, the need for forest defence, the need for civil protection, and territorial value. To define and calculate the factors, variables and indicators that reflected aspects of the components of vulnerability (such as exposure, sensitivity, and the capacity to fight fires) were used. These were combined in a hierarchical structure, each having its own cartographical representation. Geographical information systems and multi‐criteria evaluation were then used to provide a successful framework for the analysis of vulnerability in relation to wildland fires. The cartographical outputs of the various components of the index are of particular interest to the planning of certain activities (e.g. forest, wildland fire, and civil protection), all of which are directly involved in the management of risk. In turn, the final synthetic index provides comprehensive spatial information that is useful for spatial planning and also enables the assessment of potential future land use in view of its usefulness in simulations.
Are Geographical Indications a Wise Strategy for Developing Country Farmers? Greenfields, Clawbacks and Monopoly Rents
Authors: Yeung May T. , Kerr William A.
Published: September 2011

Currently there are proposals and negotiations regarding the strengthening of protection for geographical indications (GIs) in the World Trade Organization. A major proponent of stronger protection for GIs has been the European Union. One of the arguments it has put forward for stronger protection has been that it will provide an avenue for economic development for agricultural producers in developing countries—a way to capture rents in the markets of developed countries. This paper first outlines the proposed changes to the international protection of GIs. Second, the potential for groups of producers to generate and capture rents in foreign markets is assessed under differing assumptions pertaining to industry structure, product differentiation in the short and long run, barriers to entry, reputation and the form of legal protection in importing countries. A discussion of the resource requirements to establish and maintain a GI is also provided.
Transthoracic Impedance Accurately Estimates Pulmonary Wedge Pressure in Patients With Decompensated Chronic Heart Failure
Authors: Malfatto Gabriella , Blengino Simonetta , Perego Giovanni B. , Branzi Giovanna , Villani Alessandra , Facchini Mario , Parati Gianfranco
Published: September 2011

Routine cardiac catheterization to assess pulmonary capillary wedge pressure (PCWP) is not recommended in heart failure (HF), and various noninvasive tools have been proposed. The authors evaluated the reliability of echocardiography, brain natriuretic peptide (BNP), and thoracic electrical bioimpedance (TEB) in predicting PCWP in 29 patients (72±4 years, New York Heart Association class 3.5±0.9, ejection fraction 28%±6%) who underwent hemodynamic evaluation for worsening HF. Echocardiography was performed immediately before the hemodynamic study. During clinical stability, PCWP, plasma BNP, and TEB were simultaneously assessed. Among TEB variables, thoracic conductance (thoracic fluid content [TFC]=1/kΩ) was used. PCWP was related with E/E′ obtained with mitral Doppler and mitral annulus tissue Doppler imaging echocardiography ( R=0.55, P<.005), with BNP levels (R=0.43, P<.01) and TFC values (R=0.69, P<.001). For detection of PCWP ≥15 mm Hg, TFC ≥35/kΩ had high specificity (97%) and sensitivity (86%) and negative (92%) and positive (97%) predictive value, while E/E′ and BNP levels had poorer specificity. After infusion of the inodilator levosimendan, changes in TFC and PCWP were of the same order of magnitude and mutually related. In worsening HF, TEB could help avoid right heart catheterization, since it may estimate PCWP better than BNP or echocardiography. Moreover, TFC could be used for noninvasive assessment of drugs’ effect. Congest Heart Fail. 2012;18:25–31. ©2011 Wiley Periodicals, Inc.
Algorithm‐Based Assessment of Target Weight Removal in Acute Decompensated Heart Failure
Authors: O’Brien Thomas M. , Menon Santosh , Stephens Tracy , Mazur Wojciech , Chung Eugene S.
Published: September 2011

Acute decompensated heart failure (ADHF) remains a leading cause of hospitalization. The majority of these patients are admitted for volume overload, with fluid removal as the main therapeutic target. Practice guidelines do not appoint methods for determining the amount of volume that should be removed. The authors hypothesize that rigorous, protocol‐driven establishment of a target weight to be removed would enhance actual volume removal and short‐term outcomes. Forty‐seven patients admitted with ADHF were enrolled. Each patient had target weight removal (TWR) determined by a heart failure (HF) specialist (serving as the gold standard). Separately, a nurse practitioner calculated the TWR from an algorithm using: (1) baseline weight, (2) renal function, and (3) degree of lower extremity edema. There was good correlation of TWR from an algorithmic approach compared with expert determination (r2=0.8). A total of 87% of patients reached a discharge weight within 20% of the TWR. A more standardized approach to estimating target weight loss for hospitalized HF patients approximates those of HF specialists. Furthermore, this algorithm could be utilized by general practitioners in settings where an HF specialist is not readily available. Congest Heart Fail. 2012;18:43–46. ©2011 Wiley Periodicals, Inc.
Aspalathus crewiana sp. nov. (Crotalarieae, Fabaceae) from the Western Cape Province, South Africa
Authors: Boatwright J. S. , Cupido C. N.
Published: September 2011

A new species, Aspalathus crewiana is described and illustrated. It is closely similar to A. lenticula in the strongly rostrate keel petals and thorny leaflets, but differs in the subulate, spine‐tipped bracts, bracteoles and calyx lobes, presence of a pseudo‐peduncle and larger flowers. The new species, like A. lenticula, is placed in the Terminales group of A. subgenus Aspalathus. It is known from only two localities in the Western Cape where it was collected in Swartland Granite Renosterveld.
Variability in Operative Management of Proximal Humerus Fractures
Authors: Boykin Robert E. , Jawa Andrew , O'Brien Travis , Higgins Laurence D. , Warner Jon J. P.
Published: September 2011

Background

Controversy exists regarding the best methods for the operative management of proximal humerus fractures. We hypothesized that trauma surgeons perform the majority of these procedures and that there is variability in the type of fixation used at our institutions based on the type of fellowship training.

Methods

A retrospective review of 177 consecutive operative closed proximal humerus fractures was conducted. All images were classified based on the Neer system, including: simple (two-part surgical neck or isolated tuberosity) or complex (three- or four-part). Choice of fixation was determined based on surgeon subspecialty.

Results

One-hundred and nine procedures were performed by trauma, 45 by shoulder, and 17 by hand. Thirty-eight percent (67/177) were simple and 62% (110/177) were complex. A significant difference was only found in blade plating of two-part surgical neck fractures ( p < 0.05) and the management of tuberosity fractures ( p < 0.05). Analysis of complex fractures showed a significant difference in the rate of arthroplasty ( p < 0.05).

Discussion

Trauma surgeons perform the majority of procedures on proximal humerus fractures, although at a similar rate to shoulder surgeons. A significant difference in management was found with regard to the utilization of blade plating, arthroplasty and the management of tuberosity fractures.
THE PREDICTABILITY OF STOCK MARKET RETURNS IN SOUTH AFRICA: PARAMETRIC VS. NON‐PARAMETRIC METHODS
Authors: BONGA‐BONGA LUMENGO , MWAMBA MUTEBA
Published: September 2011

This paper compares the forecasting performance of a sub‐class of univariate parametric and non‐parametric models in predicting stock market returns in South Africa. To account for conditional heteroskedasticity in stock returns data, the non‐parametric model is generated by the conditional heteroskedastic non‐linear autoregressive (NAR) model, while the parametric model is produced by the generalised autoregressive conditional heteroskedastic in mean (GARCH‐M) model. The results of the paper show that the NAR as a non‐parametric model performs better than the GARCH‐M model in short‐term forecasting horizon, and this indicates the importance of a distribution‐free model in predicting stock returns in South Africa.
Anticipating the Species Jump: Surveillance for Emerging Viral Threats
Authors: Flanagan M. L. , Parrish C. R. , Cobey S. , Glass G. E. , Bush R. M. , Leighton T. J.
Published: September 2011

Zoonotic disease surveillance is typically triggered after animal pathogens have already infected humans. Are there ways to identify high‐risk viruses before they emerge in humans? If so, then how and where can identifications be made and by what methods? These were the fundamental questions driving a workshop to examine the future of predictive surveillance for viruses that might jump from animals to infect humans. Virologists, ecologists and computational biologists from academia, federal government and non‐governmental organizations discussed opportunities as well as obstacles to the prediction of species jumps using genetic and ecological data from viruses and their hosts, vectors and reservoirs. This workshop marked an important first step towards envisioning both scientific and organizational frameworks for this future capability. Canine parvoviruses as well as seasonal H3N2 and pandemic H1N1 influenza viruses are discussed as exemplars that suggest what to look for in anticipating species jumps. To answer the question of where to look, prospects for discovering emerging viruses among wildlife, bats, rodents, arthropod vectors and occupationally exposed humans are discussed. Finally, opportunities and obstacles are identified and accompanied by suggestions for how to look for species jumps. Taken together, these findings constitute the beginnings of a conceptual framework for achieving a virus surveillance capability that could predict future species jumps.
Validation of a cranial injection technique of the medial femorotibial joint in the horse
Authors: Down S. S. , Munroe G. A. , Murray R. C.
Published: September 2011

A cranial technique for entry of the medial femorotibial (MFT) joint in the horse was validated. It was hypothesised that the frequency of correct placement into the MFT joint using the described cranial technique would be similar to using a standard medial approach. Twenty‐four limbs from 15 horses were injected with a latex mixture. Limbs with stifle joint effusion and/or known stifle pathology were grouped separately to those without. When effusion/pathology was not present the medial technique (93%) was almost twice as successful as the cranial technique (53%), including when extremes of size were removed from the population. With the presence of femoropatellar or medial femorotibial effusion, the cranial technique (20%) was 5 times less successful than using the medial technique (100%). When extremes of size were removed from the population of horses with effusion, the success of the cranial technique was marginally improved (33%). When an ‘average size’ of horse is used with or without joint effusion, the cranial technique is successful in entering the MFT joint in approximately 50% of cases, and may hence be of use in a fractious animal without sedation, a stallion, or in the presence of a wound/skin infection at the site of the medial needle entrance.
Review of injection techniques targeting the sacroiliac region in horses
Authors: Engeli E. , Haussler K. K.
Published: September 2011

Local anaesthetic techniques and diagnostic imaging tools are currently used in conjunction with thorough physical and lameness examinations to diagnose sacroiliac disease (SID) in the horse. The deep and inaccessible location of the sacroiliac joint (SIJ), however, often renders diagnostic imaging modalities, such as radiography, nuclear scintigraphy and ultrasonography, unreliable in identifying sacroiliac problems. The equine clinician therefore often has to rely on positive results of local anaesthetic techniques to confirm a diagnosis of SID. Regional infiltration techniques have been described but result in a diffuse distribution of large volumes of local anaesthetic solution throughout the entire lumbosacroiliac region, which is nonspecific to the SIJ and has the potential to produce false positive results. Several periarticular injection approaches to the SIJ have recently been described. A combination of periarticular SIJ injections with the use of modest amounts of local anaesthetic solution provides increased SIJ specificity, but may lead to false negative results in cases where the pain originates from surrounding soft tissues. This article clarifies terminology related to sacroiliac injections, reviews current injection techniques, highlights the advantages and disadvantages of each approach, and investigates injectate volume considerations.
Past imperfect, future conditional: Fifty years of test theory
Authors: Blinkhorn S. F.
Published: September 2011

This essay takes a broad view of developments in test theory over the past 50 years from the point of view of a test constructor. Increasing theoretical and technical sophistication has not, in general, resulted in commensurate improvements in test design. Contemporary test theory, with its emphasis on statistical rather than psychological models, has become inaccessible to the majority of test users, and predominantly reflects educational rather than psychological concerns. Real progress may depend on the emergence of a new and radical reconceptualization.
Maximum likelihood estimation in covariance structure analysis with truncated data
Authors: Tang Man‐Lai , Bentler Peter M.
Published: September 2011

We study an estimation procedure for maximum likelihood estimation in covariance structure analysis with truncated data, and obtain the statistical properties of the estimator as well as a test of the model structure. Truncated data with and without knowledge about the number of unmeasured observations are both considered. The Broyden‐Fletcher‐Goldfarb‐Shanno (BFGS) algorithm, which requires only first derivatives, is proposed to obtain the maximum likelihood estimates. We illustrate the statistics and parameter estimates by a fictitious example. The maximum likelihood method is compared to an alternative two‐stage method.
Moral reasoning and emotion attributions of adolescent bullies, victims, and bully‐victims
Authors: Perren Sonja , Gutzwiller‐Helfenfinger Eveline , Malti Tina , Hymel Shelley
Published: September 2011

This study investigated different facets of moral development in bullies, victims, and bully‐victims among Swiss adolescents. Extending previous research, we focused on both bullying and victimization in relation to adolescents’ morally disengaged and morally responsible reasoning as well as moral emotion attributions. A total of 516 adolescents aged 12–18 (57% females) reported the frequency of involvement in bullying and victimization. Participants were categorized as bullies (14.3%), bully‐victims (3.9%), and victims (9.7%). Moral judgment, moral justifications, and emotion attributions to a hypothetical perpetrator of a moral transgression (relational aggression) were assessed. Bullies showed more morally disengaged reasoning than non‐involved students. Bully‐victims more frequently indicated that violating moral rules is right. Victims produced more victim‐oriented justifications (i.e., more empathy) but fewer moral rules. Among victims, the frequency of morally responsible justifications decreased and the frequency of deviant rules increased with age. The findings are discussed from an integrative moral developmental perspective.
Antibodies to Streptococcus pneumoniae Capsular Polysaccharide Enhance Pneumococcal Quorum Sensing
Authors: Yano Masahide , Gohil Shruti , Coleman J. Robert , Manix Catherine , Pirofski Liise-anne
Published: September 2011

The use of pneumococcal capsular polysaccharide (PPS)-based vaccines has resulted in a substantial reduction in invasive pneumococcal disease. However, much remains to be learned about vaccine-mediated immunity, as seven-valent PPS-protein conjugate vaccine use in children has been associated with nonvaccine serotype replacement and 23-valent vaccine use in adults has not prevented pneumococcal pneumonia. In this report, we demonstrate that certain PPS-specific monoclonal antibodies (MAbs) enhance the transformation frequency of two different
Streptococcus pneumoniae
serotypes. This phenomenon was mediated by PPS-specific MAbs that agglutinate but do not promote opsonic effector cell killing of the homologous serotype
in
vitro
. Compared to the autoinducer, competence-stimulating peptide (CSP) alone, transcriptional profiling of pneumococcal gene expression after incubation with CSP and one such MAb to the PPS of serotype 3 revealed changes in the expression of competence (
com
)-related and bacteriocin-like peptide (
blp
) genes involved in pneumococcal quorum sensing. This MAb was also found to induce a nearly 2-fold increase in CSP2-mediated bacterial killing or fratricide. These observations reveal a novel, direct effect of PPS-binding MAbs on pneumococcal biology that has important implications for antibody immunity to pneumococcus in the pneumococcal vaccine era. Taken together, our data suggest heretofore unsuspected mechanisms by which PPS-specific antibodies could affect genetic exchange and bacterial viability in the absence of host cells.

IMPORTANCE
Current thought holds that pneumococcal capsular polysaccharide (PPS)-binding antibodies protect against pneumococcus by inducing effector cell opsonic killing of the homologous serotype. While such antibodies are an important part of how pneumococcal vaccines protect against pneumococcal disease, PPS-specific antibodies that do not exhibit this activity but are highly protective against pneumococcus in mice have been identified. This article examines the effect of nonopsonic PPS-specific monoclonal antibodies (MAbs) on the biology of
Streptococcus pneumoniae
. The results showed that in the presence of a competence-stimulating peptide (CSP), such MAbs increase the frequency of pneumococcal transformation. Further studies with one such MAb showed that it altered the expression of genes involved in quorum sensing and increased competence-induced killing or fratricide. These findings reveal a novel, previously unsuspected mechanism by which certain PPS-specific antibodies exert a direct effect on pneumococcal biology that has broad implications for bacterial clearance, genetic exchange, and antibody immunity to pneumococcus.
Lean thinking transformation of the unsedated upper gastrointestinal endoscopy pathway improves efficiency and is associated with high levels of patient satisfaction
Authors: Hydes Theresa , Hansi Navjyot , Trebble Timothy M
Published: September 2011

Background

Upper gastrointestinal (UGI) endoscopy is a routine healthcare procedure with a defined patient pathway. The objective of this study was to redesign this pathway for unsedated patients using lean thinking transformation to focus on patient-derived value-adding steps, remove waste and create a more efficient process. This was to form the basis of a pathway template that was transferrable to other endoscopy units.

Methods

A literature search of patient expectations for UGI endoscopy identified patient-derived value. A value stream map was created of the current pathway. The minimum and maximum time per step, bottlenecks and staff–staff interactions were recorded. This information was used for service transformation using lean thinking. A patient pathway template was created and implemented into a secondary unit. Questionnaire studies were performed to assess patient satisfaction.

Results

In the primary unit the patient pathway reduced from 19 to 11 steps with a reduction in the maximum lead time from 375 to 80 min following lean thinking transformation. The minimum value/lead time ratio increased from 24% to 49%. The patient pathway was redesigned as a ‘cellular’ system with minimised patient and staff travelling distances, waiting times, paperwork and handoffs. Nursing staff requirements reduced by 25%. Patient-prioritised aspects of care were emphasised with increased patient–endoscopist interaction time. The template was successfully introduced into a second unit with an overall positive patient satisfaction rating of 95%.

Conclusion

Lean thinking transformation of the unsedated UGI endoscopy pathway results in reduced waiting times, reduced staffing requirements and improved patient flow and can form the basis of a pathway template which may be successfully transferred into alternative endoscopy environments with high levels of patient satisfaction.
‘Do Not Attempt Cardiopulmonary Resuscitation’ discussions at the point of discharge: a case note review of hospice practice following local integrated policy implementation
Authors: Hall Charlie Christopher , Mark Kathleen , Oxenham David , Spiller Juliet Anne
Published: September 2011

Background

An integrated ‘Do Not Attempt Cardiopulmonary Resuscitation’ (DNACPR) policy was implemented across Lothian in 2006 (for ease of reading the terminology ‘DNACPR’ has been used throughout the paper where the original Lothian Policy used ‘DNAR’). Patients were, for the first time, able to be discharged home with their DNACPR form after discussion about cardiopulmonary resuscitation (CPR).

Aims

To ascertain the number of patients who, following a discussion, were discharged with a DNACPR form and the reasons for not holding discussions with certain patients.

Methods

Two retrospective case note reviews of 50 patients discharged over two 4-month periods (2007 and 2009).

Results

There was a high proportion (78–80%) of CPR discussions for patients discharged from the hospice. Reasons for not discussing CPR were: potential for excess distress (10–12% 2007 and 2009) and lack of time (4% both years). Of those discussing CPR on discharge, 90% took forms home in both years. The reasons patients did not take forms home were: form not taken in error (two patients in 2007); patients refusing a form at home (one and three patients in 2007 and 2009); form to be arranged by general practitioner and one incomplete discussion. The proportion of patients with forms already at home increased from 10% (2007) to 28% (2009).

Conclusion

It is possible to discuss CPR with a high proportion of hospice patients prior to discharge from a hospice. Following the introduction of an integrated policy, more patients have DNACPR forms prior to admission. Most patients receiving specialist palliative care find DNACPR discussions acceptable and understand the benefits of having a DNACPR form.
Enriching the experience of patients on a hospice ward with volunteer carers
Authors: Carpenter Jane
Published: September 2011

Introduction

We are working in a difficult global economic climate, increasingly caring for patients with complex needs. As a local charity we need to make best use of our resources, spend donated money in the most responsible manner while continuing to expand patient care services, maintaining the highest quality of patient focused care.

Aim

To develop volunteers to undertake clinical activity and enhance the inpatient experience, making better use of all resources.

Methods

The ward volunteers were approached with a proposal to expand their role. The staff were informed of the plans and their concerns addressed at an early stage; they were involved throughout the project.

The plan followed was:

▶

A consultative approach

▶

Volunteer skills portfolios developed

▶

Ward competencies, supervised practice and classroom based training for volunteers

▶

Initial focus – patient nutrition and oral care

▶

Subsequent introduction of hygiene care.

Results

An increasingly confident and flexible volunteer workforce with more involvement in clinical patient care. An efficient use of resources, releasing staff to focus on complex aspects of care, Volunteers are now offering ward administrative support, helping patients with creative activities and are becoming integral to all aspects of ward activity.

Discussion and conclusion

Developing volunteers in this way has taken investment of time and staff resources, resulting in an increased richness to the inpatient environment. Volunteers now utilise other skills so that they can participate more fully in the ward domain. Ward nurses now appreciate the volunteer input and rely on their presence; the changes have enhanced our skill-mix and increased our staff: patient ratios.