bluuebunny/crossref_metadata_2025 huggingface dataset:
AGENCY, PERSONHOOD AND THE ‘I’ OF DISCOURSE IN THE PACIFIC AND BEYOND
Authors: Rumsey Alan
Published: September 2010

Sahlins bases his account of Polynesian ‘heroic history’ partly on the fact that chiefs used the pronoun ‘I’ in reference to their whole group. Mosko (1992) argues that Sahlins’s consequent emphasis on ‘encompassment’ as the modality of chiefly action is diametrically opposed to Strathern’s on ‘partibility’, the effacement of parts of the person as a condition of action. Drawing on comparative material from the New Guinea Highlands, where big men also use ‘I’ for their whole group, and on Benveniste’s and Urban’s accounts of the meaning and use of personal pronouns, I argue instead that moments of both encompassment and partibility are inherent in language, corresponding to two distinct dimensions in which the pronouns are meaningful (the ‘direct indexical’ and the ‘anaphoric’), and that close attention to the interaction between the two can yield new insights into the nature of personhood and social agency.
LAND FOR LOGISTICS: LOCATIONAL DYNAMICS, REAL ESTATE MARKETS AND POLITICAL REGULATION OF REGIONAL DISTRIBUTION COMPLEXES
Authors: Hesse Markus
Published: September 2010

Physical distribution, logistics and freight transport are currently being shaped by new technologies, corporate restructuring, and a changing market environment. Following the rapid growth of logistics, the demand for distribution facilities increases significantly. As a consequence, logistics real estate markets have emerged, shaping local development practices. By establishing distri‐bution centres as single entities and integrated freight centres as agglomerations, they contribute to the formation of ‘regional distribution complexes’. The paper aims to exemplify this interrelation with two case studies in Berlin‐Brandenburg, Germany: first a publicly developed integrated freight centre, offering multi‐modal transport access and logistics services, and second a dispersed logistics site off the regional beltway, developed with respect to market requirements only. The paper finds that rising locational competition contributes to accelerated land consumption and further dispersal. Speculative development and outsourcing of facilities are ‘mobilising’ not only goods flows but also logistics infrastructure. Both practices, originally developed in the USA and the UK, are now changing land markets in continental Europe and affect urban and regional development.
MARKET CONCENTRATION IN THE AIR FREIGHT FORWARDING INDUSTRY
Authors: Bowen John , Leinbach Thomas
Published: September 2010

A rapid increase in the level of market concentration in the supply chain management industries has created firms that enjoy the economies of scale and scope necessary to offer multinational clients integrated services on a worldwide basis. This paper examines how changes in the structure of the freight forwarding industry have affected the nature of the services the industry offers across several Southeast Asian economies. The paper focuses on the role that large global forwarders have played in bringing advanced logistics services, especially those linked to the air freight industry, to this industrialising region. Data is used from interviews with over 100 freight forwarders in Singapore, Malaysia, and the Philippines to examine both the geographic variation in the provision of air cargo services and the manner in which the types of services a forwarder offers vary with firm size.
Clinical effects of undershirts coated with borage oil on children with atopic dermatitis: A double‐blind, placebo‐controlled clinical trial
Authors: KANEHARA Shoko , OHTANI Toshio , UEDE Koji , FURUKAWA Fukumi
Published: September 2010

It has been reported that γ‐linolenic acid contained in borage oil is effective against atopic dermatitis. The clinical effects of undershirts coated with borage oil rich in γ‐linolenic acid on atopic dermatitis were evaluated. Thirty‐two children, aged 1–10 years, were involved in the clinical control study. Sixteen had worn undershirts coated with borage oil everyday for 2 weeks, and 16 had worn non‐coated undershirts as a placebo. Their symptoms were assessed on a 4‐point scale. Those children who had worn undershirts coated with borage oil for 2 weeks showed improvements in their erythema and itch, which were statistically significant. Transepidermal water loss from the back was decreased. In the placebo group, there were no statistically significant differences. The undershirts coated with borage oil were found to be statistically effective, and had no side‐effects on children with mild atopic dermatitis.
Characterization of Ninjurin and TSC22 induction after X‐irradiation of normal human skin cells
Authors: KOIKE Manabu , NINOMIYA Yasuharu , KOIKE Aki
Published: September 2010

The skin is an external organ that is most frequently exposed to radiation. It is important to elucidate the influence of radiation exposure on the skin at the molecular level. To identify radiation‐responsive genes in human skin cells, we used microarray technology to examine the effects of irradiation on 641 genes in normal human epidermal keratinocytes at 4 h and 8 h postirradiation with a cytotoxic dose of X‐ray (10 Gy). We found that 18 genes were upregulated and 35 genes were downregulated in keratinocytes at 4 h and/or 8 h postirradiation. Ninjurin, whose function remains unknown in keratinocytes, was induced most strongly by X‐irradiation. Several known apoptosis‐related genes, such as TSC22, were also upregulated. We characterized Ninjurin and TSC22 induction after X‐irradiation of normal human skin cells. The induction of the expression of Ninjurin and TSC22 mRNA in keratinocytes following high‐dose X‐irradiation was confirmed by northern blot analysis. In dermal fibroblasts, Ninjurin, but not TSC22, was induced after X‐ray irradiation. The dependence of both gene expression on the status of an apoptosis regulator, p53, was found. In addition, the expression of both mRNA was induced upon treatment with an apoptosis inducer, etoposide. On the other hand, TSC22, but not Ninjurin, was induced and accumulated in keratinocytes upon treatment with an apoptosis inducer, anisomycin. However, in transient expression assay, EYFP‐TSC22, as well as EYFP‐Ninjurin or EYFP alone, did not induce apoptosis in keratinocytes in contrast to EYFP‐GADD45. Taken together, these findings have important implications on the understanding of the mechanism underlying the complex response of skin cells following X‐irradiation.
Proteolytic activation of heparin‐binding EGF‐like growth factor by membrane‐type matrix metalloproteinase‐1 in ovarian carcinoma cells
Authors: Koshikawa Naohiko , Mizushima Hiroto , Minegishi Tomoko , Eguchi Fuyuki , Yotsumoto Fusanori , Nabeshima Kazuki , Miyamoto Shingo , Mekada Eisuke , Seiki Motoharu
Published: September 2010

Increased expression of heparin‐binding EGF‐like growth factor (HB‐EGF) and membrane‐type matrix metalloproteinase‐1 (MT1‐MMP) is frequently associated with various types of malignant tumor. HB EGF‐like growth factor has been reported to promote the malignant progression of ovarian carcinoma. Based on this finding, inhibition of HB‐EGF activity with CRM197 is now under phase I clinical evaluation. On the other hand, MT1‐MMP expressed in ovarian carcinoma cells is thought to promote invasion and growth of tumor cells by degrading the extracellular matrix. However, we recently demonstrated that co‐expression of MT1‐MMP and HB‐EGF in gastric carcinoma cells leads to cleavage of HB‐EGF within its N‐terminal heparin‐binding region, converting it into a potent heparin‐independent growth factor. In this study, we evaluated the importance of regulation of HB‐EGF by MT1‐MMP in clinical samples of ovarian carcinoma. We detected co‐expression of HB‐EGF and MT1‐MMP in clear cell ovarian carcinoma tissues, particularly at the invasion front and in tumor cells that had disseminated into the ascites, whereas HB‐EGF alone was expressed in non‐invasive borderline ovarian tumor tissue. Furthermore, a soluble HB‐EGF fragment that corresponds to that processed by MT1‐MMP was detected in malignant ascites obtained from patients with metastatic ovarian carcinoma. Ovarian carcinoma cells that express MT1‐MMP and HB‐EGF exhibited enhanced cell growth in a 3D‐collagen matrix and anchorage‐independent growth in suspension. These results indicate that MT1‐MMP co‐expressed with HB‐EGF in ovarian carcinoma cells potentiates the activity of HB‐EGF to promote invasive tumor growth and spreading in vivo. (Cancer Sci 2011; 102: 111–116)
Superior discriminating value of ACTH‐stimulated serum 21‐deoxycortisol in identifying heterozygote carriers for 21‐hydroxylase deficiency
Authors: Costa‐Barbosa Flávia A. , Tonetto‐Fernandes Vânia F. , Carvalho Valdemir M. , Nakamura Odete H. , Moura Vivian , Bachega Tânia A. S. S. , Vieira José G. H. , Kater Claudio E.
Published: September 2010

Background  Congenital adrenal hyperplasia caused by classic 21‐hydroxylase deficiency (21OHD) is an autosomal recessive disorder with a high prevalence of asymptomatic heterozygote carriers (HTZ) in the general population, making case detection desirable by routine methodology. HTZ for classic and nonclassic (NC) forms have basal and ACTH‐stimulated values of 17‐hydroxyprogesterone (17OHP) that fail to discriminate them from the general population. 21‐Deoxycortisol (21DF), an 11‐hydroxylated derivative of 17OHP, is an alternative approach to identify 21OHD HTZ.

Objective  To determine the discriminating value of basal and ACTH‐stimulated serum levels of 21DF in comparison with 17OHP in a population of HTZ for 21OHD (n = 60), as well as in NC patients (n = 16) and in genotypically normal control subjects (CS, n = 30), using fourth generation tandem mass spectrometry after HPLC separation (LC‐MS/MS).

Results  Basal 21DF levels were not different between HTZ and CS, but stimulated values were increased in the former and virtually nonresponsive in CS. Only 17·7% of the ACTH‐stimulated 21DF levels overlapped with CS, when compared to 46·8% for 17OHP. For 100% specificity, the sensitivities achieved for ACTH‐stimulated 21DF, 17OHP and the quotient [(21DF + 17OHP)/F] were 82·3%, 53·2% and 87%, using cut‐offs of 40, 300 ng/dl and 46 (unitless), respectively. Similar to 17OHP, ACTH‐stimulated 21DF levels did not overlap between HTZ and NC patients. A positive and highly significant correlation (r = 0·846; P < 0·001) was observed between 21DF and 17OHP pairs of values from NC and HTZ.

Conclusion  This study confirms the superiority of ACTH‐stimulated 21DF, when compared to 17OHP, both measured by LC‐MS/MS, in identifying carriers for 21OHD. Serum 21DF is a useful tool in genetic counselling to screen carriers among relatives in families with affected subjects, giving support to molecular results.
Lack of in vitro constitutive activity for four previously reported TSH receptor mutations identified in patients with nonautoimmune hyperthyroidism and hot thyroid carcinomas
Authors: Jaeschke Holger , Mueller Sandra , Eszlinger Markus , Paschke Ralf
Published: September 2010

Objective  Constitutively activating mutations (CAMs) of the TSHR are the major cause for nonautoimmune hyperthyroidism. Re‐examination of constitutive activity previously determined in CHO cell lines recently demonstrated the caveats for the in vitro determination of constitutive TSHR activity, which leads to false positive conclusions regarding the molecular origin of hyperthyroidism or hot thyroid carcinomas.

Design  Mutations L677V and T620I identified in hot thyroid carcinomas were previously characterized in CHO and in 3T3‐Vill cell lines, respectively, stably expressing the mutant without determination of TSHR expression. F666L identified in a patient with hot thyroid nodules, I691F in a family with nonautoimmune hyperthyroidism and F631I identified in a hot thyroid carcinoma were not characterized for their in vitro function. Therefore, we decided to (re)evaluate the in vitro function of these five TSHR variants by determination of cell surface expression, and intracellular cAMP and inositol phosphate levels and performed additionally linear regression analyses to determine basal activity independently from the mutant’s cell surface expression in COS‐7 and HEKGT cells.

Results and Conclusions  Only one (F631I) of the five investigated TSHR variants displayed constitutive activity for Gαs signalling and showed correlation with the clinical phenotype. The previous false classification of T620I and L677V as CAMs is most likely related to the fact that both mutations were characterized in cell lines stably expressing the mutated receptor construct without assessing the respective receptor number per cell. Other molecular aetiologies for the nonautoimmune hyperthyroidism and/or hot thyroid carcinomas in these three patients and one family should be elucidated.
Pore‐space CO2 dynamics in a deep, well‐aerated soil
Authors: Maier M. , Schack‐Kirchner H. , Hildebrand E. E. , Holst J.
Published: September 2010

Most studies implicitly consider soil carbon dioxide (CO2) efflux as the instantaneous soil respiration and thereby neglect possible changes in the amount of CO2 stored in the soil pore‐space. We measured the CO2 concentration profile of a well‐aerated soil continuously to evaluate the dynamics of the stored CO2 and to analyse the influence of environmental factors. For 25% of the observation period, changes in the amount of stored CO2 accounted for more than 15% of the soil‐CO2 efflux. The following factors were identified to interfere with steady‐state CO2 storage: (i) the fluctuating groundwater table altered the volume of the vadose zone, causing viscous airflow in air‐filled soil pores, (ii) atmospheric turbulence caused pressure‐pumping at the soil–atmosphere interface and (iii) intense rain greatly reduced the diffusivity of the uppermost soil layer. The friction velocity above the canopy was strongly correlated with fluctuations in the differential pressure between soil air and atmosphere, but no static pressure gradient could be detected because of the permeable nature of the soil. Unexpected short‐term declines in the soil CO2 concentration were observed during intense rainfall events. These declines were explained by the intensified CO2 saturation deficit of the infiltrating rainwater caused by the carbonate chemistry of the soil solution.
Oxidative stress as a life‐history constraint: the role of reactive oxygen species in shaping phenotypes from conception to death
Authors: Metcalfe Neil B. , Alonso‐Alvarez Carlos
Published: September 2010

1. Oxidative stress is usually defined as an imbalance arising when the rate of production of reactive oxygen species (ROS) exceeds the capacity of the antioxidant defence and repair mechanisms, leading to oxidative damage to biomolecules, but the concept can be expanded to include the disruption of reduction : oxidation (redox) reactions involved in cellular signalling. In this review, we consider how the need to circumvent oxidation may shape the phenotypes of organisms throughout their life and that of their offspring, underpinning a diverse range of life‐history trade‐offs.

2. A recent explosion of interest in this field has shown that both ROS production and the capacity of animals to deal with it change from early development through to adulthood, and vary with environmental conditions and lifestyle. Oxidative stress may both stimulate and be caused by reproduction, although direct evidence of either process is surprisingly weak. Many forms of secondary sexual traits may signal the individual’s oxidative balance to potential mates, but the underlying mechanisms are still debated.

3. Germline cells may be especially vulnerable to oxidative stress, leading to transgenerational effects on offspring viability and possible consequences for the evolution of mate choice.

4. Both antioxidant defences and the ability to repair oxidative damage tend to decline with old age, contributing to cellular and whole organism senescence. This increasing vulnerability to oxidative stress, although little studied, appears especially marked in sexually selected traits.

5. Challenges for the future include the incorporation of longitudinal approaches into experiments that analyse oxidative balance over an individual’s lifetime (preferably under near‐natural conditions), the exploration of the genetic basis for trade‐offs involving oxidative stress, the assimilation of current redox signalling knowledge, and the study of the consequences of heritable oxidative damage to germline DNA.
Ecological, biomedical and epidemiological approaches to understanding oxidative balance and ageing: what they can teach each other
Authors: Cohen Alan A. , de Magalhães João Pedro , Gohil Kishorchandra
Published: September 2010

1. Oxidative stress and antioxidants have been studied in a number of disciplines, but these disciplines have not always been informed by each other’s work.

2. Here, we discuss the strengths and weaknesses of oxidative stress and antioxidant research in the areas of (i) ecology, (ii) ageing research, (iii) epidemiology, and (iv) physiology of model organisms, with an emphasis on what ecologists can learn from and bring to other fields.

3. We find that physiologists provide an essential role in clarifying basic mechanisms, but that many of their findings are context‐dependent. Ecologists and epidemiologists bring strengths in understanding the relevance of context, whether it is across species, environments, or diets. Ageing research has helped to provide a clear theoretical framework for all fields and has thus spurred much of the research to date.

4. Comprehensive understanding of the complexity of oxidative balance systems will rely on integration of knowledge of physiological pathways from studies of model organisms, knowledge of long‐term interactions of many parameters from epidemiological studies, and knowledge of specificity and generality of results across species and conditions as gleaned from ecological studies.

5. Studies of ageing have helped to show that all fields of antioxidant/oxidative stress research should focus not on individual markers of oxidative damage or antioxidant status, but on how they integrate into oxidative balance systems. Free radicals can have beneficial roles in signalling as well as causing damage and should not be interpreted out of context.
Disentangling the effects of predator body size and prey density on prey consumption in a lizard
Authors: González‐Suárez Manuela , Mugabo Marianne , Decencière Beatriz , Perret Samuel , Claessen David , Le Galliard Jean‐François
Published: September 2010

1. Understanding proximate determinants of predation rates is a central question in ecology. Studies often use functional response (density dependent) or allometric (mass dependent) models but approaches that consider multiple factors are critical to capture the complexity in predator–prey interactions. We present a novel comprehensive approach to understand predation rates based on field data obtained from a vertebrate predator.

2. Estimates of food consumption and prey abundance were obtained from 21 semi‐natural populations of the lizard Zootoca vivipara. We identified the most parsimonious feeding rate function exploring allometric, simple functional response and allometric functional response models. Each group included effects of sex and weather conditions.

3. Allometric models reveal the importance of predator mass and sex: larger females have the highest natural feeding rates. Functional response models show that the effect of prey density is best represented by a Holling type II response model with a mass, sex and weather dependent attack rate and a constant handling time. However, the best functional response model only received moderate support compared to simpler allometric models based only on predator mass and sex.

4. Despite this limited effect of prey densities on feeding rates, we detected a significant negative relationship between an index of preferred prey biomass and lizard density.

5. Functional response models that ignore individual variation are likely to misrepresent trophic interactions. However, simpler models based on individual traits may be best supported by some data than complex allometric functional responses. These results illustrate the importance of considering individual, population and environmental effects while also exploring simple models.
Long‐term tissue response to bacteria enclosed in a subcutaneous implant that simulates the infected dental root canal
Authors: MOORER W. R. , VAN VELZEN S. K. THODEN , WESSELINK P. R.
Published: September 2010

Summary. An implant simulating the dental root canal was tested for its suitability to accommodate experimental inocula of bacteria. The inflammatory response provoked by some of the inocula in the subcutaneous tissues of rabbits after 90 days, indicated that the model may be of value for studying the virulence of pathogenic endodontic bacterial mixtures.
The effect of mineral trioxide aggregate on the apexification and periapical healing of teeth with incomplete root formation
Authors: Felippe W. T. , Felippe M. C. S. , Rocha M. J. C.
Published: September 2010

Aim  To evaluate the influence of mineral trioxide aggregate (MTA) on apexification and periapical healing of teeth in dogs with incomplete root formation and previously contaminated canals and to verify the necessity of employing calcium hydroxide paste before using MTA.

Methodology  Twenty premolars from two 6‐month old dogs were used. After access to the root canals and complete removal of the pulp, the canal systems remained exposed to the oral environment for 2 weeks. Canal preparation was then carried out using Hedström files, under irrigation with 1% sodium hypochlorite, 1 mm short of the radiographic apex. After drying, the canals of two premolars in each dog were left empty (control group). The other eight teeth in each animal were divided into two experimental groups. The apical thirds of the canals of group 1 were filled with MTA. In the teeth of group 2, the canals were dressed with a calcium hydroxide–propylene glycol paste. After 1 week, the paste was removed and the apical third was filled with MTA. All teeth were restored with reinforced zinc oxide cement (IRM) and amalgam. The animals were killed 5 months later, and blocks of the teeth and surrounding tissues were submitted to histological processing. The sections were studied to evaluate seven parameters: formation of an apical calcified tissue barrier, level of barrier formation, inflammatory reaction, bone and root resorption, MTA extrusion, and microorganisms. Results of experimental groups were analysed by Wilcoxon's nonparametric tests and by the test of proportions. The critical value of statistical significance was 5%.

Results  Significant differences (P < 0.05) were found in relation to the position of barrier formation and MTA extrusion. The barrier was formed in the interior of the canal in 69.2% of roots from MTA group only. In group 2, it was formed beyond the limits of the canal walls in 75% of the roots. MTA extrusion occurred mainly in roots from group 2. There was similarity between the groups for the other parameters.

Conclusions  Mineral trioxide aggregate used after root canal preparation favoured the occurrence of the apexification and periapical healing. The initial use of calcium hydroxide paste was not necessary for apexification to occur, and has shown to be strongly related to the extrusion of MTA and formation of barriers beyond the limits of the root canal walls.
Parametric intensity and the spatial arrangement of the terrestrial mollusc herbivoresDeroceras reticulatumandArion intermedius
Authors: Bohan David A. , Glen David M. , Wiltshire Christopher W. , Hughes Louise
Published: September 2010

1.Parametric intensity and spatial arrangement analyses were used to investigate the spatial pattern of the slugsArion intermediusandDeroceras reticulatum.

2.The spatial lag of sampling (distance between sampling points) was shown to be unimportant in the intensity analyses. Rather, the 0·25 m grain scale was imposed on the whole sampling. The observed slope of the variance to mean relationships was common to both species, possibly determined by egg laying in batches at 0·25 m. However, the variance of the sample, for a given mean, was lower in summer. This corresponded with a reduction in the proportion of zero counts, which could be due to slug movement, possibly increased by predator activity, acting at the 0·25 m scale.

3.By contrast with the intensity analyses, the lag scale was important for spatial arrangement. At 0·25 m, in March 1997, theA. intermediusandD. reticulatumjuveniles were aggregated, presumably about where egg batches were laid. At higher scales, the arrangements ofD. reticulatumbecame spatially random, andA. intermediusresolved to a patch arrangement at the 16 m scale.

4.Over time, theD. reticulatumspatial arrangements remained random and independent of the previous sampling date. From March to July 1997, theA. intermediuspatch persisted. A crash in abundance of both species, between July and October 1997, appeared to destroy the patch, but subsequent association suggested that the patch persisted until March 1998. The arrangements of the species were independent of one another on all sampling dates.

5.These species‐specific spatial arrangements were independent of all measured environmental factors and consistent with differences in the local reproduction, survival and migration ofA. intermediusandD. reticulatum.

6.This comparative study indicates that the terms aggregated, random and regular should have separate definitions for parametric intensity and spatial arrangement. Furthermore, spatial scale has different meaning in intensity and arrangement analyses. Spatial arrangements are not described by parametric intensity. Spatial arrangements change with spatial scale. Temporal changes in intensity need not manifest as changes in spatial arrangement.
Comparison of puberty and psychosocial adjustment between Taiwanese adolescent females with and without diabetes
Authors: Hsu Yu‐Yun Alice , Dorn Lorah D , Sereika Susan M
Published: September 2010

Aims and objectives.  The aims of this study were to (1) determine the differences in puberty and psychosocial adjustment among Taiwanese adolescent females with and without type 1 diabetes mellitus, and (2) examine the interaction between pubertal timing and diabetes in relation to its effect on adolescent’s psychosocial adjustment.

Background.  Rapid physical and sexual changes during puberty elicit a wide array of psychosocial adjustments. The effects of pubertal changes among adolescent females with type 1 diabetes mellitus on psychosocial adjustment are unknown.

Design.  This study used a comparative, case‐controlled design. A total of 82 adolescent females, aged 10–17, were recruited for the study. Forty‐one adolescents with type 1 diabetes mellitus were age‐matched to 41 adolescents without type 1 diabetes mellitus.

Methods.  Adolescents’ psychosocial adjustment, including internalising and externalising behaviours, was assessed using the Child Behaviour Checklist (parental report) and the Youth Self‐Report (individual self‐report). The self‐reported Pubertal Development Scale was used to measure adolescents’ puberty, including onset of menses, age at menarche and pubertal timing.

Results.  When compared to their counterparts, adolescent females with type 1 diabetes mellitus reported a delayed menarche and a delayed puberty. Females with type 1 diabetes mellitus had significantly greater internalising and externalising behaviours than their counterparts according to parental reports. Onset of menses and adolescent self‐reported psychosocial adjustment were not different between the two groups. Interaction analyses showed that the association between pubertal timing and internalising behaviours was related to the presence of diabetes. According to parental reports, early pubertal timing had positive effects on internalising behaviours for adolescent females with type 1 diabetes mellitus not for adolescent females without type 1 diabetes mellitus.

Relevance to clinical practice.  A multi‐informant approach is suggested when health care professionals assess adolescent psychosocial adjustment. Health care professionals must provide female teenagers with information and opportunities to discuss the impact of type 1 diabetes mellitus on their puberty and psychosocial adjustment.
Partnership‐based nursing practice for people with chronic obstructive pulmonary disease and their families: influences on health‐related quality of life and hospital admissions
Authors: Ingadottir Thorbjorg S , Jonsdottir Helga
Published: September 2010

Aims and objectives.  To evaluate the outcome of a coherent nursing practice in the form of partnership that addresses the complexity of living with chronic obstructive pulmonary disease.

Background.  Chronic obstructive pulmonary disease is a wide‐ranging and progressive chronic disease that not only requires relentless attentiveness of the persons having the disease but also the families involved. Particular consideration is called for in health care for those with an advanced and complicated stage of the disease. The nursing practice, grounded in the theoretical framework of ‘partnership as practice’, is participatory comprehensive, long‐term and dynamic to individual patient‐family needs.

Design.  Retrospective and prospective pretest–post‐test intervention study.

Methods.  Eleven men and 39 women participated (n = 50). Mean age was 66 years. The majority (n = 36) had severe chronic obstructive pulmonary disease (GOLD stage III and IV). Actual study period was six months (T2). Hospital admission data were collected six months prior to (T1) and six months after that period (T3), a total of 18 months.

Results.  Hospital admission rate and days spent in hospital because of chronic obstructive pulmonary disease were significantly reduced. Disease‐specific health‐related quality of life measured by St. George’s Respiratory Questionnaire improved significantly. For those with clinical anxiety and depression, both decreased significantly. Of those who were underweight, body mass index improved significantly. Abstinence from smoking changed non‐significantly. Capability in the use of inhaler medications improved.

Conclusions.  These results are in contrast to previous studies on outpatient nursing care for people with chronic obstructive pulmonary disease. The participatory nature of partnership with dialogue as central and which was uniquely implemented in this study might be of particular relevance for individuals and families living with chronic obstructive pulmonary disease.

Relevance to clinical practice.  Complex and comprehensive health needs of people with chronic obstructive pulmonary disease and their families may be effectively addressed in partnership centred on dialogue together with efficient intra‐and interdisciplinary collaboration.
Understanding coronary atherosclerosis in relation to obesity: is getting the distribution of body fatness using dual‐energy X‐ray absorptiometry worth the effort? A novel perspective using Bayesian Networks
Authors: Foltran Francesca , Berchialla Paola , Bigi Riccardo , Migliaretti Giuseppe , Bestetti Alberto , Gregori Dario
Published: September 2010

Aim  A relative excess of fat in the upper body region has been proven to be associated with increased coronary artery disease (CAD) risk. Dual‐energy X‐ray absorptiometry (DXA) is probably the most accurate and precise method available to study fat regional distribution and to directly measure total body fat and lean soft tissue mass. However, while several studies have investigated the abilities of obesity anthropometric measures in predicting CAD, only few studies have evaluated DXA as CAD predictor; particularly, a comparison between a model including information coming from anthropometric measurements and a model in which fat is precisely measured by DXA, is still lacking. In order to verify if CAD severity, as measured by Gensini score, is better predicted when a prognostic model includes DXA measurements rather than anthropometric measures, we compared performance obtained by two Bayesian Networks (BNs) including standard anthropometric measures and DXA, respectively.

Methods  Data come from 58 consecutive patients, 79% of them having suspected and 21% known CAD. Two BNs were implemented: input variables include anamnestic information, biochemical data and obesity measures. In the first model (BN1) obesity was measured by body mass index and waist‐to‐hip ratio, while in the second one (BN2) it is quantified by DXA‐derived parameters.

Results  Network graphs and results coming from sensitivity analysis show that in both models lipoproteins and biomarkers of inflammation act as proximal node, while obesity (independently of the chosen measure) appears to be a distal node acting by the intermediation of other variables. Both models show high predictive abilities, the mean percentage classification errors being, respectively, 14.13 and 18.87.

Conclusions  In our study, the BN predictive ability is slightly superior when obesity is measured using anthropometric data instead of DXA measurements. The reason probably relies on the fact that in the BN the obesity role in predicting CAD is mediated by the action of other factors that appear to be more directly influencing the outcome. Thus, the necessity to dispose of a perfect measure becomes less compulsory and the huge effort to precisely estimate body composition with complex methods as DXA could be avoided when using expert system such as BN as predictive tool.
Making sense of polarities in health organizations for policy and leadership
Authors: Martin Carmel M.
Published: September 2010

Making sense of complex adaptive clinical practice and health systems is a pressing challenge as health services continue to struggle to adapt to changing internal and external constraints. In this Forum, we begin with Dervin's Sense‐Making theories and research in communications. This provides a conceptual and theoretical context for this editions research on comparative complexity of family medicine consultations in the USA, models for adaptive leadership in clinical care and social networking to make sense of health promotion challenges for young people. Finally, a Sense‐Making schema is proposed.
Trends in the perceived complexity of primary health care: a secondary analysis
Authors: Katerndahl David , Parchman Michael , Wood Robert
Published: September 2010

Rationale  If the complexity of the patient's medical problems increases or the complexity of the interactions between the doctor and the patient, the staff or the health care system increase, then complexity of patient care will increase. This study examined trends in patient complexity, and identified doctor, practice and improvement strategy characteristics associated with perceived complexity.

Methods  This secondary analysis used data from three Community Tracking Surveys with 22 134 primary care doctors completing surveys about themselves, their practice setting, practice improvement strategies and complexity of care in three consecutive 2‐year time periods (1996–1997, 1998–1999, 2000–2001). Data were analysed using hierarchical logistic regression.

Results  The proportion of primary care doctors who perceived that complexity of care had increased over the past 2 years rose from 31.5% to 35.9%. Perceived complexity of patient care was consistently related to being in solo practice and the belief that they could not frequently obtain high‐quality services and referrals for patients. As availability of services increased, complexity decreased whereas as use of practice improvement strategies increased, complexity also increased.

Conclusions  Understanding that we cannot determine whether respondents understood care as ‘complicated’ or ‘complex’, potential consequences of this increase in complexity include an increase in medical errors and referral rates along with decreased quality of patient care and career satisfaction.
Adaptive leadership and the practice of medicine: a complexity‐based approach to reframing the doctor–patient relationship
Authors: Thygeson Marcus , Morrissey Lawrence , Ulstad Val
Published: September 2010

Rationale, aims and objectives  This paper applies the concepts of ‘adaptive leadership’, as developed by Ron Heifetz, MD, to the practice of medicine.

Methods  Literature review and theory development.

Results  Patients are complex adaptive systems facing both adaptive and technical health challenges. Technical health challenges are amenable to the simple or complicated expert‐mediated technical interventions that are common in modern medicine, but complex adaptive challenges can only be addressed by patients doing the adaptive work to learn new attitudes, beliefs and behaviours. In medicine, we often make the mistake of offering technical interventions in lieu of supporting patients' adaptive work. This error can result in poor clinical outcomes and wasted resources. Expecting simple or complicated technical ‘solutions’ to resolve complex adaptive health challenges is a failure of adaptive leadership and violates Ashby's law of requisite variety. Adaptive leadership behaviours correspond to and complement doctor practices that have been shown to improve health outcomes and doctor–patient communication.

Conclusions  Adopting an adaptive leadership framework in the practice of medicine will require adaptive work on our part, but it promises to improve the doctor–patient relationship, increase our effectiveness as healers and reduce unnecessary health care utilization.
Comparison of the efficacy of three PubMed search filters in finding randomized controlled trials to answer clinical questions
Authors: Yousefi‐Nooraie Reza , Irani Shirin , Mortaz‐Hedjri Soroush , Shakiba Behnam
Published: September 2010

Objective  The aim of this study was to compare the performance of three search methods in the retrieval of relevant clinical trials from PubMed to answer specific clinical questions.

Methods  Included studies of a sample of 100 Cochrane reviews which recorded in PubMed were considered as the reference standard. The search queries were formulated based on the systematic review titles. Precision, recall and number of retrieved records for limiting the results to clinical trial publication type, and using sensitive and specific clinical queries filters were compared. The number of keywords, presence of specific names of intervention and syndrome in the search keywords were used in a model to predict the recalls and precisions.

Results  The Clinical queries‐sensitive search strategy retrieved the largest number of records (33) and had the highest recall (41.6%) and lowest precision (4.8%). The presence of specific intervention name was the only significant predictor of all recalls and precisions (P = 0.016).

Conclusion  The recall and precision of combination of simple clinical search queries and methodological search filters to find clinical trials in various subjects were considerably low. The limit field strategy yielded in higher precision and fewer retrieved records and approximately similar recall, compared with the clinical queries‐sensitive strategy. Presence of specific intervention name in the search keywords increased both recall and precision.
Attenuated Stress Response to Acute Restraint and Forced Swimming Stress in Arginine Vasopressin 1b Receptor Subtype (Avpr1b) Receptor Knockout Mice and Wild‐Type Mice Treated with a Novel Avpr1b Receptor Antagonist
Authors: Roper J. A. , Craighead M. , O’Carroll A‐M. , Lolait S. J.
Published: September 2010

Arginine vasopressin (AVP) synthesised in the parvocellular region of the hypothalamic paraventricular nucleus and released into the pituitary portal vessels acts on the 1b receptor subtype (Avpr1b) present in anterior pituitary corticotrophs to modulate the release of adrenocorticotrophic hormone (ACTH). Corticotrophin‐releasing hormone is considered the major drive behind ACTH release; however, its action is augmented synergistically by AVP. To determine the extent of vasopressinergic influence in the hypothalamic‐pituitary‐adrenal axis response to restraint and forced swimming stress, we compared the stress hormone levels [plasma ACTH in both stressors and corticosterone (CORT) in restraint stress only] following acute stress in mutant Avpr1b knockout (KO) mice compared to their wild‐type controls following the administration of a novel Avpr1b antagonist. Restraint and forced swimming stress‐induced increases in plasma ACTH were significantly diminished in mice lacking a functional Avpr1b and in wild‐type mice that had been pre‐treated with Avpr1b antagonist. A corresponding decrease in plasma CORT levels was also observed in acute restraint‐stressed knockout male mice, and in Avpr1b‐antagonist‐treated male wild‐type mice. By contrast, plasma CORT levels were not reduced in acutely restraint‐stressed female knockout animals, or in female wild‐type animals pre‐treated with Avpr1b antagonist. These results demonstrate that pharmacological antagonism or inactivation of Avpr1b causes a reduction in the hypothalamic‐pituitary‐adrenal (HPA) axis response, particularly ACTH, to acute restraint and forced swimming stress, and show that Avpr1b knockout mice constitute a model by which to study the contribution of Avpr1b to the HPA axis response to acute stressors.
A behavioural and electrophysiological study of ovi position cues for Culex quinquefasciatus
Authors: BLACKWELL1 A. , (LUNTZ) A. J. MORDUE , HANSSON B. S. , WADHAMS L. J. , PICKETT J. A.
Published: September 2010

Abstract. Both the synthetic oviposition pheromone, erythro‐6‐acetoxy‐5‐hexa‐decanolide (0.01–80 μg) and a polluted water sample (0.01–80%) significantly increased oviposition by gravid female Culex quinquefasciatus Say (Diptera: Culicidae) in a laboratory assay against clean water. An additive effect resulted when 0.05 μg oviposition pheromone was combined with the polluted water dilution series. Undiluted, however, both the oviposition pheromone and the polluted water sample, alone and in combination, reduced the oviposition response to control levels. A previously reported oviposition site odour component, 3‐methylindole, also significantly increased oviposition at 1 × 10_8 to 1 × 10‐7g but at 1 × 10_7g significantly less oviposition occurred than in control treatments. The biological activities of the compounds were additionally evaluated electrophysiologically by an EAG assay. Female mosquitoes were electrophysiologically sensitive to the oviposition cues, both pheromone and habitat‐related; EAG responses of males were considerably lower than of females with 3‐methylindole.
Turbiditic, clay‐rich event beds in fjord‐marine deposits caused by landslides in emerging clay deposits – palaeoenvironmental interpretation and role for submarine mass‐wasting
Authors: HANSEN LOUISE , L’HEUREUX JEAN SEBASTIEN , LONGVA ODDVAR
Published: September 2010

Distinct, clay‐rich beds are common in fjord‐marine deposits in Trondheimsfjorden near the outlet of the Nidelva River. Their characteristic light‐grey colour makes the beds easily distinguishable from the surrounding brownish, bioturbated, muddy fjord sediments. The clay‐rich beds commonly display a clear stratification in clay, silt and very fine sand. The beds are interpreted as originating primarily from large quick‐clay landslides upstream along the Nidelva River. Such events resulted in a sudden increase in the supply of fines to the fjord from disintegrating landslide debris and heavily loaded effluent plumes, possibly favouring hyperpycnal flow. Typical beds can be divided into a clay‐rich lower section, reflecting an initial surge with high concentrations of suspended mud, and a sandier upper section reflecting pulses of higher energy. This development can be explained, for example, by a lowering in the supply of mud, an increasing activity of deltaic sediment gravity flows due to a higher availability of sandy sediments in the landslide‐affected river, and by flooding and/or breaching of landslide dams. The typical, stratified beds are interpreted as the result of one quick‐clay landslide, whereas exceptionally thick, less organized, stratified beds are possibly the result of several large and/or complex landslides. Radiocarbon dating of mollusc shells has helped to establish a chronology for major terrestrial landslides in the area. The frequency of landslides increases towards the end of the Holocene. This is explained by a progressively deeper incision of rivers during glacioisostatic rebound, possibly combined with a change to a wetter climate. The marine core record displays deformation structures and hiati representing submarine mass‐wasting events, and supports the evidence that the clay‐rich beds are weak layers in the fjord‐marine stratigraphy. The inherent weakness of these layers may be explained by their composition, immature texture, loose fabric and contrasting permeabilities in the deposits. Slide‐prone layers similar to the clay‐rich beds described here may be found in other comparable fjord‐marginal settings and are considered to be of importance for geohazard assessments.
The ultrafine component in Chinese loess and its variation over the past 7·6 Ma: implications for the history of pedogenesis
Authors: SUN DONGHUAI , SU RUIXIA , LI ZAIJUN , LU HUAYU
Published: September 2010

Grain‐size data from different climatic zones across the Chinese Loess Plateau show that the loess generally contains an ultrafine component, which has a consistent modal grain size of ca 0·37 μm and a variable proportion of 4 to 10%. The variation of the ultrafine component through a loess section is characterized by a high proportion and fine grain size in palaeosols, and by a low proportion and coarse grain size in loess layers. Its proportional content in a stratum roughly increases from north‐west to south‐east across the Loess Plateau. Quantitative X‐ray diffraction analysis indicates that the ultrafine component is composed mainly of clay minerals (ca 70%), which are mostly illite (ca 80%), and with significant amounts of kaolinite (ca 8%) and chlorite (ca 2%). The temporal and spatial variations of the ultrafine component, and the degree of illite crystallinity, suggest that this component in aeolian sediments is linked closely to the process of pedogenesis. Weakly altered loess on the north‐western margin of the Loess Plateau contains considerable amounts of detrital clay minerals derived from the aeolian source areas. Results from a loess section with a basal age of 7·6 Ma in the central Loess Plateau show that the ultrafine component increased from 7·6 to 5 Ma, and progressively decreased thereafter. This trend was punctuated by two abrupt changes at 2·6 and 0·6 Ma. These variations reflect to a considerable extent the history of pedogenesis during the Late Cenozoic.
Windblown desert sands in coeval shallow marine deposits: a key for the recognition of coastal ergs in the mid‐Cretaceous Iberian Basin, Spain
Authors: Rodríguez‐López J.P. , De Boer P.L. , Meléndez N. , Soria A.R. , Pardo G.
Published: September 2010

Grain size and SEM analyses suggest the presence of Cretaceous windblown desert sands in coeval shallow marine environments. Size distributions and microtexture data allowed us to infer a climate change to more arid conditions in the Iberian Basin during the mid‐Cretaceous. The grain size of the sands in the late Aptian to early Cenomanian shallow‐marine deposits in the western sub‐basins of the Maestrazgo Basin (Teruel, Spain) is almost exclusively in the range between 1.5 and 3 Φ (0.35–0.125 mm), reflecting a prolonged or at least recurrent preselection of aeolian sands. The palaeolatitude of 25°N showed a change from a warm humid climate during the Lower Cretaceous to an arid desert climate in the eastern sector of Iberia during the late Aptian–early Cenomanian. Winds supplied abundant desert sand to the estuarine and deltaic sedimentary environments where it was worked up in sandy sub‐ and intertidal facies with a striking absence of mud in cross‐bedded sets which otherwise clearly reflect the influence of a semi‐diurnal tidal system.