bluuebunny/crossref_metadata_2025 huggingface dataset:
Understanding and Addressing Barriers to Implementation of Environmental and Policy Interventions to Support Physical Activity and Healthy Eating in Rural Communities
Authors: Barnidge Ellen K. , Radvanyi Catherine , Duggan Kathleen , Motton Freda , Wiggs Imogene , Baker Elizabeth A. , Brownson Ross C.
Published: September 2012

Purpose: Rural residents are at greater risk of obesity than urban and suburban residents. Failure to meet physical activity and healthy eating recommendations play a role. Emerging evidence shows the effectiveness of environmental and policy interventions to promote physical activity and healthy eating. Yet most of the evidence comes from urban and suburban communities. The objectives of this study were to (1) identify types of environmental and policy interventions being implemented in rural communities to promote physical activity or healthy eating, (2) identify barriers to the implementation of environmental or policy interventions, and (3) identify strategies rural communities have employed to overcome these barriers.

Methods: Key informant interviews with public health professionals working in rural areas in the United States were conducted in 2010. A purposive sample included 15 practitioners engaged in planning, implementing, or evaluating environmental or policy interventions to promote physical activity or healthy eating.

Findings: Our findings reveal that barriers in rural communities include cultural differences, population size, limited human capital, and difficulty demonstrating the connection between social and economic policy and health outcomes. Key informants identified a number of strategies to overcome these barriers such as developing broad‐based partnerships and building on the existing infrastructure.

Conclusion: Recent evidence suggests that environmental and policy interventions have potential to promote physical activity and healthy eating at the population level. To realize positive outcomes, it is important to provide opportunities to implement these types of interventions and document their effectiveness in rural communities.
Barriers to Cancer Clinical Trial Participation Among American Indian and Alaska Native Tribal College Students
Authors: Sprague Debra , Russo Joan , LaVallie Donna L. , Buchwald Dedra
Published: September 2012

Purpose: American Indians and Alaska Natives (AIs/ANs) have some of the highest cancer‐related mortality rates of all US racial and ethnic groups, but they are underrepresented in clinical trials. We sought to identify factors that influence willingness to participate in cancer clinical trials among AI/AN tribal college students, and to compare attitudes toward clinical trial participation among these students with attitudes among older AI/AN adults.

Methods: Questionnaire data from 489 AI/AN tribal college students were collected and analyzed along with previously collected data from 112 older AI/AN adults. We examined 10 factors that influenced participation in the tribal college sample, and using chi‐square analysis and these 10 factors, we compared attitudes toward research participation among 3 groups defined by age: students younger than 40, students 40 and older, and nonstudent adults 40 and older.

Findings: About 80% of students were willing to participate if the study would lead to new treatments or help others with cancer in their community, the study doctor had experience treating AI/AN patients, and they received payment. Older nonstudent adults were less likely to participate on the basis of the doctor's expertise than were students (73% vs 84%, P = .007), or if the study was conducted 50 miles away (24% vs 41%, P= .001).

Conclusions: Finding high rates of willingness to participate is an important first step in increasing participation of AIs/ANs in clinical trials. More information is needed on whether these attitudes influence actual behavior when opportunities to participate become available.
Are Primary Care Practices Ready to Become Patient‐Centered Medical Homes?
Authors: Ullrich Fred A. , MacKinney A. Clinton , Mueller Keith J.
Published: September 2012

Purpose: To measure the readiness of rural primary care practices to qualify as patient‐centered medical homes (PCMHs), one step toward participating in changes underway in health care finance and delivery.

Methods: We used the 2008 Health Tracking Physician Survey to compare PCMH readiness scores among metropolitan and nonmetropolitan primary care practices. The National Committee on Quality Assurance (NCQA) assessment system served as a framework to assess the PCMH capabilities of primary care practices based on their services, processes, and policies.

Findings: We found little difference between urban and rural practices. Approximately 41% of all primary care practices offer minimal or no PCMH services. We also found that large practices score higher on standards primarily related to information technology and care management.

Conclusions: Achieving the benefits of the PCMH model in small rural practices may require additional national promotion, technical assistance, and financial incentives.
Health Care Utilization Patterns for Young Children in Rural Counties of the I‐95 Corridor of South Carolina
Authors: McElligott James T. , Summer Andrea P.
Published: September 2012

Objective: The objective of this study was to assess health care utilization patterns for young children with Medicaid insurance in the rural counties of the I‐95 corridor in South Carolina relative to other regions of the state. We hypothesize that young children received less well care and higher levels of tertiary care in the rural counties along the I‐95 corridor (I‐95) of South Carolina.

Design/Methods: A Medicaid cohort of children less than 3 years of age was used to compare Early, Periodic, Diagnosis, Screening and Treatment (EPSDT) visits; preventable emergency department (ED) visits; and inpatient visits between I‐95, other rural and urban county groupings.

Results: The adjusted odds of a child having had 80% of the recommended EPSDT visits were reduced for I‐95 compared to other rural counties. The odds of a preventable inpatient or ED visit were increased for all rural counties, with the highest rates in the other rural counties.

Conclusions: Children accessed well care less in the I‐95 corridor compared to other rural areas of South Carolina. Rural children accessed tertiary care more often than urban children, a finding most prominent outside the I‐95 corridor, likely attributable to more available access of tertiary care in rural counties outside the I‐95 corridor.
Epizootics of sudden death in tammar wallabies (Macropus eugenii) associated with an orbivirus infection
Authors: Rose KA , Kirkland PD , Davis RJ , Cooper DW , Blumstein D , Pritchard LI , Newberry KM , Lunt RA
Published: September 2012

Epizootics of sudden death in tammar wallabies (Macropus eugenii) occurred at six research facilities and zoological gardens in New South Wales, Australia, in late 1998 and at one Queensland research facility in March 1999. There were 120 confirmed tammar wallaby deaths during this period; however, population censuses indicated that up to 230 tammar wallabies may have died. The majority of animals died without premonitory signs. A small proportion of wallabies exhibited increased respiratory rate, sat with a lowered head shortly before death or were discovered in lateral recumbency, moribund and with muscle fasciculations. Gross postmortem findings consistently included massive pulmonary congestion, mottled hepatic parenchyma and subcutaneous oedema throughout the hindlimbs and inguinal region. Approximately 30% of the animals examined also had extensive haemorrhage within the fascial planes and skeletal muscle of the hindlimb adductors, inguinal region, ventral thorax, dorsal cervical region and perirenal retroperitoneal area. The tissues of affected animals became autolytic within a short period after death. Bacteriological examination of tissues from 14 animals did not provide any significant findings. Toxicological examination of the gastric and colonic contents of four animals did not reveal evidence of brodifacoume or other rodenticides. Viruses from the Eubenangee serogroup of the Orbivirus genus were isolated from the cerebral cortex of nine, and the myocardium of two, tammar wallabies and the liver and intestine of another tammar wallaby. A similar orbivirus was also isolated from the cerebrospinal fluid of another tammar wallaby that died suddenly. The disease agent appears to be a previously unrecognised orbivirus in the Eubenangee serogroup. This is the first report of epizootics of sudden deaths in tammar wallabies apparently associated with an orbivirus infection.
Enseñanzas de la reducción de las pensiones del segundo pilar en Hungría y Polonia
Authors: Fultz Elaine
Published: September 2012

En 1997 Hungría y Polonia fueron los primeros países de Europa Central en privatizar parcialmente sus sistemas nacionales de pensiones. Para ello desviaron parte de las cotizaciones al régimen público de pensiones a cuentas de inversión individuales gestionadas de manera privada. Tras la crisis económica mundial, ambos gobiernos racionalizaron estos regímenes de segundo pilar: en diciembre de 2010 Hungría dejó de financiar las cuentas y recuperó la mayor parte de los saldos de las cuentas de los trabajadores y, en abril de 2011, Polonia redujo el desvío de cotizaciones al segundo pilar. Los factores que llevaron a estas reducciones se remontan a los proyectos originales del segundo pilar de 1997, que omitieron condiciones fundamentales relacionadas con la financiación de las cuentas, el proyecto de las prestaciones privadas y la reglamentación de las comisiones de gestión privada. A pesar de que a lo largo de la puesta en práctica los dos gobiernos trataron de compensar la ausencia de estas condiciones de proyecto, los resultados fueron limitados. Al reducir el rendimiento de las inversiones y aumentar los costos de los préstamos, la crisis económica mundial llevó la problemática a un punto crítico. En la conclusión se señalan algunas cuestiones importantes cuya resolución determinará las repercusiones a largo plazo de las reducciones del segundo pilar.
El declive de las vías alternativas hacia la jubilación: observaciones empíricas en el sector de la salud de los Países Bajos
Authors: Euwals Rob , van Vuren Annemiek , van Vuuren Daniel
Published: September 2012

En los Países Bajos los regímenes de jubilación anticipada y el seguro de invalidez se reformaron varias veces en los últimos decenios. Las reformas aumentaron los incentivos para que los trabajadores mayores sigan trabajando y redujeron prevalencia de las vías alternativas hacia la jubilación. Este artículo presenta una reseña de las reformas y, a la luz de los datos administrativos sobre los trabajadores del sector de la salud, pone a prueba varias hipótesis acerca de la tasa actividad de los trabajadores mayores. Se extraen dos conclusiones principales: a) las reformas neerlandesas han sido eficaces ya que la tasa de actividad de los trabajadores mayores ha aumentado, y b) el concepto de vías alternativas ha perdido relevancia dado que se ha cerrado el acceso a la jubilación anticipada a través del seguro de invalidez. No obstante, no se recomienda generalizar sistemáticamente las conclusiones del caso neerlandés a otros países de la OCDE, ya que es probable que el contexto institucional nacional influya en los resultados.
Correlation between pennation angle and image quality of skeletal muscle fibre tractography using deterministic diffusion tensor imaging
Authors: Okamoto Yoshikazu , Okamoto Toru , Yuka Kujiraoka , Hirano Yuji , Isobe Tomonori , Minami Manabu
Published: September 2012

Introduction

The aim of this study was to ascertain whether a correlation existed between muscle pennation angle and the ability to successfully perform tractography of the lower leg muscle fibres with deterministic diffusion tensor imaging (DTI) in normal volunteers.

Methods

Fourteen volunteers aged 20–39 (mean 28.2 years old) were recruited. All volunteers were scanned using DTI, and six fibre tractographs were constructed from one lower leg of each volunteer, and the ‘fibre density’ was calculated in each of the tractographs. The pennation angle is the angle formed by the muscle fibre and the aponeurosis. The average pennation angle (AVPA) and standard deviation of the pennation angle (SDPA) were also measured for each muscle by ultrasonography in the same region as the MRI scan. For all 84 tractography images, the correlation coefficient between the fibre density and AVPA or SDPA was calculated.

Results

Fibre density and AVPA showed a moderate negative correlation (R = −0.72), and fibre density and SDPA showed a weak negative correlation (R = −0.47). With respect to comparisons within each muscle, AVPA and fibre density showed a moderate negative correlation in the gastrocnemius lateralis muscle (R = −0.57).

Conclusions

Our data suggest that a larger, more variable pennation angle resulted in worse skeletal muscle tractography using deterministic DTI.
Lymphangiography as therapeutic management of chylothorax
Authors: Juszczyk Karolina , Waugh Richard , Sandroussi Charbel
Published: September 2012

Chylothorax is a rare post surgical complication. It is often initially treated using conservative management such as chest drain insertion, a medium chain triglyceride diet, total parenteral nutrition and somatostatin analogues. Lymphangiography has been used in the past, mainly to identify the site of a chyle leak, but there have been reports where lymphangiography has been therapeutic in the management of chylothorax and has led to resolution of the chyle leak. This paper describes the case of a 15‐year‐old male who presented with a post‐operative chylothorax. He was initially managed conservatively, which failed to stop the chyle leak and lymphangiography was performed. Imaging confirmed that lymphangiography was successful in stopping the chyle leak, leading to resolution of the chylothorax.

Conclusion

This case demonstrates that lymphangiography can be used as a therapeutic measure in the management of a chylothorax.
Variant treatment for gastric varices with polidocanol foam using balloon‐occluded retrograde transvenous obliteration: A pilot study
Authors: Clements Warren , Cavanagh Karda , Ali Faizal , Kavnoudias Helen , Kemp William , Roberts Stuart , Lyon Stuart
Published: September 2012

Introduction

Treatment of gastric variceal rupture remains difficult with current options including transjugular intrahepatic portosystemic shunt and endoscopic therapies having significant side effects or reduced efficacy. We report five cases of gastric varices that were successfully treated with balloon‐occluded retrograde transvenous obliteration of varices (BRTO) using Polidocanol foam as an alternative sclerosant to ethanolamine oleate.

Methods

Patients were recruited with cirrhotic liver disease, a history of upper gastrointestinal bleeding, and large gastric fundal varices confirmed on gastroscopy and CT venogram. BRTO was performed as a same‐day procedure using a balloon catheter inserted via a gastro‐renal shunt with Polidocanol foam injected and a balloon inflated for 2 h. Follow‐up was with repeat CT portovenogram, gastroscopy at 6 weeks post‐procedure, and in a gastroenterology liver clinic at 1‐ to 3‐month intervals.

Results

Between January and December 2009, five patients safely underwent BRTO therapy of gastric varices without complication. At 6 weeks following the procedure, upper gastrointestinal endoscopy showed complete resolution of varices in 5 out of 5 patients, while CT portovenography showed resolution of varices in 4 out of 5 patients, with results in the last patient inconclusive. Clinical follow‐up at 1, 3 and 6 months indicated no further episodes of bleeding.

Conclusions

Our study further supports the use of foam sclerosants including Polidocanol in BRTO, showing it is a safe and effective minimally‐invasive procedure to treat gastric fundal varices in the short term.
Serum proteome analysis in patients with rheumatoid arthritis receiving therapy with etanercept, a chimeric tumor necrosis factor‐alpha receptor
Authors: Yanagida Mitsuaki , Jung Giman , Tanaka Yoshinori , Sone Saburo , Fujishiro Maki , Ikeda Keigo , Nozawa Kazuhisa , Kaneko Hiroshi , Takasaki Yoshinari , Ogawa Hideoki , Takamori Kenji , Sekigawa Iwao
Published: September 2012

Aim

Rheumatoid arthritis (RA) is a chronic inflammatory disorder of the synovium resulting in the destruction of affected joint cartilage and bone structures. Etanercept is a biological agent that blocks the tumor necrosis factor‐α (TNF‐α)‐mediated inflammatory processes in RA patients, and has a regenerative effect on cartilage. In order to identify novel disease‐related proteins and candidate biomarkers, we performed proteomic profiling of the serum in patients with RA who were treated with etanercept.

Method

Serum samples were obtained from eight RA patients before and after etanercept treatment. The low molecular weight proteins in the serum were concentrated and analyzed by liquid chromatography‐tandem mass spectrometry. The results before and after etanercept treatment were compared by the spectrum count method.

Results

Among a total of 477 proteins identified, 12 were found to be decreased and five were increased by etanercept treatment. Some of the changed proteins were known to be related to RA, and most of the other changed proteins may play possible roles in the TNF‐α signaling pathway or the state of cartilage and extracellular matrix.

Conclusion

The present proteomic study identified several proteins that could be involved in the pathogenesis of RA. These findings could thus lead to the identification of novel candidate disease‐related protein biomarkers for RA, or indicate new targets for therapy.
Development of an immunosensor assay for detection of haptoglobin in mastitic milk
Authors: Tan Xun , Ding Shou‐Qiang , Hu Yu‐Xia , Li Jun‐Jun , Zhou Ji‐Yong
Published: September 2012

Background

Detection of subclinical mastitis in dairy cows is important, as it represents a major economic challenge for the dairy industry worldwide owing to propagation of mastitis‐causing pathogens and to long‐term reduction in milk yield and quality. Haptoglobin (Hp) is one of the most sensitive acute phase proteins in milk during udder inflammation and as an indicator of mastitis.

Objectives

The aim of this study was to develop a rapid and sensitive immunosensor assay for measuring Hp concentration in mastitic milk.

Methods

The immunosensor was constructed by immobilizing anti‐bovine Hp antibody on a gold electrode through gold nanoparticles fabricated on self‐assembled L‐cysteine layers. The immunosensor assay was used to measure Hp concentration in 20 milk samples positive for bacteria with a somatic cell count > 5 × 105 cells/mL from cows without clinical signs of mastitis. Results were compared with those obtained using a commercial ELISA kit.

Results

Reproducibility of Hp measurement and stability after storage for 20 days were good for the immunosensor assay. Measurement of Hp was linear over a range of 15–100 mg/L, with a limit of detection of 0.63 mg/L. Agreement between results obtained with the immunosensor and ELISA methods was satisfactory as analyzed using the Wilcoxon signed‐rank test (Z = –1.739, P = .073).

Conclusion

An immunosensor assay for measuring Hp in milk provided rapid results and was easy to perform, facilitating its potential use in the field for the diagnosis of subclinical mastitis once a cutoff value for Hp concentration is established.
Hematologic and plasma biochemical reference intervals for health monitoring of wild Australian tree frogs
Authors: Young Sam , Warner Jeff , Speare Rick , Berger Lee , Skerratt Lee F. , Muller Reinhold
Published: September 2012

Background

Few hematologic and biochemical reference intervals for wild amphibians have been established. Reference values would aid in early detection of emerging infectious diseases, which are a significant problem for amphibian conservation efforts.

Objective

We aimed to establish reference intervals for a wide range of hematologic and plasma biochemistry variables for 2 species of Australian tree frogs, describe morphologic features of leukocytes, and analyze the effects of season, year, and parasite status on blood values.

Methods

Blood specimens were collected from reference populations of wild adult Australian tree frogs, Litoria caerulea and L infrafrenata, for analysis of hematologic (manual) variables, plasma biochemical (automated) analytes, and plasma and serum proteins using automated methods, refractometry, and electrophoresis.

Results

Inter‐ and intraspecies differences were found in L caerulea (n = 80) and L infrafrenata (n = 66) frogs for hematologic and biochemical variables. Intraspecies differences were largely associated with seasonal variations. In the dry season, both species had higher WBC counts, with higher lymphocyte counts in L caerulea and higher neutrophil counts in L infrafrenata, and uric acid concentrations. In the wet season, both species had higher glucose and potassium concentrations, L caerulea frogs had higher neutrophil counts, and L infrafrenata frogs had higher total protein, phosphorus, and sodium concentrations, AST activity, PCV, hemoglobin concentration, and RBC, thrombocyte, and basophil counts. Hemogregarines were identified in 19% of blood samples from L infrafrenata frogs; multiple hematologic and biochemical variables were altered in infected frogs.

Conclusions

Wide interspecies and seasonal variations highlight the need to establish species‐ and season‐specific reference intervals for amphibians. Hematologic and plasma biochemical reference values should be useful in assessing the health status and in detecting emerging diseases in wild amphibians.
Application of an online post-column derivatization HPLC-DPPH assay to detect compounds responsible for antioxidant activity in Sonchus oleraceus L. leaf extracts
Authors: Ou Zong-Quan , Schmierer David M , Rades Thomas , Larsen Lesley , McDowell Arlene
Published: September 2012

Objectives

To use an online assay to identify key antioxidants in Sonchus oleraceus leaf extracts and to investigate the effect of leaf position and extraction conditions on antioxidant concentration and activity.

Methods

Separation of phytochemicals and simultaneous assessment of antioxidant activity were performed online using HPLC and post-column reaction with a free-radical reagent (2, 2-diphenylpicrylhydrazyl, DPPH). Active compounds were identified using nuclear magnetic resonance spectroscopy and mass spectrometry. We applied the online HPLC-DPPH radical assay to evaluate antioxidants in leaves from different positions on the plant and to assess the effect of pre-treatment of leaves with liquid N2 before grinding, extraction time, extraction temperature and method of concentrating extracts.

Key findings

Key antioxidants identified in S. oleraceus leaf extracts were caftaric acid, chlorogenic acid and chicoric acid. Middle leaves contained the highest total amount of the three key antioxidant compounds, consisting mainly of chicoric acid. Pre-treatment with liquid N2, increasing the extraction temperature and time and freeze-drying the extract did not enhance the yield of the key antioxidants.

Conclusion

The online HPLC-DPPH radical assay was validated as a useful screening tool for investigating individual antioxidants in leaf extracts. Optimized extraction conditions were middle leaves pre-treated with liquid N2, extraction at 25°C for 0.5 h and solvent removal by rotary evaporation.
Nurse Competence: A Concept Analysis
Authors: Smith Sarah A.
Published: September 2012

PURPOSE:  The purpose of this analysis was to explore the concept of nurse competence.

DATA SOURCES:  Data sources include EBSCOhost, Gale PowerSearch, ProQuest, PubMed Medline, Google Scholar, and Online Journal of Issues in Nursing.

DATA SYNTHESIS:  This paper utilizes Rodgers' evolutionary method to analyze the concept of nurse competence.

CONCLUSION:  Antecedents to nurse competence include personal and external motivations. Attributes include integrating knowledge into practice, experience, critical thinking, proficient skills, caring, communication, environment, motivation, and professionalism. Consequences include confidence, safe practice, and holistic care. Implications for nursing responsibility regarding defining nurse competence and ensuring nurse competence need to be identified. More research is needed to determine the best evaluation methods for the different facets of nurse competence.
Collaboration among nurse practitioners and registered nurses in outpatient oncology settings in Canada
Authors: Moore Jane , Prentice Dawn
Published: September 2012

Aim

This article is a report on a case study that described and analysed the collaborative process among nurse practitioners and registered nurses in oncology outpatient settings to understand and improve collaborative practice among nurses.

Background

Changes in the health system have created new models of care delivery, such as collaborative nursing teams. This has resulted in the increased opportunity for enhanced collaboration among nurse practitioners and registered nurses. The study was guided by Corser's Model of Collaborative Nurse‐Physician Interactions (1998).

Design

Embedded single case design with multiple units of analysis.

Methods

Qualitative data were collected in 2010 using direct participant observations and individual and joint (nurse dyads) interviews in four outpatient oncology settings at one hospital in Ontario, Canada.

Findings

Thematic analysis revealed four themes: (1) Together Time Fosters Collaboration; (2) Basic Skills: The Brickworks of Collaboration; (3) Road Blocks: Obstacles to Collaboration; and (4) Nurses' Attitudes towards their Collaborative Work.

Conclusion

Collaboration is a complex process that does not occur spontaneously. Collaboration requires nurses to not only work together but also spend time socially interacting away from the clinical setting. While nurses possess the conceptual knowledge of the meaning of collaboration, findings from this study showed that nurses struggle to understand how to collaborate in the practice setting. Strategies for improving nurse–nurse practitioner collaboration should include: the support and promotion of collaborative practice among nurses by hospital leadership and the development of institutional and organizational education programmes that would focus on creating innovative opportunities for nurses to learn about intraprofessional collaboration in the practice setting.
DNA methylation of the filaggrin gene adds to the risk of eczema associated with loss‐of‐function variants
Authors: Ziyab A.H. , Karmaus W. , Holloway J.W. , Zhang H , Ewart S. , Arshad S.H.
Published: September 2012

Background  Loss‐of‐function variants within the filaggrin gene (FLG) are associated with a dysfunctional skin barrier that contributes to the development of eczema. Epigenetic modifications, such as DNA methylation, are genetic regulatory mechanisms that modulate gene expression without changing the DNA sequence.

Objectives  To investigate whether genetic variants and adjacent differential DNA methylation within the FLG gene synergistically act on the development of eczema.

Methods  A subsample (n = 245, only females aged 18 years) of the Isle of Wight birth cohort participants (n = 1456) had available information for FLG variants R501X, 2282del4 and S3247X and DNA methylation levels for 10 CpG sites within the FLG gene. Log‐binomial regression was used to estimate the risk ratios (RRs) of eczema associated with FLG variants at different methylation levels.

Results  The period prevalence of eczema was 15.2% at age 18 years and 9.0% of participants were carriers (heterozygous) of FLG variants. Of the 10 CpG sites spanning the genomic region of FLG, methylation levels of CpG site ‘cg07548383’ showed a significant interaction with FLG sequence variants on the risk for eczema. At 86% methylation level, filaggrin haploinsufficient individuals had a 5.48‐fold increased risk of eczema when compared to those with wild type FLG genotype (P‐value = 0.0008).

Conclusions  Our novel results indicated that the association between FLG loss‐of‐function variants and eczema is modulated by DNA methylation. Simultaneously assessing the joint effect of genetic and epigenetic factors within the FLG gene further highlights the importance of this genomic region for eczema manifestation.
Development of NMR spectroscopic methods for dynamic detection of acetylcholine synthesis by choline acetyltransferase in hippocampal tissue
Authors: Hall Hélène , Cuellar‐Baena Sandra , Denisov Vladimir , Kirik Deniz
Published: September 2012

Choline acetyltransferase (ChAT) is the key enzyme for acetylcholine (ACh) synthesis and constitutes a reliable marker for the integrity of cholinergic neurons. Cortical ChAT activity is decreased in the brain of patients suffering from Alzheimer's and Parkinson's diseases. The standard method used to measure the activity of ChAT enzyme relies on a very sensitive radiometric assay, but can only be performed on post‐mortem tissue samples. Here, we demonstrate the possibility to monitor ACh synthesis in rat brain homogenates in real time using NMR spectroscopy. First, the experimental conditions of the radiometric assay were carefully adjusted to produce maximum ACh levels. This was important for translating the assay to NMR, which has a low intrinsic sensitivity. We then used 15N‐choline and a pulse sequence designed to filter proton polarization by nitrogen coupling before 1H‐NMR detection. ACh signal was resolved from choline signal and therefore it was possible to monitor ChAT‐mediated ACh synthesis selectively over time. We propose that the present approach using a labeled precursor to monitor the enzymatic synthesis of ACh in rat brain homogenates through real‐time NMR represents a useful tool to detect neurotransmitter synthesis. This method may be adapted to assess the state of the cholinergic system in the brain in vivo in a non‐invasive manner using NMR spectroscopic techniques.
Splanchnic net balance of oxygen and metabolites in response to a discontinuous mesenteric vein infusion of ammonium in sheep
Authors: Recavarren M. I. , Milano G. D.
Published: September 2012

To simulate daily episodes of high absorption associated with the intake of diets with high N content, four wethers (42 ± 3.4 kg body weight), fitted with permanent catheters in the femoral artery and splanchnic vessels, were infused with 340 μmol into the mesenteric vein for 3 h, during the morning meal, over seven consecutive days. On the 7th day, mass transfers of , urea, glucose, lactate, ß‐OH‐butyrate and O2 were measured across portal‐drained viscera (PDV), liver and splanchnic tissues during the last 90 min of the infusion. Measurements were repeated on the following day, at the same time, without the infusion. Plasma concentration in the portal vein (+332 μm; p = 0.006), portal absorption (+424 μmol/min; p < 0.001), liver uptake (+375 μmol/min; p = 0.003) and urea N production (+338 μmol/min; p = 0.059) were higher during infusion. Mass transfers of urea, glucose, lactate, ß‐OH‐butyrate and O2 across the PDV, and glucose, lactate, ß‐OH‐butyrate and O2 across the liver, were not altered by the infusion. Results suggest that a daily, discontinuous increase in portal flow during a meal stimulates liver removal and urea N production but does not significantly affect liver glucose production and O2 consumption in sheep.
Asymptomatic groin dermatophyte carriage detected during routine gynaecologic examinations
Authors: Küçükgöz‐Güleç Ümran , Gümral Ramazan , Güzel Ahmet B. , Khatib Ghanim , Karakaş Mehmet , Ilkit Macit
Published: September 2012

We investigated the epidemiological characteristics of both symptomatic and asymptomatic dermatophytic groin infections in 1970 women (age: 36.2 ± 12.5) during routine gynaecologic examinations. Bilateral groin samples were collected with sterile cotton swabs premoistened with sterile physiological saline. The samples were then separately inoculated onto Sabouraud glucose agar. Fungi were identified by sequencing the rDNA internal transcribed spacer region. Dermatophytes were recovered from five patients (four Trichophyton rubrum and one Arthroderma vanbreuseghemii, 0.25%) with a diagnosis of asymptomatic carriers (four) and tinea inguinalis (one). In one case, groin carriage converted into tinea inguinalis after 3 weeks. Analysis of risk factors indicated that patients of at least 49 years were more likely to be positive for dermatophyte isolation (P = 0.002). In conclusion, groin dermatophyte carriage is more common than tinea inguinalis and can potentially convert into a symptomatic infection.
A novel phosphotransferase system of Streptococcus mutans is responsible for transport of carbohydrates with α‐1,3 linkage
Authors: Ajdic D. , Chen Z.
Published: September 2012

The most common type of carbohydrate‐transport system in Streptococcus mutans is the phosphoenolpyruvate–sugar phosphotransferase system (PTS). Fourteen PTS exist in S. mutans UA159. Several studies have shown that microorganisms growing in biofilms express different genes compared with their planktonic counterparts. In this study, we showed that one PTS of S. mutans was expressed in sucrose‐grown biofilms. Furthermore, the same PTS was also responsible for the transport and metabolism of disaccharide nigerose (3‐O‐α‐d‐glucopyranosyl‐d‐glucose). Additionally, the results indicate that the studied PTS might be involved in the transport and metabolism of carbohydrates synthesized by glucosyltransferase B and glucosyltransferase C of S. mutans. To our knowledge, this is the first report that shows PTS transport of a disaccharide (and possibly extracellular oligosaccharides) with α‐1,3 linkage.
Family and social aspects associated with depression among older persons in aChinese context
Authors: Zeng Wen , North Nicola , Kent Bridie
Published: September 2012

Aim

This study aims to explore the factors associated with depression among older persons inMacau, in relation to family and social aspects.

Background

Depression among community‐dwelling older persons inMacau has been shown to be present at high rates. InChinese culture, depression leads to social stigmatisation, suggesting a need to better understand depression as a sociocultural phenomenon.

Methods

A mixed methods study was undertaken to identify the key influences on depression amongChinese older persons inMacau. Quantitative (standardised tests) and qualitative (collection of narratives) data were collected from 31 purposively selected participants, all community‐dwelling older persons with depression.

Results

Depression was common among the participants. The paper reports on the family and social aspects, one of the findings of the study. Informants readily described their thoughts and judgements of themselves in graphic language. As they explored their life stories, family and social aspects emerged as significant influences that associated with depression. In a society and culture that relies on and values filial support, experiences of being widowed, having poor family support and weak social networks appeared to compound and exacerbate depression.

Conclusions

These findings highlight that filial support, valued inChinese culture, is seriously strained by the realities of contemporary society. Yet current government policies rely on and confirm the role of family support. Findings from this study suggest a need for such policies to be reviewed to address the realities of family and social support.

Implications for practice

The findings have several implications for clinical practice. Firstly, the cultural context ofChinese older persons should be considered and emphasised in nursing practice. Secondly, the root of depression among Chinese older persons is seen to lie in their social, family, cultural and day‐to‐day living issues.
Comparison of the bronchodilating effects of albuterol delivered by valved vs. non‐valved spacers in pediatric asthma
Authors: Rodriguez‐Martinez Carlos E. , Sossa‐Briceño Mónica P. , Castro‐Rodriguez Jose A.
Published: September 2012

Introduction

Inhaled therapy using a metered‐dose inhaler (MDI) with attached valved holding chamber has been increasingly recognized as the optimal method for delivering bronchodilators for asthma treatment. However, mainly due to the high cost of these valved holding chambers in many developing countries, the use of non‐valved spacers is frequent, despite the scarce evidence that supports their efficacy. The aim of this study was to compare the bronchodilator response to albuterol administered by MDI with and without a valved spacer.

Methods

In a randomized, two‐period, two‐sequence crossover clinical trial, we analyzed 31 stable asthmatic children (6–18 yrs of age) on two consecutive days, who were randomly assigned to receive 100 μg of albuterol MDI through either a locally produced valved spacer or a non‐valved spacer. The next day, a crossover treatment was employed through the use of the other spacer. Spirometry was recorded before and after each albuterol administration.

Results

As we were not able to identify any sequence or carryover effect, we tested for treatment effects in both periods. No significant differences in the absolute change in FEV1 (0.20 ± 0.17 vs. 0.18 ± 0.16, p = 0.63), FVC (0.07 ± 0.13 vs. 0.07 ± 0.16, p = 0.88), or MMEF (0.49 ± 0.31 vs. 0.43 ± 0.39, p = 0.53) after bronchodilator administration were found between the use of valved and non‐valved spacers.

Conclusions

In stable asthmatic children, albuterol administered through MDI using a non‐valved spacer produces a bronchodilator response similar to that of a spacer with a valve that requires an inhalatory opening pressure (with flows between 2 and 32 l/min) that even toddlers with bronchial obstruction can easily generate.
Comparison of success rate of ultrasound‐guided sciatic and femoral nerve block and neurostimulation in children with arthrogryposis multiplex congenita: a randomized clinical trial
Authors: Ponde Vrushali , Desai Ankit P. , Shah Dipal
Published: September 2012

Background and objectives

Arthrogryposis multiplex congenital is hallmarked with immobile joints and muscle fibrosis. The main objective of this study was to compare the success rate of ultrasound‐guided sciatic and femoral nerve blocks with nerve stimulations in children diagnosed with distal arthrogryposis multiplex congenita.

Method

Sixty children aged 8 months to 2 years posted for foot surgery were randomly assigned to group NS and group US of 30 each. Under general anesthesia, femoro‐sciatic block was performed with nerve stimulator guidance in group NS and ultrasound guidance in group US.

Results

Group NS: 23 of 30 (76.7%) children showed ankle movement with sciatic neurostimulation. In 7 (23.6%), distal motor response could not be elicited and the block was abandoned. Out of 23 children who could be given femoral block, in 12 (52%) patients quadriceps contractions were not elicited and fascia iliaca block was given. All 23 blocks were successful. CHIPPS score at 1, 4, 6, 8, and 10 h was 1.05 ± 0.90, 1.82 ± 1.18, 3.36 ± 1.65, 2.23 ± 2.02, and 1.18 ± 1.14, respectively. Group US: In 29 of 30 patients (96.6%), sciatic nerve was visualized with ultrasonography. All 29 children received femoral block, and they were successful. The odds of success in group US were 8.9 (95% confidence interval [1.0, 77.9]) as compared with NS group. The difference in success rate was statistically significant (P = 0.026). The analgesic duration difference in the US and NS groups was a mean 7.62 ± 0.57 h in group NS and 8.60 ± 0.66 h in group US (statistically significant [P < 0.001]). CHIPPS score at 1, 4, 6, 8, and 10 h was 0.79 ± 0.96, 1.61 ± 0.92, 2.96 ± 1.04, 2.36 ± 2.54, and 1.14 ± 1.01, respectively. The difference between the CHIPPS score was not statistically significant.

Conclusion

Ultrasonography significantly increases the success rate of sciatic and femoral block in arthrogryposis.
Nonylphenol Polyethoxylates Degraded by Three Different Wavelengths of UV and Their Genotoxic Change—Detected by Generation of γ‐H2AX
Authors: Kubota Toru , Toyooka Tatsushi , Ibuki Yuko
Published: September 2012

UV rays in sunlight are an important factor in the degradation of chemicals. In this study, we investigated the degradation of nonionic surfactants, nonylphenol polyethoxylates (NPEOs) with 10 or 70 ethylene oxide (EO) units using UVA, B and C, and their genotoxic change based on phosphorylation of histone H2AX (γ‐H2AX), a marker of DNA damage. NPEOs were degraded dependent on the energy of UV, that is, UVC having the highest energy was most effective, whereas UVA having the lowest energy caused little change. The EO side chain of NPEO(70) was broken near the benzene ring by UV, producing NPEOs with a shortened EO chain (around 10 units). The generation of γ‐H2AX reflected the pattern of degradation; shortening of the EO chain changed NPEO(70) into an inducer for γ‐H2AX, and degradation of NPEO(10) attenuated the genotoxicity. The γ‐H2AX generated by NPEO(10) and UV‐degraded NPEO(70) was independent of the cell cycle. The formation of DNA double strand breaks detected by gel electrophoresis was consistent with the results for γ‐H2AX. These results suggested that UV rays can make NPEOs harmless or genotoxic according to the degradation of the EO side chain, the effects being dependent on wavelength.
Descriptive Epidemiology of Non‐syndromic Complete Atrioventricular Canal Defects
Authors: Agopian A. J. , Moulik Mousumi , Gupta‐Malhotra Monesha , Marengo Lisa K. , Mitchell Laura E.
Published: September 2012

Background:  Complete atrioventricular canal defects (CAVC) are a common heart defect, but few epidemiologic studies have evaluated non‐syndromic CAVC. Risk factors for non‐syndromic CAVC have not been well established.

Methods:  To assess the relationship between risk for non‐syndromic CAVC in offspring and several sociodemographic and reproductive parental factors, including maternal diabetes and obesity, we conducted Poisson regression analyses, using data ascertained through the Texas Birth Defects Registry, a large, population‐based birth defects registry. Data were evaluated for 563 non‐syndromic cases with CAVC.

Results:  Significant associations were observed between non‐syndromic CAVC in offspring and maternal pregestational diabetes (adjusted prevalence ratio (aPR) 6.74; 95% confidence interval (CI) 3.67, 12.37), gestational diabetes (aPR 1.69; 95% CI 1.03, 2.79) and obesity (aPR 1.69; 95% CI 1.24, 2.30).

Conclusions:  Our findings add non‐syndromic CAVC to the growing list of birth defects that appear to be associated with maternal diabetes and obesity.
Graftula: A Composite Access Consisting of a Graft Used to Repair a Dysfunctional Hemodialysis Fistula
Authors: Ramani Karthik , Kallam Ajay , Zibari Gazi , Caldito Gloria , Ram Sunanda J. , Abreo Kenneth D. , Sequeira Adrian
Published: September 2012

Nonmaturing or dysfunctional hemodialysis fistulas are often repaired with interposition grafts placed either within the fistula (fistula‐to‐fistula configuration), or connected to another vein (fistula‐to‐vein configuration). The goal of this study was to compare the survival and usefulness of the composite accesses thus created, which we call “graftulas,” with upperarm grafts. This was a retrospective study wherein we determined the survival and thrombosis rates of graftulas (n = 24) and upper arm grafts (n = 31) placed 1/1/07 through 12/31/09 and followed through 11/30/10. Graftulas resembled grafts as most (96%) were successfully cannulated in 65 ± 43 days. Survival of graftulas was also similar to grafts (58%, 47%, and 32% vs. 56%, 47%, and 39% at 1, 2, and 3 years respectively, p = 0.60). However, graftulas had a lower thrombosis rate than grafts (0.5 vs. 1.2 per patient year, p = 0.04), and in the fistula‐to‐fistula configuration, a 2‐year thrombosis‐free survival of 78%. Total survival of the access site (fistula + graftula) was 92%, 73%, and 42% at 1, 3, and 5 years, respectively. Graftulas possess certain beneficial properties of fistulas and grafts that allows for continued use of the original access site.
Blood Pressure and Blood Volume: Acute and Chronic Considerations in Hemodialysis
Authors: Lewicki Michelle C. , Kerr Peter G. , Polkinghorne Kevan R.
Published: September 2012

Hypertension is highly prevalent yet poorly controlled in the majority of dialysis patients and represents a significant burden of disease, with rates of morbidity and mortality greater than those in the general population. In dialysis, blood volume plays a critical role in the pathogenesis of hypertension, with expansion of extracellular volume increasingly recognized as an independent risk factor for morbidity and mortality. Within the current paradigm of dialysis prescription the majority of patients remain chronically volume expanded. However, management of blood pressure and volume state is difficult for clinicians with a paucity of randomized evidence adding to the complexity of nonlinear morbidity and mortality associations. With dialysis itself as a significant cardiac stressor, control of volume state is critical to minimize intradialytic hemodynamic instability, aid in preservation of cardiac anatomy and prevent progression to cardiovascular morbidity and mortality. This review explores the relationship of blood volume to blood pressure and potential targets for management in this at risk population.
Dihydropyridine receptors actively control gating of ryanodine receptors in resting mouse skeletal muscle fibres
Authors: Robin Gaëlle , Allard Bruno
Published: September 2012

Key points

Depolarization of the skeletal muscle membrane elicits a change in the configuration of dihydropyridine receptors that in turn triggers sarcoplasmic reticulum (SR) Ca2+ release through ryanodine receptors.

At rest, it is assumed, but never demonstrated in adult muscle fibres, that dihydropyridine receptors exert a repressive action on ryanodine receptors that keeps them in a closed state.

By measuring Ca2+ changes in the SR in voltage‐clamp conditions, we report that any interventions designed to alter the conformation of dihydropyridine receptors at rest induce an SR Ca2+ efflux.

These results show that dihydropyridine receptors maintain a strict control upon ryanodine receptors in resting skeletal mouse muscle fibres.

Abstract  Contraction of skeletal muscle is triggered by the release of Ca2+ from the sarcoplasmic reticulum (SR) in response to depolarization of the muscle membrane. Depolarization is known to elicit a conformational change of the dihydropyridine receptor (DHPR) in the tubular membrane that controls in a time‐ and voltage‐dependent manner the opening of the ryanodine receptor (RyR), the SR Ca2+ release channel. At rest, it is assumed that RyRs are kept in a closed state imposed by the repressive action of DHPRs; however, a direct control of the RyR gating by the DHPR has up to now never been demonstrated in resting adult muscle. In this study, we monitored slow changes in SR Ca2+ content using the Ca2+ indicator fluo‐5N loaded in the SR of voltage‐clamped mouse muscle fibres. We first show that external Ca2+ removal induced a reversible SR Ca2+ efflux at −80 mV and prevented SR Ca2+ refilling following depolarization‐evoked SR Ca2+ depletion. The dihydropyridine compound nifedipine induced similar effects. The rate of SR Ca2+ efflux was also shown to be controlled in a time‐ and voltage‐dependent manner within a membrane potential range more negative than −50 mV. Finally, intracellular addition of ryanodine produced an irreversible SR Ca2+ efflux and kept the SR in a highly depleted state following depolarization‐evoked SR Ca2+ depletion. The fact that resting SR Ca2+ efflux is modulated by conformational changes of DHPRs induced by external Ca2+, nifedipine and voltage demonstrates that DHPRs exert an active control on gating of RyRs in resting skeletal muscle.