bluuebunny/crossref_metadata_2025 huggingface dataset:
Degree and correlates of patient trust in their cardiologist
Authors: Kayaniyil Sheena , Gravely‐Witte Shannon , Stewart Donna E. , Higginson Lyall , Suskin Neville , Alter David , Grace Sherry L.
Published: June 2009

Rationale and objectives  Trust in one's doctor has been associated with increased treatment adherence, patient satisfaction and improved health status. This study investigated the level and correlates of patient trust in their cardiac specialist.

Methods  All 386 urban cardiologists in Southern Ontario (95 participating, response rate = 30%) were approached to recruit a sample of their coronary artery disease outpatients. A total of 1111 recent and consecutive patients consented to participate (approximately 13 patients per cardiologist, 317 female (26.7%); response rate = 60%), and clinical data were extracted from their medical charts. Participants completed a mailed survey including the Trust in Physicians scale, in addition to an assessment of socio‐demographic, clinical and psychosocial correlates.

Results  The mean trust score was equivalent to that reported in studies of primary care patients. Results of the significant multivariate model (F = 7.631, P < 0.001) revealed that less education (P < 0.001), higher systolic blood pressure (P = 0.022), less perceived cyclical/unpredictable illness timeline (P = 0.007) and greater perceived personal control over their heart condition (P = 0.004), were significant correlates of greater trust in cardiologist care.

Conclusions  The significance of education is corroborated by findings of lower satisfaction with cardiac care among those of higher socio‐economic status, despite having generally greater access to care in Ontario. Moreover, the relationship between hypertension and greater trust may suggest that such perceptions are not based on doctor competence. Future studies should further investigate the correlates of trust, as well as the impact of trust on cardiac health outcomes.
Clinical decision making and the provision of information in PEG feeding: an exploration of patients and their carers’ perceptions
Authors: Brotherton A. , Abbott J.
Published: June 2009

Background:  Government health care policy encourages a culture of patient choice and involvement in decision making, although the complexities and challenges involved in fully engaging patients in clinical decision making can be perceived as barriers to effective communication between the professional and patient. The present study aimed to explore the patients and their carers perceptions of the adequacy of the information provided and their subsequent involvement in the decision making process for percutaneous endoscopic gastrostomy (PEG) tube insertion.

Methods:  The study used purposive sampling. A cross‐sectional qualitative design was utilised using semi‐structured interviews, which were tape recorded. Sixteen patients and 27 carers were interviewed. The interviews were then transcribed verbatim and data analysis was undertaken using thematic analysis.

Results:  Only four patients and 11 carers reported having a choice in the decision for PEG placement, with only four patients and 10 carers, respectively, reporting they received sufficient information regarding the PEG. Poor communication, lack of information and inappropriate information, attitudes of health care professionals and exclusion were key themes for patients.

Conclusions:  Clinicians should develop interdisciplinary and participative practices to agree shared treatment goals and evaluate patient experiences. Consideration should also be given to the use of decision making models; in our opinion, the development of such a model, which supports interdisciplinary and participative approaches to decision making, is urgently required.
Mothers’ views on portion sizes for children
Authors: Croker H. , Sweetman C. , Cooke L.
Published: June 2009

Background:  Childhood obesity has increased steadily over recent years and has coincided with a general trend towards larger portions of foods consumed both inside and outside the home. A causal link between portion size and weight gain has not been established, although there is evidence of an association between larger portions and greater energy intake. The present study aimed to investigate parent’s attitudes, knowledge, practices, and concerns about appropriate portions for children.

Methods:  Four focus groups with a total of 14 volunteer mothers of 8–11‐year‐old children taking part in a larger school‐based study. Mothers were asked their views about portion sizes for their children and were asked to demonstrate typical servings that they would offer their children, by weighing five common foods provided. Conversations were tape‐recorded and transcribed for thematic analysis.

Results:  Participants were unconcerned about portion sizes and would not welcome official guidance, particularly if it involved weighing foods. Mothers fed their children the amount that they believed they would eat and felt that this varied across children and across occasions. The weighing task revealed a wide variation in portion sizes served to children, with portions of the more energy‐dense foods being smaller on average than those of less energy‐dense foods.

Conclusions:  There was little understanding of age‐appropriate serving sizes amongst mothers in this study. Education campaigns should be mindful of the need to make portion information clear and simple because parents may not be prepared to weigh the food that they serve to their children.
The effect of substituting alternative grains in the diet on the nutritional profile of the gluten‐free diet
Authors: Lee A. R. , Ng D. L. , Dave E. , Ciaccio E. J. , Green P. H. R.
Published: June 2009

Background:  The only treatment for coeliac disease is lifelong adherence to a gluten‐free diet. Several studies have reported nutritional deficiencies in individuals on a gluten‐free diet. The present study aimed to determine whether the nutritional profile of gluten‐free diet could be improved through the use of alternative grains.

Methods:  A retrospective review of diet history records by a celiac specialist dietitian were used to establish a ‘standard’ gluten‐free dietary pattern. An ‘alternative’ gluten‐free dietary pattern was developed that substituted naturally gluten‐free grains or gluten‐free products made from ‘alternative’ flours (oats, high fibre gluten‐free bread and quinoa) in the standard pattern. A paired t‐test was performed to identify statistical significance between the ‘alternative’ and standard gluten‐free dietary pattern.

Results:  Analysis of standard pattern indicated that 38% of meals and snacks contained no grain or starch choice. Of those meals that contained a grain or starch component, rice was the grain chosen 44% of the time. The inclusion of alternative grains or grain products provided a higher nutrient profile compared to the standard gluten‐free dietary pattern (P = 0.002). Several nutrients; protein (20.6 g versus 11 g), iron (18.4 mg versus 1.4 mg), calcium (182 mg versus 0 mg) and fibre (12.7 g versus 5 g) were significantly increased by changing the grain or starch component in the dietary pattern. The B vitamin content (riboflavin, niacin and folate) was improved, although this was not statistically significant (P = 0.125).

Discussion:  The inclusion of alternative grain‐based products increased the nutrient profile of the gluten‐free dietary pattern significantly.
Bulk leaf δ18O and δ13C reflect the intensity of intraspecific competition for water in a semi‐arid tussock grassland
Authors: RAMÍREZ DAVID A. , QUEREJETA JOSÉ I. , BELLOT JUAN
Published: June 2009

We investigated the extent to which plant water and nutrient status are affected by intraspecific competition intensity and microsite quality in a monodominant tussock grassland. Leaf gas exchange and stable isotope measurements were used to assess the water relations of Stipa tenacissima tussocks growing along a gradient of plant cover and soil depth in a semi‐arid catchment of Southeast Spain. Stomatal conductance and photosynthetic rate decreased with increasing intensity of competition during the wet growing season, leading to foliar δ18O and δ13C enrichment. A high potential for runoff interception by upslope neighbours exerted strong detrimental effects on the water and phosphorus status of downslope S. tenacissima tussocks. Foliar δ15N values became more enriched with increasing soil depth. Multiple stepwise regression showed that competition potential and/or rhizosphere soil depth accounted for large proportions of variance in foliar δ13C, δ18O and δ15N among target tussocks (57, 37 and 64%, respectively). The results presented here highlight the key role that spatial redistribution of resources (water and nutrients) by runoff plays in semi‐arid ecosystems. It is concluded that combined measurement of δ13C, δ18O and nutrient concentrations in bulk leaf tissue can provide insight into the intensity of competitive interactions occurring in natural plant communities.
Metabolomic and physiological responses reveal multi‐phasic acclimation of Arabidopsis thaliana to chronic UV radiation
Authors: LAKE JANICE A. , FIELD KATIE J. , DAVEY MATTHEW P. , BEERLING DAVID J. , LOMAX BARRY H.
Published: June 2009

Biochemical changes in vivo and pathway interactions were investigated using integrated physiological and metabolic responses of Arabidopsis thaliana L. to ultraviolet (UV) radiation (280–400 nm) at 9.96 kJ m−2 d−1 over the entire life cycle from seed to seed (8 weeks). Columbia‐0 (Col‐0) and a UV‐B sensitive accession (fah‐1) showed significant (P < 0.001) reductions in leaf growth after 6 weeks. Col‐0 recovered growth after 8 weeks, with recovery corresponding to a switch from production of phenylpropanoids to flavonoids. fah‐1 failed to recover, indicating that sinapate production is an essential component of recovery. Epidermal features show that UV radiation caused significant (P < 0.001) increases in trichome density, which may act as a structural defence response. Stomatal indices showed a significant (P < 0.0001) reduction in Col‐0 and a significant (P < 0.001) increase in fah‐1. Epidermal cell density was significantly increased under UV radiation on the abaxial leaf surface, suggesting that that a fully functioning phenylpropanoid pathway is a requirement for cell expansion and leaf development. Despite wild‐type acclimation, the costs of adaptation lead to reduced plant fitness by decreasing flower numbers and total seed biomass. A multi‐phasic acclimation to UV radiation and the induction of specific metabolites link stress‐induced biochemical responses to enhanced acclimation.
OsMADS50andOsMADS56function antagonistically in regulating long day (LD)‐dependent flowering in rice
Authors: RYU CHOONG‐HWAN , LEE SHINYOUNG , CHO LAE‐HYEON , KIM SONG LIM , LEE YANG‐SEOK , CHOI SANG CHUL , JEONG HEE JOONG , YI JAKYUNG , PARK SOON JU , HAN CHANG‐DEOK , AN GYNHEUNG
Published: June 2009

In much of the tropics and subtropics, rice (Oryza sativaL.) is grown under long days (LDs). Therefore, LD must play a major role in inducing flowering signal in rice. However, little is known on LD‐dependent flowering signal in the species. We previously reported thatOsMADS50, which is highly homologous toArabidopsis SOC1, functions as a positive regulator for flowering. However, its detailed photoperiodic mechanism was not yet elucidated. Here, we report the functional analysis ofOsMADS50and its closely related geneOsMADS56. Knock‐out ofOsMADS50caused a late‐flowering phenotype only under LD conditions. Overexpression ofOsMADS56(56OX) also resulted in delayed flowering under LD. In theosmads50mutants and 56OX transgenic plants, transcripts ofEhd1,Hd3aandRFT1were reduced, although that ofOsLFL1increased. On the other hand, mRNA levels ofOsGI,Hd1,OsId1,OsDof12,Ghd7,Hd6andSE5were unchanged. These observations imply thatOsMADS50andOsMADS56function antagonistically throughOsLFL1‐Ehd1in regulating LD‐dependent flowering. Yeast two‐hybrid and co‐immunoprecipitation analyses indicated an interaction between those two proteins as well as their formation of homodimers. These results suggest that OsMADS50 and OsMADS56 may form a complex that regulates downstream target genes.
Root based approaches to improving nitrogen use efficiency in plants
Authors: GARNETT TREVOR , CONN VANESSA , KAISER BRENT N.
Published: June 2009

In the majority of agricultural growing regions, crop production is highly dependent on the supply of exogenous nitrogen (N) fertilizers. Traditionally, this dependency and the use of N‐fertilizers to restore N depleted soils has been rewarded with increased plant health and yields. In recent years, increased competition for non‐renewable fossil fuel reserves has directly elevated prices of N‐fertilizers and the cost of agricultural production worldwide. Furthermore, N‐fertilizer based pollution is becoming a serious issue for many regions where agriculture is highly concentrated. To help minimize the N footprint associated with agricultural production there is significant interest at the plant level to develop technologies which can allow economically viable production while using less applied N. To complement recent reviews examining N utilization efficiency in agricultural plants, this review will explore those strategies operating specifically at the root level, which may directly contribute to improved N use efficiencies in agricultural crops such as cereals, where the majority of N‐fertilizers are used and lost to the environment. Root specific phenotypes that will be addressed in the context of improvements to N acquisition and assimilation efficiencies include: root morphology; root to shoot ratios; root vigour, root length density; and root N transport and metabolism.
Putting child mortality on a map: towards an understanding of inequity in health
Authors: Tottrup C. , Tersbol B. P. , Lindeboom W. , Meyrowitsch D.
Published: June 2009

Objectives  To map and analyse geographical (spatial) variations of child mortality trends in mainland Tanzania.

Methods  We used a geographic information system to integrate data on child mortality and associated risk factors. We then applied spatial statistics to quantify the spatial component of child mortality trends, and employed multivariate analysis to break mortality down into a spatial and a local component.

Results  The results support our hypothesis that child mortality trends have a spatial component that can be attributed to broad‐scale environmental and social‐economic factors. However, the multivariate analysis showed that the spatial component only explained one‐third of the variation in child mortality trends. The results thus point towards the presence of local (non‐spatial) causative factors, including variations in the access to and quality of child health care.

Conclusions  The method we used is a cost‐effective way to systematically assess geographical variations in health outcomes. It can thus provide researchers and practitioners with a good first‐line tool in understanding local contributions to differences in mortality and other indicators, and give authorities at all levels a better foundation for addressing health inequities.
CLINICAL STUDY: A comparison of exposure to carcinogens among roll‐your‐own and factory‐made cigarette smokers
Authors: Shahab Lion , West Robert , McNeill Ann
Published: June 2009

Consumption of roll‐your‐own (RYO) tobacco is rising, but little is known about its in vivo delivery of toxins relative to factory‐made (FM) cigarettes. To start to address this issue, this study compared the concentrations of metabolites of recognized human carcinogens in smokers of RYO tobacco and FM cigarettes. We opportunistically recruited 127 FM and 28 RYO cigarette smokers in central London and collected saliva and urine samples. Saliva samples were assayed for cotinine while urinary samples were assayed for 1‐hydroxypyrene (1‐HOP) and total 4‐(methylnitrosamino)‐1‐(3‐pyridyl)‐1‐butanol (NNAL), metabolic markers of polycyclic aromatic hydrocarbons and tobacco‐specific N‐nitrosamines, respectively. Data on socio‐demographic, anthropometric and puffing characteristics were also obtained. Both unadjusted and adjusted analyses (controlling for age, sex, body mass index, puff flow, puff duration and cotinine) showed no difference in metabolic markers between RYO and FM cigarette smokers. However, significant main effects for cotinine levels and sex were observed in adjusted analyses. Greater levels of cotinine were associated with a greater concentration of both 1‐HOP (B = 0.002, P = 0.037) and NNAL (B = 0.002, P < 0.001). In addition, women had significantly greater concentrations of urinary 1‐HOP (B = 0.679, P = 0.004) and total NNAL metabolites (B = 0.117, P = 0.024) than men, irrespective of the type of cigarettes smoked. More research is now needed to confirm these findings and gender‐specific effects in a larger, representative sample. However, results do not support the common belief that RYO cigarettes are less harmful than manufactured cigarettes.
CLINICAL STUDY: Predicting the effect of naltrexone and acamprosate in alcohol‐dependent patients using genetic indicators
Authors: Ooteman Wendy , Naassila Mickaël , Koeter Maarten W. J. , Verheul Roel , Schippers Gerard M. , Houchi Hakim , Daoust Martine , Van Den Brink Wim
Published: June 2009

Acamprosate and naltrexone are effective medications in the treatment of alcoholism. However, effect sizes are modest. Pharmacogenomics may improve patient‐treatment‐matching and effect sizes. It is hypothesized that naltrexone exerts its effect through genetic characteristics associated with the dopaminergic/opioidergic positive reinforcement system, whereas acamprosate works through the glutamatergic/GABAergic negative reinforcement system. Alcohol‐dependent subjects were randomly assigned to either acamprosate or naltrexone. Subjects participated in a cue‐exposure experiment at the day before and at the last day of medication. Reductions in cue‐induced craving and physiological cue reactivity were measured. Differential effects of naltrexone and acamprosate on these outcomes were tested for different polymorphisms of the opioid, dopamine, glutamate and GABA‐receptors. Significant matching effects were found for polymorphisms at the DRD2, GABRA6 and GABRB2 gene. In addition, a trend was found for the OPRM1 polymorphism. This provides evidence for the matching potential of genotypes. It is expected that more effective treatments can be offered when genetic information is used in patient‐treatment‐matching.
PRECLINICAL STUDY: Circadian regulation of central ethanol sensitivity by themPer2gene
Authors: Perreau‐Lenz Stéphanie , Zghoul Tarek , De Fonseca Fernando R. , Spanagel Rainer , Bilbao Ainhoa
Published: June 2009

The effect of alcohol is known to vary with the time of the day. Although initially it was suggested that this phenomenon may be due to diurnal differences in ethanol metabolism, more recent studies were contradicting. In the present study, we therefore first set out in assessing the diurnal variations in ethanol sensitivity in mice analysing, concurrently, ethanol elimination rates. Ethanol‐induced (3.5 g/kg; intraperitoneal) loss of righting reflex (LORR) duration was thus determined at several Zeitgeber time (ZT) points (ZT5, 11, 17 and 23) in C57BL/6N mice. In parallel, the corresponding ethanol elimination rates were also assessed. The results display the existence of a distinct diurnal rhythm in LORR duration peaking at ZT11, whereas no differences could be observed regarding the elimination rates of alcohol. Successively, we checked the involvement of the clock genesmPer1andmPer2in conveying this rhythm in sensitivity, testing LORR and hypothermia at the peak and trough previously observed (ZT5 and ZT11).Per1Brdm1mice demonstrate a similar diurnal pattern as control mice, with enhanced LORR durations at ZT11. In contrast,Per2Brdm1mice did not exhibit a temporal variation to the depressant effects of ethanol with respect to LORR, revealing a constant high sensitivity to ethanol. The present study reveals a central role of themPer2gene in inhibiting alcohol sensitivity at the beginning of the inactive phase.
Identification of a novel HLA‐DRB1*12 allele, DRB1*1218, in Chinese population
Authors: Gao S.‐Q. , Deng Z.‐H. , Xu Y.‐P.
Published: June 2009

Here, we report the identification of a novel human leukocyte antigen‐DRB1*12 variant, DRB1*1218 allele, in a Chinese Han individual. The novel DRB1*12 variant allele differed from the closest allele DRB1*120201 by nucleotide 262 G>C (codon 59 GAG>CAG) missense mutation in exon 2, which resulted in an amino acid substitution of Glu>Gln.
Fatal hemorrhage in two renal graft recipients with multi‐drug resistant Pseudomonas aeruginosa infection
Authors: Orlando G. , Di Cocco P. , Gravante G. , D'Angelo M. , Famulari A. , Pisani F.
Published: June 2009

Abstract: Pseudomonas aeruginosa (PA) infections occurring after renal transplantation (RT) represent a potentially life‐threatening complication. We present 2 cases of early death following RT in which PA was transmitted, possibly from the donor to the recipients, despite preoperative cultures that were negative. The donor had developed PA‐related bilateral pneumonia while in the intensive care unit. However, after appropriate antibiotic therapy, no signs of infection were present at the time of organ retrieval and cultures were negative. Both recipients received a renal graft from the same donor and developed multi‐drug resistant (MDR)‐PA infections with bacterial phenotypes and resistances similar to the donor. The first recipient died 9 days after RT from rupture of a false aneurysm of the external iliac artery, caused by a fully thickened PA‐related arteritis. The second recipient died postoperatively on day 10 after rupture of an aneurysm in the right vertebral artery. Our experience shows that MDR‐PA infection early after RT may be a catastrophic event. Specific anti‐PA antibiotic therapy in RT patients during the perioperative period is recommended in the case of PA infection in the donor, even after apparent successful therapy with negative cultures.
Effects of dexmedetomidine or methylprednisolone on inflammatory responses in spinal cord injury
Authors: CAN M. , GUL S. , BEKTAS S. , HANCI V. , ACIKGOZ S.
Published: June 2009

Background: The aim of this study was to compare the anti‐inflammatory response of methylprednisolone and the α2‐agonist dexmedetomidine in spinal cord injury (SCI).

Methods: Twenty‐four male adult Wistar albino rats, weight 200–250 g, were included in the study. The rats were divided into four groups as follows: the control group (n: 6) received only laminectomy; the SCI group (n: 6) with trauma alone; the SCI+methylprednisolone group (n: 6) with trauma and 30 mg/kg methylprednisolone, followed by a maintenance dose of 5.4 mg/kg/h; and the SCI+dexmedetomidine group (n: 6) with trauma and 10 μg/kg dexmedetomidine treatment intraperitoneally. Twenty‐four hours after the trauma, spinal cord samples were taken for histopathological examination and serum samples were collected for interleukin‐6 (IL‐6) and tumor necrosis factor (TNF)‐α measurement.

Results: TNF‐α (P=0.009) and IL‐6 (P=0.009) levels were significantly increased in the SCI group. TNF‐α and IL‐6 levels were significantly decreased with methylprednisolone (P=0.002, 0.002) and dexmedetomidine (P=0.002, 0.009) treatment, respectively. Methylprednisolone and dexmedetomidine treatment reduced neutrophils' infiltration in SCI.

Conclusions: The current study does not clarify the definitive mechanism by which dexmedetomidine decreases inflammatory cytokines but it is the first study to report the anti‐inflammatory effect of dexmedetomidine in SCI. Further studies are required to elucidate the effects of dexmedetomidine on the inflammatory response.
Intravenous magnesium sulfate for post‐operative pain in patients undergoing lower limb orthopedic surgery
Authors: DABBAGH A. , ELYASI H. , RAZAVI S. S. , FATHI M. , RAJAEI S.
Published: June 2009

Introduction: This study looks at the effect of supplementary intravenous magnesium sulfate on acute pain when administered in patients undergoing lower limb orthopedic surgery using spinal anesthesia with bupivacaine.

Method and materials: In this double‐blind, randomized, placebo‐controlled clinical trial, 60 patients were selected and randomly divided into two groups. Efforts were made to place both groups under the same method of anesthesia. One group received 8 mg/kg intravenous magnesium sulfate, started before the incision and continued up to the end of the surgical procedure, using a 50 ml syringe, via a peripheral large bore catheter; the second group received the same volume of placebos using the same method. To present the results, mean (± SD) was used; a P value of <0.05 was considered significant.

Results: There was no difference between the two groups in terms of the basic variables. Pain reported by the first group that received magnesium sulfate was significantly less at the first, third, sixth and 12th hours after the operation in comparison with the group that received placebo. Also, the intravenous morphine requirements in the first 24 h after the surgery were less in the magnesium group (4.2 ± 1.6 mg) than in the control group (9.8 ± 2.1 mg).

Conclusion: Intravenous magnesium sulfate can serve as a supplementary analgesic therapy to suppress the acute post‐operative pain, leading to less morphine requirements in the first 24 h.
A database of vertebrate longevity records and their relation to other life‐history traits
Authors: DE MAGALHÃES J. P. , COSTA J.
Published: June 2009

Longevity is a major characteristic of animals that has long fascinated scientists. In this work, we present a comprehensive database of animal longevity records and related life‐history traits entitled AnAge, which we compiled and manually curated from an extensive literature. AnAge started as a collection of longevity records, but has since been expanded to include quantitative data for numerous other life‐history traits, including body masses at different developmental stages, reproductive data such as age at sexual maturity and measurements of reproductive output, and physiological traits related to metabolism. AnAge features over 4000 vertebrate species and is a central resource for applying the comparative method to studies of longevity and life‐history evolution across the tree of life. Moreover, by providing a reference value for longevity and other life‐history traits, AnAge can prove valuable to a broad range of biologists working in evolutionary biology, ecology, zoology, physiology and conservation biology. AnAge is freely available online (http://genomics.senescence.info/species/).
Phenotypic plasticity of desiccation resistance inGlossinapuparia: are there ecotype constraints on acclimation responses?
Authors: TERBLANCHE J. S. , KLEYNHANS E.
Published: June 2009

Phenotypic plasticity allows organisms to cope with environmental variation and may aid in the evolution of novel traits. However, whether phenotypic plasticity is beneficial, or if acclimation responses might be constrained to particular ecotypes is generally poorly explored. Here we test the beneficial acclimation hypothesis (BAH) and its alternatives for desiccation resistance to atmospheric moisture in mesic‐ and xeric‐adaptedGlossinaspecies. Highly significant interactions among acclimation and test humidity were detected for water loss rates indicative of significant phenotypic plasticity. Ordered‐factoranovawas unable to reject predictions of the ‘drier is better’ acclimation hypothesis in xericGlossina morsitansand mesicG. austeni. Evidence for the ‘deleterious acclimation hypothesis’ was found for mesicG. palpalisas expected from the moist habitats it typically occupies. By contrast, support for the ‘optimal acclimation hypothesis’ was found in xericG. pallidipes. Little support for BAH was obtained in the present study, although other hypotheses, which might enhance fitness within the environments these species are typically exposed to, were supported. However, acclimation responses were not necessarily constrained to xeric/mesic ecotypes which might be expected if adaptation to a particular environment arose as a trade‐off between plastic responses and living in a particular habitat. These results highlight the complexity of acclimation responses and suggest an important role for phenotypic plasticity in moderating environmental effects on evolutionary fitness inGlossina.
Effect of acute citrate load on markers of bone metabolism in healthy volunteers
Authors: Chen Y. , Bieglmayer C. , Höcker P. , Dettke M.
Published: June 2009

Background and objectives  This study aims to investigate the possible effects of acute citrate administration on bone metabolism in healthy men.

Materials and methods  A placebo‐controlled, crossover trial was conducted on 10 male volunteers. The volunteers received either a standardized infusion of citrate at 1·5 mg/kg body weight/min or the equal volume of placebo, separated by a washout period of 14 days. Serial blood and urine samples were collected and analysed for bone biochemical markers and electrolytes.

Results  Infusion of citrate resulted in increased serum levels of the bone formation marker osteocalcin (OC) and bone resorption marker C‐telopeptide of type 1 collagen (CTX). Increases in CTX and OC were positively correlated to the surge in the serum concentration of intact parathyroid hormone (iPTH) but only OC showed correlation to changes in ionized calcium. Citrate infusion showed no effect on serum concentrations of bone alkaline phosphatase, osteoprotegerin, and bone tartrate‐resistant acid phosphatase 5b, or the expression of receptor activator of nuclear factor kappa B ligand. Variations in OC and CTX were short‐term as both bone markers gradually declined within 90 min following citrate exposure.

Conclusion  Acute citrate load resulted in profound alterations of the bone markers OC and CTX. The short‐term increase of CTX suggests a temporary shift to a higher bone turnover rate, although the clinical consequence of the observed changes in bone markers remains open.
Ultrastructure of the Spermatozoa of the Yangtze Finless Porpoise (Neophocaena phocaenoides asiaeorientalis)
Authors: Li H. Y. , Zhang X. F. , Wang D. , Chen D. Q.
Published: June 2009

Semen sample was collected from two captive adult Yangtze finless porpoises (Neophocaena phocaenoides asiaeorientalis) during physical examination. One individual was aged about 9 years with body length 143 cm (total length) and body weight 46.1 kg in 2003. The age of the other was unknown and its body length was 147 cm and body weight was 43 kg in 2004. Ultrastructure of their spermatozoa was examined using scanning and transmission electron microscope. The sperm concentration was 4.17 × 109spermatozoa per ml by the cytometer. The approximate dimensions of the spermatozoa were as follows: head length, 3.366 ± 0.140 μm (mean ± SE,n = 15); head width, 1.896 ± 0.099 μm (n = 15); and neck length, 1.004 ± 0.074 μm (n = 10). The tail included midpiece, principal piece and terminal piece. The length of the midpiece was 1.882 ± 0.077 μm (n = 9). There is no apparent boundary between the principal piece and the terminal piece, so the length of the principal piece and the terminal piece was 44.612 ± 3.485 μm (n = 5). Total length of the spermatozoa was 53.314 ± 4.580 μm (n = 10). The acrosome covered approximately 45.8% of the anterior portion of the head.
Assessment of DNA Damage during In Vitro Development of Buffalo (Bubalus bubalis) Embryos: Effect of Cysteamine
Authors: Mukherjee A , Kumar D , Singh KP , Chauhan MS , Singla SK , Palta P , Manik RS
Published: June 2009

Contents

Comet assay was used in the present study to examine DNA damage to buffalo oocytes and embryos during in vitro culture. Embryos were produced in vitro from oocytes obtained from slaughterhouse ovaries in presence of cysteamine (IVM and IVC media supplemented with 50 and 100 μm, respectively) or in its absence (controls). Compared to controls, cysteamine supplementation increased (p < 0.01) cleavage rate and proportion of oocytes that developed to 8‐ to 16‐cell stage. The incidence of DNA damage was lower (p < 0.01) in cysteamine group than that in controls at 8‐ to 16‐ (19.3 ± 4.24 vs 72.0 ± 5.22%) but not in 2‐cell stage embryos (11.7 ±  5.63 vs 20.8 ± 5.49%) or in mature oocytes (5.3 ± 3.43 vs 10.3 ± 4.73%). The tail length, which indicates magnitude of DNA damage, was shorter (p < 0.01) in cysteamine group than in controls in mature oocytes (25.5 ± 0.5 vs 36.0 ± 0.71 pixels) and 8‐ to 16‐cell stage (49.2 ± 1.64 vs 152.7 ± 1.28 pixels) but not in 2‐cell stage embryos (36.3 ± 1.54 vs 36.4 ± 0.75 pixels). Also, exposure of oocytes/embryos to UV radiation or H2O2 caused extensive DNA damage. In conclusion, these results suggest that oocytes/embryos suffer from DNA damage during progress of in vitro culture, which can be partly ameliorated by cysteamine supplementation of culture media.
Health promotion: Facilitators and barriers perceived by district nurses
Authors: Wilhelmsson Susan , Lindberg Malou
Published: June 2009

Purpose: To investigate district nurses' (DN) opinions regarding facilitators and barriers in their work with health promotion.

Methods: Qualitative descriptive study. Interviews with a purposeful sampling of 54 DNs. Data were analysed with content analysis.

Results: The DNs expressed that nursing was the right profession to work with health promotion, and that it was an important task that was done by no one else. They experienced being stuck between disease‐oriented and health promotion work and that priorities were wrong. The focus was not on health promotion and the time DNs could spend with health promotion was limited, and instead they had to perform elementary medical tasks.

Conclusions: Tasks of a medical nature are given priority over health promotion. DNs lack support and no one asked or cared about the results from health promotion activities.
Building social capital with women in a socially disadvantaged community
Authors: Griffiths Rhonda , Horsfall Jan , Moore Margo , Lane Di , Kroon Veronica , Langdon Rachel
Published: June 2009

Individual and community health outcomes are strengthened by friendships and social support networks. Community interventions aimed at improving the social factors that influence the health of individuals and communities increasingly include strategies to develop resilience through building networks and social capital. The study reported here used a cross‐sectional survey design, administered at two time points, to measure the effect of a community capacity‐building programme implemented by Women's Health Nurses. Data described and where possible measured women's perceptions of their physical and mental well‐being, friendships and support networks, community connectedness and participation, safety, and knowledge of and access to local community services. The follow‐up survey also measured the impact of specific community development initiatives. Overall, findings of both surveys were consistent, with some notable exceptions. For example, at follow up there was a significant improvement in mental health indicators and fewer women believed their physical or emotional problems imposed a considerable burden on their daily activities. They also believed people from other cultures were more likely to be accepted by neighbours and reported increased involvement in community activities as a direct result of the Villawood Icebreakers Project.
Effects of coping styles and stressful life events on depression and anxiety in Japanese nursing students: A longitudinal study
Authors: Shikai Noriko , Shono Masahiro , Kitamura Toshinori
Published: June 2009

Nursing students face stressful situations during a clinical training. This two‐wave (between June and December 2004) study explored the relationship between the coping styles and stressful life events in terms of the occurrence of depression and anxiety among 97 Japanese female nursing students before (Time 1) and after (Time 2) a clinical training. In a structural equation modelling, Time 2 depression was significantly predicted by Time 1 depression and stressful life events whereas Time 2 anxiety was predicted by Time 1 anxiety, stressful life events and emotion‐oriented coping. Moreover, Time 1 depression predicted the impact of stressful life events and Time 1 anxiety predicted emotion‐oriented coping.
Paraffin (kerosene)* poisoning in under‐five children: A problem of developing countries
Authors: Tshiamo Wananani
Published: June 2009

Although developed countries have largely eliminated the problem of paraffin ingestion in young children, many developing countries have not. Paraffin, used as a home energy source, particularly in rural area, accounts for a significant percent of paediatric poisoning and can lead to serious health problems, complications and death.

This paper presents a review done by a nurse clinician concerned about the number of paediatric poisonings she saw in the hospital in one developing country, Botswana. The first stage of solving the problem is presented in which she established the extent and epidemiology of the issue. Suggestions for its solution are also discussed. It is hoped that this can serve both to increase awareness in developing countries of the dangers of paraffin poisoning and serve as a model for nurse clinicians and researchers in developing countries.
Conventional nutritional counselling maintains nutritional status of patients on continuous ambulatory peritoneal dialysis in spite of systemic inflammation and decrease of residual renal function
Authors: MARTÍN‐DEL‐CAMPO FABIOLA , GONZÁLEZ‐ESPINOZA LILIANA , ROJAS‐CAMPOS ENRIQUE , RUIZ NORMA , GONZÁLEZ JUANA , PAZARÍN LEONARDO , CUETO‐MANZANO ALFONSO M
Published: June 2009

Aim:  To evaluate the effect of nutritional counselling on nutritional status in peritoneal dialysis patients.

Methods:  Twenty‐nine peritoneal dialysis patients were randomly selected to receive conventional nutritional counselling during 6 months of follow up. All patients had monthly clinical and biochemical evaluations, and assessments of dialysis adequacy, inflammation and nutritional status at 0, 3 and 6 months.

Results:  Moderate‐severe malnutrition decreased 28% whereas normal nutrition increased 23% at final evaluation (non‐significant). Calorie and protein intake remained stable throughout the study (baseline vs final, calorie: 24 ± 8 vs 23 ± 5 Kcal/kg; protein: 1.1 ± 0.5 vs 1.0 ± 0.3 g/Kg, respectively). On the other hand, triceps (16 ± 6 vs 18 ± 8 mm) and subscapular (17 ± 8 vs 20 ± 5 mm) skinfold thicknesses, and mid‐arm circumference (27 ± 3 vs 28 ± 3 mm) significantly increased; mid‐arm muscle area displayed a non‐significant trend to increase (30 ± 9 vs 31 ± 9 cm2) whereas serum albumin significantly increased at the end of study (2.67 ± 0.46 vs 2.94 ±  0.48 g/dL). At final evaluation, median renal creatinine clearance decreased (6.3 (0.8–15.3) vs 2.0 (0.1–6.3) L/week per 1.73 m2) whereas interleukin‐6 increased (2.33 (1.9–7.0) vs 4.02 (2.1–8.4) pg/mL).

Conclusion:  Even though conventional nutritional counselling, as an isolated measure, did not significantly improve all nutritional parameters, it prevented a greater deterioration during 6 months. Nutritional counselling maintained the nutritional status in spite of a decrease in residual renal function and higher systemic inflammation.
Changes in prostate volume in Japanese patients with benign prostatic hyperplasia: Association with other urological measures and risk of surgical intervention
Authors: Tsukamoto Taiji , Masumori Naoya , Nakagawa Haruo , Arai Yoichi , Komiya Akira , Ichikawa Tomohiko , Takei Mineo , Yamaguchi Akito , Liu Ying , Crane Martin M
Published: June 2009

Objectives:  To evaluate changes in prostate volume (PV) and its association with selected urological measures and risk of surgical intervention in Japanese men with benign prostatic hyperplasia (BPH).

Methods:  The medical records of all consecutive urologist‐diagnosed BPH patients of ≥40 years old who attended any of four urology clinics in Japan during January 2004–June 2006 were reviewed. Both cross‐sectional and longitudinal data were captured to analyze baseline correlations among urological measures, to evaluate the longitudinal changes in PV and selected urological measures, and to examine the predictors of surgical intervention.

Results:  The follow‐up period was 2.8 years. Mean PV and mean prostate‐specific antigen (PSA) of 1331 eligible patients were 34.0 mL and 4.0 ng/mL, respectively. Both measures increased directly with age. Baseline PV correlated with residual urine volume (r = 0.18, P < 0.05) and PSA (r = 0.41, P < 0.001). Among 319 patients who had more than one PV measurement, PV increased in 51% of patients, remained the same in 28% and decreased in 21%. Use of α‐blockers at baseline and during follow up was not associated with PV change. Patients who had a PV ≥30 mL, a severe International Prostate Symptom Score and a PSA level ≥1.5 ng/mL at baseline, were more likely to have surgical intervention during the follow‐up period.

Conclusions:  Predictors generated in this study may help to identify a subset of BPH patients at high risk of surgical intervention.
RNA interference targeting of sphingomyelin phosphodiesterase 1 protects human granulosa cells from apoptosis
Authors: Gao Jun , Zhang Ren‐Li , Zhou Can‐Quan , Ma Yun , Zhuang Guang‐Lun
Published: June 2009

Aim:  Sphingomyelin phosphodiesterase 1 (SMPD1) plays an essential role in initiating the female germ cell death signal. To evaluate whether RNA interference has potential as a new approach in germ cell protection, we tested the effect of SMPD1 knockdown on human granulosa cells in vitro.

Methods:  We designed and synthesized three small interference RNA (siRNA) sequences targeted on SMPD1 and transfected them into human luteinizing granulosa cells (hGC) in vitro. Forty‐eight hours after transfecting with siRNAs, hGC were treated with mitomycin C (MMC) to induce apoptosis. mRNA was detected with quantitative RT‐PCR and protein was detected with Western blot. Methyl thiazolyl tetrazolium (MTT) assay was used to measure cell survival rate and detection of apoptotic rate of cells with Annexin V‐PI staining by flow cytometer (FCM). Study groups were compared with liposome (lipofectamine 2000), MMC control and negative control siRNA.

Results:  After treatment with siRNA targeted to SMPD1, significant SMPD1 suppression occurred. After knockdown expression of SMPD1, the survival rate of hGC increased from 32.3% to 40.3%, and the apoptosis rate decreased from 68.3% to 44%.

Conclusion:  siRNA targeted on SMPD1 can protect hGC cells from apoptosis. These results reveal SMPD1 as a significant and effective target site for RNAi in the protection of human germ cells, which may have a direct bearing on future therapeutic research.
External aortic compression device: The first aid for postpartum hemorrhage control
Authors: Soltan Mohamed Hashem , Faragallah Medhat Farag , Mosabah Mohamed Hany , Al‐adawy Ahemd Reda
Published: June 2009

Aim:  To evaluate the external aortic compression device (EACD) as a first aid to control postpartum hemorrhage (PPH).

Methods:  Three hundred women whose deliveries were complicated with PPH were recruited into a quasi‐randomization study. Groups comprised 120 women each who had atonic PPH. The EACD was used together with traditional management in study women, while traditional management alone was used in control women. Outcome measures were maternal mortality, morbidity (hysterectomy), amount of blood transfusion (BT), uterotonic drugs and time to stop bleeding. Side effects of the EACD were assessed. Atonic PPH was defined as a blood loss of ≥500 mL from an atonic uterus with circulatory compromise within 24 hrs of childbirth. Controls were treated with i.v. access, nasal oxygen, fresh BT, uterine massage, El‐Menia air inflated balloon and uterotonic drugs. Study women were treated using EACD together with conventional management.

Results:  Time to stop bleeding was significantly shorter (36.8 ± 23.4 vs 118.6 ± 36.8 min) in study women than in control women (P < 0.001); 87.5% of study women, but no single woman in the control group had their bleeding stopped within the first 45 min of PPH onset. No morbidities or mortality among those who received EACD compared with control women, among who had five surgical hysterectomies and one mortality. The amount of BT units (302 vs 200), ergometrine ampoules (3.6 ± 0.5 vs 2.5 ± 0.8), syntocinon units (30.6 ± 0.5 vs 20.5 ± 0.8) and misoprostol tablets (6.7 ± 1.8 vs 3.8 ± 0.7) received were significantly more in the control group than in the study group (P < 0.001). Adverse effects of EACD were rarely observed.

Conclusion:  EACD is a cost‐effective and easily applied maneuver that allows satisfactory management of PPH without maternal mortality or morbidity. It is of value in developing countries.
Risk factors for emergency cesarean delivery of the second twin after vaginal delivery of the first twin
Authors: Suzuki Shunji
Published: June 2009

Aim:  A case‐control study of twins was performed to identify clinical predictions of emergency cesarean delivery in the second‐born twin after vaginal delivery of the first twin.

Methods:  The obstetric records were reviewed of all twin vaginal deliveries at the Japanese Red Cross Katsushika Maternity Hospital from 2002 through 2007.

Results:  There were 206 vaginal deliveries of first twins at ≥33 weeks of gestation. Of these deliveries, nine women (4.4%) underwent an emergency cesarean for the delivery of the second twin. The incidence of cesarean delivery for the second twin was significantly greater in cases with a history of infertility therapy (odds ratio: 5.0, 95% confidence intervals: 1.2–22), gestational age at ≥39 weeks (24, 4.7–120), nonvertex presentation (6.2, 1.5–26), operative delivery of the first twin (6.1, 1.5–24) and intertwin delivery time interval >30 min (7.2, 1.7–30).

Conclusion:  The most important risk factor of emergency cesarean delivery in the second twin was a gestational age of ≥39 weeks.
Prenatal diagnosis of long QT syndrome by non‐invasive fetal electrocardiography
Authors: Fujimoto Yoshinobu , Matsumoto Tadashi , Honda Nobuhisa , Tojo Ryuichiro , Furuya Masataka , Kasai Kenji , Saito Suguru , Mochimaru Fumio , Ishikawa Yasuhiro
Published: June 2009

Long QT syndrome is a high‐risk condition associated with arrhythmia due to its sudden cause of death. Prenatal diagnosis of long QT syndrome, however, is impossible using the fetal echocardiogram. Here we present the first reported case of long QT syndrome in which a prenatal diagnosis was made using non‐invasive fetal electrocardiogram. We consider that the non‐invasive fetal electrocardiogram may be a good method for diagnosing fetal QT prolongation.
Comparison of markers for fetal inflammatory response syndrome: Fetal blood interleukin‐6 and neonatal urinary β2‐microglobulin
Authors: Nishimaki Shigeru , Sato Miho , An Hiromi , Shima Yoshio , Akaike Toru , Yokoyama Utako , Yokota Shumpei
Published: June 2009

Aim:  Chronic lung disease (CLD) is a major component in the morbidity of premature infants suffering from fetal inflammatory response (FIRS). The aim of the present study was to compare the value of measuring neonatal urinary β2‐microglobulin (β2‐MG) levels with fetal blood interleukin (IL)‐6 levels in premature infants at risk of developing CLD.

Methods:  Premature infants (gestational age <30 weeks) without CLD (n = 19) and with CLD (n = 10) were enrolled. We measured IL‐6 levels in umbilical cord blood and β2‐MG levels in urine obtained within 48 h after birth.

Results:  IL‐6 and β2‐MG levels were significantly higher in infants who developed CLD than in those who did not (median IL‐6, 54.7 vs 7.6 pg/mL; P < 0.005; β2‐MG 17.7 vs 9.3 × 104 µg/gCr; P < 0.05). The sensitivity and negative predictive value of β2‐MG at the cut‐off value at 10.0 × 104 µg/gCr (0.90 and 0.92) were comparable to IL‐6 at 16 pg/mL (0.90 and 0.94).

Conclusion:  We suggest that measuring urinary β2‐MG in premature infants soon after birth can monitor FIRS and may provide information on the risk of subsequent CLD development that is as clinically important as information derived from umbilical cord blood IL‐6.