bluuebunny/crossref_metadata_2025 huggingface dataset:
Effects of Bluetooth device electromagnetic field on hearing: pilot study
Authors: Balachandran R , Prepagaran N , Rahmat O , Zulkiflee A B , Hufaida K S
Published: February 2012

Background:

The Bluetooth wireless headset has been promoted as a ‘hands-free’ device with a low emission of electromagnetic radiation.

Objective:

To evaluate potential changes in hearing function as a consequence of using Bluetooth devices, by assessing changes in pure tone audiography and distortion production otoacoustic emissions.

Design:

Prospective study.

Materials and methods:

Thirty adult volunteers were exposed to a Bluetooth headset device (1) on ‘standby’ setting for 6 hours and (2) at full power for 10 minutes. Post-exposure hearing was evaluated using pure tone audiography and distortion production otoacoustic emission testing.

Results:

There were no statistically significant changes in hearing, as measured above, following either exposure type.

Conclusion:

Exposure to the electromagnetic field emitted by a Bluetooth headset, as described above, did not decrease hearing thresholds or alter distortion product otoacoustic emissions.
Ion-acoustic envelope excitations in multispecies plasma with non-thermally distributed electrons
Authors: BALA PARVEEN , GILL TARSEM SINGH , KAUR HARVINDER
Published: February 2012

By using the standard reductive perturbation technique, a nonlinear Schrödinger equation is derived to study the stability of finite amplitude ion-acoustic waves in an unmagnetized plasma consisting of warm positive and negative ions and non-thermal electrons. The effect of relative temperature of positive and negative ions, their charge and mass ratios, density ratios and non-thermally distributed electrons on modulational instability of fast and slow ion-acoustic mode is investigated. It is found that these parameters significantly change the domain of modulation instability. Both, envelope and dark solitons appear in different regions of parameter space.
Beltrami fields in a hot electron–positron–ion plasma
Authors: IQBAL M. , SHUKLA P. K.
Published: February 2012

A possibility of relaxation of relativistically hot electron and positron (e − p) plasma with a small fraction of hot or cold ions has been investigated analytically. It is observed that a strong interaction of plasma flow and field leads to a non-force-free relaxed magnetic field configuration governed by the triple curl Beltrami (TCB) equation. The triple curl Beltrami (TCB) field composed of three different Beltrami fields gives rise to three multiscale relaxed structures. The results may have the strong relevance to some astrophysical and laboratory plasmas.
Bartonellaspecies in bat flies (Diptera: Nycteribiidae) from western Africa
Authors: BILLETER S. A. , HAYMAN D. T. S. , PEEL A. J. , BAKER K. , WOOD J. L. N. , CUNNINGHAM A. , SUU-IRE R. , DITTMAR K. , KOSOY M. Y.
Published: February 2012

Bat flies are obligate ectoparasites of bats and it has been hypothesized that they may be involved in the transmission ofBartonellaspecies between bats. A survey was conducted to identify whetherCyclopodia greefi greefi(Diptera: Nycteribiidae) collected from Ghana and 2 islands in the Gulf of Guinea harbourBartonella. In total, 137 adult flies removed fromEidolon helvum, the straw-coloured fruit bat, were screened for the presence ofBartonellaby culture and PCR analysis.BartonellaDNA was detected in 91 (66·4%) of the specimens examined and 1 strain of aBartonellasp., initially identified inE. helvumblood from Kenya, was obtained from a bat fly collected in Ghana. This is the first study, to our knowledge, to report the identification and isolation ofBartonellain bat flies from western Africa.
Nicaragua: 25 Years Later
Authors: HOSS CRISTINA , VILLALPANDO SANTIAGO , SIVAKUMARAN SANDESH
Published: February 2012

The case concerning Military and Paramilitary Activities in and against Nicaragua, better known as the ‘Nicaragua case’ or simply Nicaragua, is arguably one of the most important and controversial cases ever to be heard by the International Court of Justice. Twenty-five years after the judgment on the merits was handed down, it is high time to reassess the impact of Nicaragua on international law. The joint efforts of the Grotius Centre of the Leiden Law School, the Centre on International Courts and Tribunals at University College London, the Netherlands Society of International Law, and the law firm Foley Hoag LLP resulted in a one-day conference, on 27 June 2011, the very day on which the judgment on the merits of the Nicaragua case was handed down, 25 years ago.
The problem of nitrogen disposal in the obese
Authors: Alemany Marià
Published: February 2012

Amino-N is preserved because of the scarcity and nutritional importance of protein. Excretion requires its conversion to ammonia, later incorporated into urea. Under conditions of excess dietary energy, the body cannot easily dispose of the excess amino-N against the evolutively adapted schemes that prevent its wastage; thus ammonia and glutamine formation (and urea excretion) are decreased. High lipid (and energy) availability limits the utilisation of glucose, and high glucose spares the production of ammonium from amino acids, limiting the synthesis of glutamine and its utilisation by the intestine and kidney. The amino acid composition of the diet affects the production of ammonium depending on its composition and the individual amino acid catabolic pathways. Surplus amino acids enhance protein synthesis and growth, and the synthesis of non-protein-N-containing compounds. But these outlets are not enough; consequently, less-conventional mechanisms are activated, such as increased synthesis of NO∙followed by higher nitrite (and nitrate) excretion and changes in the microbiota. There is also a significant production of N2gas, through unknown mechanisms. Health consequences of amino-N surplus are difficult to fathom because of the sparse data available, but it can be speculated that the effects may be negative, largely because the fundamental N homeostasis is stretched out of normalcy, forcing the N removal through pathways unprepared for that task. The unreliable results of hyperproteic diets, and part of the dysregulation found in the metabolic syndrome may be an unwanted consequence of this N disposal conflict.
The conservation of the avifauna in a lowland Atlantic forest in south-east Brazil
Authors: Aleixo Alexandre , Galetti Mauro
Published: February 2012

The avifauna of a pristine lowland Atlantic forest in south-east Brazil was studied over 2 years. A total of 234 species was recorded, of which 190 species (81.54%) occured in forested habitats. Thirty one species are listed as threatened or near-threatened and information on habitat and abundance is described for each species. The Parque Estadual Intervales holds one of the last pristine lowland Atlantic forests and it is one of the few reserves that encompasses a large altitudinal gradient. In the past few years the protection of the reserve has been threatened by palm harvesting, hunting, dams and mining.

A avifauna de uma regiao de Mata Atlântica de baixada no sudeste do estado de São Paulo foi estudada por um periodo continuo de 2 anos. Foram observados um total de 234 espécies de aves sendo que 190 espécies (81,54%) ocorreram predominantemente em ambientes florestais primários e perrubados. Trinta e uma espécies São consideradas ameaçadas ou vulneráveis e informações sobre hábitat e abundância são fornecidas. Nos últimos anos a proteção da reserva está ameaçada pelo corte do palmito, caça, construções de hidroéletricas e mineração.
High sensitivity of ultra‐oligotrophic marine ecosystems to atmospheric nitrogen deposition
Authors: Mouriño‐Carballido Beatriz , Pahlow Markus , Oschlies Andreas
Published: February 2012

Using a model of plankton and organic‐matter cycling we demonstrate that variable stoichiometric ratios can lead to a more than 5‐fold higher sensitivity of simulated carbon export to atmospheric N deposition in the ultra‐oligotrophic eastern part of the North Atlantic subtropical gyre compared to the westerly oligotrophic region near Bermuda, often used as a reference site for subtropical regions. Stronger nutrient limitation in the ultra‐oligotrophic east causes higher phytoplankton C:N ratios and lower carbon assimilation efficiency of zooplankton in the model, which results in a higher export efficiency of carbon to the deep ocean compared to the less nutrient‐limited western site. Our results indicate that previous estimates of oceanic carbon uptake associated with atmospheric nitrogen deposition may not be fully robust and that spatial variability in nutrient stress and ecological stoichiometry could significantly affect the biogeochemical impact of increasing atmospheric deposition of anthropogenic nitrogen.
Analysis of a ray‐tracing model for gravity waves generated by tropospheric convection
Authors: Broutman Dave , Eckermann Stephen D.
Published: February 2012

The Vadas‐Fritts ray‐tracing model for convectively generated gravity waves is analyzed using the stationary phase approximation and is interpreted in terms of a ray Jacobian approximated by the density of rays. The Vadas‐Fritts model launches rays from the convective source region, with initial conditions for the ray‐tracing deduced from a near‐field integral representation. In the far‐field the rays are binned in space‐time grid cells. The contribution of each ray to the spatial wave amplitude is determined by its spectral amplitude and by the local density of rays within the grid cells. The present analysis accomplishes two things. First, the stationary phase analysis gives the formal initial conditions for the ray‐tracing, which mostly agree with the Vadas‐Fritts initialization but also suggest some refinements. Secondly, the Jacobian and ray‐density analysis shows how the Vadas‐Fritts model can be generalized to follow a beam of rays with a single moving grid cell.
Comparing satellite‐based phytoplankton classification methods
Authors: Hirata Takafumi , Hardman‐Mountford Nick , Brewin Robert J. W.
Published: February 2012

Satellite Phytoplankton Functional Type Algorithm Intercomparison Workshop; Sapporo, Japan, 22–23 November 2011 Satellite observations of ocean color have become synonymous with derivations of chlorophyll a concentration as a proxy for phytoplankton biomass. In addition, a number of satellite algorithms for estimating the phytoplankton community structure have been developed that provide size‐structure estimates of phytoplankton and detect taxonomic groups (termed phytoplankton functional types, or PFTs). These new algorithms provide an increased level of observational detail for ecosystem and biogeochemical studies of the role of phytoplankton in marine systems.
Association of Type 2 Diabetes Susceptibility Loci With One‐Year Weight Loss in the Look AHEAD Clinical Trial
Authors: Peter Inga , McCaffery Jeanne M. , Kelley‐Hedgepeth Alyson , Hakonarson Hakon , Reis Steven , Wagenknecht Lynne E. , Kopin Alan S. , Huggins Gondon S. ,   For the Genetics Subgroup of the Look AHEAD Study
Published: February 2012

The importance of lifestyle intervention for the prevention and treatment of type 2 diabetes (T2D) has been underscored by the limited benefit of pharmacologic therapies. We sought to determine whether genetic variants that contribute to T2D risk modify the response of weight and waist circumference to an intensive lifestyle intervention (ILI) in patients with obesity and T2D. Look AHEAD (Action for Health in Diabetes) is a randomized clinical trial comparing an ILI with a control condition on the risk of cardiovascular disease in overweight adults with T2D. We analyzed 28 single‐nucleotide polymorphisms (SNPs) at/near 17 T2D‐susceptibility genes in 3,903 consented participants. We genetically characterized the cohort by assessing whether T2D‐susceptibility loci were overrepresented compared with a nondiabetic community‐based cohort (N= 1,016). We evaluated the association of individual variants and a composite genetic risk score (GRS) with anthropometric traits at baseline and after 1‐year of intervention. Look AHEAD subjects carried more T2D‐susceptibility alleles than the control population. At baseline,TCF7L2risk alleles and the highest GRS were associated with lower BMI and waist circumference. Nominally significant genotype‐by‐intervention interactions were detected for 1‐year change in waist circumference withJAZF1,MTNR1B, andIRS1, and BMI withJAZF1. Highest GRS was associated with a greater reduction in waist circumference at year 1, although the variance in change attributable to the GRS was small. This study shows that the genetic burden associated with T2D risk does not undermine the effect of lifestyle intervention and suggests the existence of additional genomic regions, distinct from the T2D‐susceptibility loci, which may enhance or mitigate weight loss.
Base recognition by l-nucleotides in heterochiral DNA
Authors: Ogawa Shuji , Wada Shun-ichi , Urata Hidehito
Published: February 2012

An l-nucleotide residue in heterochiral oligodeoxynucleotides possesses base pairing selectivity with different effects of the neighboring bases.
Thymic stromal lymphopoietin: an immune cytokine gene associated with the metabolic syndrome and blood pressure in severe obesity
Authors: Turcot Valérie , Bouchard Luigi , Faucher Geneviève , Garneau Véronique , Tchernof André , Deshaies Yves , Pérusse Louis , Marceau Simon , Biron Simon , Lescelleur Odette , Biertho Laurent , Vohl Marie-Claude
Published: February 2012

A previous expression profiling of VAT (visceral adipose tissue) revealed that the TSLP (thymic stromal lymphopoietin) gene was less expressed in severely obese men with (n=7) compared with without (n=7) the MetS (metabolic syndrome). We hypothesized that TSLP SNPs (single nucleotide polymorphisms) are associated with TSLP gene expression in VAT and with MetS phenotypes. Following validation of lower TSLP expression (P=0.003) in VAT of severely obese men and women with (n=70) compared with without (n=60) the MetS, a detailed genetic investigation was performed at the TSLP locus by sequencing its promoter, exons and intron–exon splicing boundaries using DNA of 25 severely obese subjects. Five tagging SNPs were genotyped in the 130 subjects from the expression analysis to test whether these SNPs contributed to TSLP expression variability (ANOVAs) and then genotyped in two independent samples of severely obese men (total, n=389) and women (total, n=894). In a sex-stratified multistage experimental design, ANOVAs were performed to test whether tagging SNPs were associated with MetS components treated as continuous variables. We observed that the non-coding SNP rs2289277 was associated with TSLP mRNA abundance (P=0.04), as well as with SBP [systolic BP (blood pressure)] (P=0.004) and DBP (diastolic BP) (P=0.0003) in men when adjusting for age, waist circumference, smoking and medication treating hypertension. These novel observations suggest that TSLP expression in VAT may partly explain the inter-individual variability for metabolic impairments in the presence of obesity and that specific SNPs (rs2289277 and/or correlating SNPs) may influence TSLP gene expression as well as BP in obese men.
Whole‐body vibration as a method of recovery for soccer players
Authors: Marin Pedro J. , Zarzuela Raúl , Zarzosa Fernando , Herrero Azael J. , Garatachea Nuria , Rhea Matthew R. , García‐López David
Published: February 2012

The aim of this study was to determine whether superimposed whole‐body vibration could improve the recovery‐related effects of a traditional cool‐down in high‐level soccer players. Sixteen high‐level junior soccer players performed a repeated‐sprint ability test, after which they performed a traditional cool‐down, with (experimental group) or without (control group) superimposed whole‐body vibration. Functional recovery was measured through vertical jump height and maximal voluntary isometric force in leg‐extension. The repeated‐sprint ability test induced increases (from 161 to 215%; P<0.05) in muscle pain measured by visual analogue scale in the control group only. Vertical jump height was recovered earlier with than without whole‐body vibration (24 h after the repeated‐sprint ability test; P<0.05). The results of this study demonstrate that whole‐body vibration in combination with a traditional cool‐down can reduce perceived muscle pain and enhance recovery after a soccer‐specific exercise.
Inaugurating Understanding or Repackaging Explanation?
Authors: Khalifa Kareem
Published: February 2012

Recently, several authors have argued that scientific understanding should be a new topic of philosophical research. In this article, I argue that the three most developed accounts of understanding—Grimm's, de Regt's, and de Regt and Dieks's—can be replaced by earlier ideas about scientific explanation without loss. Indeed, in some cases, such replacements have clear benefits.
Segregation That No One Seeks
Authors: Muldoon Ryan , Smith Tony , Weisberg Michael
Published: February 2012

This article examines a series of Schelling-like models of residential segregation, in which agents prefer to be in the minority. We demonstrate that as long as agents care about the characteristics of their wider community, they tend to end up in a segregated state. We then investigate the process that causes this and conclude that the result hinges on the similarity of informational states among agents of the same type. This is quite different from Schelling-like behavior and suggests (in his terms) that segregation is an instance of macrobehavior that can arise from a wide variety of micromotives.
Human-specific evolution of killer cell immunoglobulin-like receptor recognition of major histocompatibility complex class I molecules
Authors: Parham Peter , Norman Paul J. , Abi-Rached Laurent , Guethlein Lisbeth A.
Published: February 2012

In placental mammals, natural killer (NK) cells are a population of lymphocytes that make unique contributions to immune defence and reproduction, functions essential for survival of individuals, populations and species. Modulating these functions are conserved and variable NK-cell receptors that recognize epitopes of major histocompatibility complex (MHC) class I molecules. In humans, for example, recognition of human leucocyte antigen (HLA)-E by the CD94:NKG2A receptor is conserved, whereas recognition of HLA-A, B and C by the killer cell immunoglobulin-like receptors (KIRs) is diversified. Competing demands of the immune and reproductive systems, and of T-cell and NK-cell immunity—combined with the segregation on different chromosomes of variable NK-cell receptors and their MHC class I ligands—drive an unusually rapid evolution that has resulted in unprecedented levels of species specificity, as first appreciated from comparison of mice and humans. Counterparts to human KIR are present only in simian primates. Observed in these species is the coevolution of KIR and the four MHC class I epitopes to which human KIR recognition is restricted. Unique to hominids is the emergence of theMHC-Clocus as a supplier of specialized and superior ligands for KIR. This evolutionary trend is most highly elaborated in the chimpanzee. Unique to the humanKIRlocus are two groups ofKIRhaplotypes that are present in all human populations and subject to balancing selection. GroupA KIRhaplotypes resemble chimpanzeeKIRhaplotypes and are enriched for genes encoding KIR that bind HLA class I, whereas groupB KIRhaplotypes are enriched for genes encoding receptors with diminished capacity to bind HLA class I. Correlating with their balance in human populations,Bhaplotypes favour reproductive success, whereasAhaplotypes favour successful immune defence. Evolution of theB KIRhaplotypes is thus unique to the human species.
Genome-wide scans provide evidence for positive selection of genes implicated in Lassa fever
Authors: Andersen Kristian G. , Shylakhter Ilya , Tabrizi Shervin , Grossman Sharon R. , Happi Christian T. , Sabeti Pardis C.
Published: February 2012

Rapidly evolving viruses and other pathogens can have an immense impact on human evolution as natural selection acts to increase the prevalence of genetic variants providing resistance to disease. With the emergence of large datasets of human genetic variation, we can search for signatures of natural selection in the human genome driven by such disease-causing microorganisms. Based on this approach, we have previously hypothesized that Lassa virus (LASV) may have been a driver of natural selection in West African populations where Lassa haemorrhagic fever is endemic. In this study, we provide further evidence for this notion. By applying tests for selection to genome-wide data from the International Haplotype Map Consortium and the 1000 Genomes Consortium, we demonstrate evidence for positive selection in
LARGE
and interleukin 21 (
IL21
), two genes implicated in LASV infectivity and immunity. We further localized the signals of selection, using the recently developed composite of multiple signals method, to introns and putative regulatory regions of those genes. Our results suggest that natural selection may have targeted variants giving rise to alternative splicing or differential gene expression of
LARGE
and
IL21
. Overall, our study supports the hypothesis that selective pressures imposed by LASV may have led to the emergence of particular alleles conferring resistance to Lassa fever, and opens up new avenues of research pursuit.
Coevolution ofaah: Adps-Like Gene with the Host Bacterium Revealed by Comparative Genomic Analysis
Authors: Ping Liyan , Platzer Matthias , Wen Gaiping , Delaroque Nicolas
Published: February 2012

A protein named AAH was isolated from the bacteriumMicrobacterium arborescensSE14, a gut commensal of the lepidopteran larvae. It showed not only a high sequence similarity to Dps-like proteins (DNA-binding proteins from starved cell) but also reversible hydrolase activity. A comparative genomic analysis was performed to gain more insights into its evolution. The GC profile of theaahgene indicated that it was evolved from a low GC ancestor. Its stop codon usage was also different from the general pattern of Actinobacterial genomes. The phylogeny ofdps-like proteins showed strong correlation with the phylogeny of host bacteria. A conserved genomic synteny was identified in some taxonomically related Actinobacteria, suggesting that the ancestor genes had incorporated into the genome before the divergence of Micrococcineae from other families. Theaahgene had evolved new function but still retained the typical dodecameric structure.
Porous Collagen Scaffold Reinforced with Surfaced Activated PLLA Nanoparticles
Authors: Xu Cancan , Lu Wei , Bian Shaoquan , Liang Jie , Fan Yujiang , Zhang Xingdong
Published: February 2012

Porous collagen scaffold is integrated with surface activated PLLA nanoparticles fabricated by lyophilizing and crosslinking via EDC treatment. In order to prepare surface-modified PLLA nanoparticles, PLLA was firstly grafted with poly (acrylic acid) (PAA) through surface-initiated polymerization of acrylic acid. Nanoparticles of average diameter 316 nm and zeta potential −39.88 mV were obtained from the such-treated PLLA by dialysis method. Porous collagen scaffold were fabricated by mixing PLLA nanoparticles with collagen solution, freeze drying, and crosslinking with EDC. SEM observation revealed that nanoparticles were homogeneously dispersed in collagen matrix, forming interconnected porous structure with pore size ranging from 150 to 200 μm, irrespective of the amount of nanoparticles. The porosity of the scaffolds kept almost unchanged with the increment of the nanoparticles, whereas the mechanical property was obviously improved, and the degradation was effectively retarded.In vitroL929 mouse fibroblast cells seeding and culture studies revealed that cells infiltrated into the scaffolds and were distributed homogeneously. Compared with the pure collagen sponge, the number of cells in hybrid scaffolds greatly increased with the increment of incorporated nanoparticles. These results manifested that the surface-activated PLLA nanoparticles effectively reinforced the porous collagen scaffold and promoted the cells penetrating into the scaffold, and proliferation.
Root perforation associated with the use of a miniscrew implant used for orthodontic anchorage: a case report
Authors: McCabe P. , Kavanagh C.
Published: February 2012

McCabe P, Kavanagh C. Root perforation associated with the use of a miniscrew implant used for orthodontic anchorage: a case report. International Endodontic Journal, 45, 678–688, 2012.

Aim  To highlight one of the possible complications associated with the inter‐radicular placement of orthodontic miniscrews.

Summary  This case report describes the endodontic treatment and surgical repair of an iatrogenic root perforation involving a maxillary first molar tooth following the placement of an orthodontic miniscrew placed for anchorage purposes in the treatment of an adult patient. The orthodontic treatment plan was completed. The long‐term follow‐up shows a successful treatment outcome.

Key learning points 

 Inter‐radicular placement of orthodontic miniscrews is a valuable source of anchorage in the treatment of orthodontic patients.

 Root perforation is a possible complication from inter‐radicular placement of orthodontic miniscrews.

 Root perforation can be successfully treated, but may involve apical surgery.
Pulpotomy in caries‐exposed immature permanent molars using calcium‐enriched mixture cement or mineral trioxide aggregate: a randomized clinical trial
Authors: NOSRAT ALI , SEIFI AMIR , ASGARY SAEED
Published: February 2012

International Journal of Paediatric Dentistry 2013; 23: 56–63

Objective.  To compare clinical and radiographic outcomes of pulpotomy treatment using calcium‐enriched mixture (CEM) cement and mineral trioxide aggregate (MTA) in carious‐exposed vital immature permanent first molars.

Design.  Fifty‐one immature molars with clinical carious exposure with symptomatic/asymptomatic pulpitis met the inclusion criteria and randomly assigned to one of the treatment groups (CEM [26 teeth; 59 roots], MTA [25 teeth; 59 roots]). After performing pulpotomy and covering the radicular pulps with the biomaterials, all teeth were permanently restored. Blinded clinical and radiographic evaluations were performed at 6 and 12 months after operation for signs of success or failure. Radiographs were evaluated for complete/partial apical closure. The data were analysed using chi‐square test and generalized estimating equation (GEE) model.

Results.  There was no significant difference at the baseline between the two experimental groups. All available cases (49 teeth) showed pulp survival and signs of continuous root development after 12 months. Overall, complete apical closure (apexogenesis) occurred in 76.8% and 73.8% of radiographically interpreted roots in CEM cement and MTA groups, respectively. There was no statistical difference in terms of radiographic outcomes between two groups.

Conclusions.  Calcium‐enriched mixture cement and MTA showed similar performance in pulpotomy of immature caries‐exposed permanent molars.
Managing asthma in primary care through imperative outcomes
Authors: du Plessis Jesslee M. , Gerber Jan J. , Brand Linda
Published: February 2012

Rationale, aims and objectives  To evaluate asthma management and control in primary care clinics so as to design improvements based on guideline‐directed outcomes.

Methods  In this study, all medical records of asthma‐diagnosed patients (children as well as adults, entire lifespan, asthma‐related visits or not) were retrospectively reviewed as a basis for assessing the level of guideline adherence and asthma control. Six primary health care clinics were visited in the Dr Kenneth Kaunda Municipal District, Potchefstroom, South Africa during May to July 2008, 2009 and 2010.

Results  A total of 323 asthma patient records were reviewed over the three time slots, resulting in 125, 87, and 111 patients respectively. A suboptimal clinical asthma control picture, with a mere 16% (n = 20) of females and 2% (n = 3) of males with Peak Expiratory Flow (PEF) percentages above 60%, were observed in the initial assessment. Improvement in control was observed during the following time slot, but with an end result in 2010 of no PEF percentages above 60% for males and only 9% (n = 7) for females.

Conclusion  Over all three of the data collection periods adherence to effectively applied management of asthma guidelines proved to be below the minimum recommended clinical evaluation work‐up as set out by the Expert Panel Report 3 (EPR3) of the National Asthma Education and Prevention Program (NAEPP). Applying a greater focus on essential outcomes through different disease management documents resulted in an improved quality of managed care, but still requires dedicated and continuous education and motivation. (NWU‐0052‐08‐A5)
Improving rates of herpes zoster vaccination with a clinical decision support system in a primary care practice
Authors: Chaudhry Rajeev , Schietel Sidna M. , North Fred , Dejesus Ramona , Kesman Rebecca L. , Stroebel Robert J.
Published: February 2012

Rationale  Herpes zoster (shingles) is a localized neurocutaneous eruption of blisters caused by reactivation of the varicella zoster virus. The cost of care for herpes zoster and its complications is estimated at $1.1 billion. The Centers for Disease Control and Prevention's Advisory Committee on Immunization Practices recommends a one‐time dose of the vaccine for adults aged 60 years or older. Despite that recommendation, utilization of the vaccine is very low. One way to boost the delivery of preventive services such as vaccinations is with a computerized clinical decision support system. Our study found that the herpes zoster vaccination rate increased significantly after the implementation of such a system.

Aims  To study utilization of herpes zoster vaccine before and after the implementation of a web‐based clinical decision support software solution in a primary care practice.

Methods  Billing data was utilized to determine number of herpes zoster vaccination administered to patients for a 12‐month period during the implementation of the software solution.

Results  The utilization of vaccinations improved from 63 to 117 (53.8% increase) for one primary care practice and from 54 to 127 (42.5% increase) in the other primary care practice.

Conclusion  Herpes zoster vaccination rate significantly improved with implementation of a web‐based clinical decision support system.
HCV burden of infection in Egypt: results from a nationwide survey
Authors: Guerra J. , Garenne M. , Mohamed M. K. , Fontanet A.
Published: February 2012

Summary. Egypt is the country with the largest hepatitis C virus (HCV) epidemic in the world. In 2008, a Demographic Health Survey (DHS) was carried out in Egypt, providing for the first time a unique opportunity for HCV antibody testing on a nationwide representative sample of individuals. Consenting individuals answered a questionnaire on socio‐demographic characteristics and iatrogenic exposures, before providing a blood sample for HCV antibody testing by enzyme‐linked immunosorbent assay. Factors independently associated with HCV infection were examined through multivariate logistic regression models. Of 12 780 eligible subjects aged 15–59 years, 11 126 (87.1%) agreed to participate and provided a blood sample. HCV antibody prevalence nationwide was 14.7% (95% CI 13.9–15.5%) in this age group. HCV antibody prevalence gradually increased with age, reaching, in the 50–59 years age group, 46.3% and 30.8% in males and females, respectively. It was higher in males compared to females (17.4% versus 12.2%, respectively,P < 0.001), and in rural compared to urban areas (18.3% versus 10.3%, respectively,P < 0.001). In multivariate analysis, age, male sex, poverty, past history of intravenous anti‐schistosomiasis treatment, blood transfusion, and living outside of the Frontier Governorates were all significantly associated with an increased risk of HCV infection. In addition, in urban areas, lack of education and being circumcised for females were associated with an increased risk of HCV infection. This study confirmed on a nationwide representative sample the very high HCV antibody prevalence in Egypt. It stresses the urgent need for strengthening prevention efforts, and bringing down the costs of antiviral drugs for countries like Egypt, where the people in the most precarious situations are also those most likely to be infected by the virus.
One hundred years of allergen immunotherapy European Academy of Allergy and Clinical Immunology celebration: review of unanswered questions
Authors: Calderón M. , Cardona V. , Demoly P. ,   on behalf of the EAACI 100 Years of Immunotherapy Experts Panel
Published: February 2012

Allergen immunotherapy was introduced by Leonard Noon 100 years ago and is the only disease‐modifying treatment for allergic individuals. Improved understanding of immunology has taught us a great deal about the underlying mechanisms involved in allergen immunotherapy; however, despite these developments, a number of important questions remain unanswered. Several of these questions relate to the practice of allergen immunotherapy in the clinic, such as: Is it possible to unify units of allergen potency? Which treatment schedules are best? Is allergen immunotherapy effective in all patient groups? Is there a dose–response relationship for efficacy and safety?, and Is there evidence for long‐term effects following allergen immunotherapy? Others are related to new developments, such as new indications, or developments in the production of allergens. On the centenary of Noon's discovery, European experts in the field of immunotherapy met in Geneva under the aegis of the EAACI to discuss these controversial issues. This study presents outcomes and conclusions from these discussions.
Sequence evolution and escape from specific immune pressure of an HIV‐1 Rev epitope with extensive sequence similarity to human nucleolar protein 6
Authors: Allard S. D. , de Goede A. L. , De Keersmaecker B. , Heirman C. , Lacor P. , Osterhaus A. D. M. E. , Demanet C. , Thielemans K. , Gruters R. A. , Aerts J. L.
Published: February 2012

Antigen‐specific immunity is crucially important for containing viral replication in human immunodeficiency virus (HIV)‐1‐infected hosts. Several epitopes have been predicted for the early expressed HIV‐1 proteins Tat and Rev, but few have been studied in detail. We characterized the human leukocyte antigen (HLA)‐B44‐restricted Rev epitope EELLKTVRL (EL9) in an HIV‐1‐infected subject treated with antiretroviral therapy. Interestingly, a high sequence similarity was found between the EL9 epitope and the human nucleolar protein 6 (NOL6). However, this similarity does not seem to impede immunogenicity as CD8+ T‐cells, previously stimulated with EL9‐pulsed dendritic cells, were able to specifically recognize the HIV‐1 Rev epitope without cross‐recognizing the human self‐antigen NOL6. After the subject interrupted antiretroviral therapy and virus rebounded, mutations within the EL9 epitope were identified. Although the emerging mutations resulted in decreased or abolished T‐cell recognition, they did not impair Rev protein function. Mutations leading to escape from T‐cell recognition persisted for up to 124 weeks following treatment interruption. This study shows that the HLA‐B44‐restricted Rev CD8+ T‐cell epitope EL9 is immunogenic notwithstanding its close resemblance to a human peptide. The epitope mutates as a consequence of dynamic interaction between T‐cells and HIV‐1. Clinical status, CD4+ T‐cell count and viral load remained stable despite escape from T‐cell recognition.
Consequences of early chilling stress in two Triticum species: plastic responses and adaptive significance
Authors: Valluru R. , Link J. , Claupein W.
Published: February 2012

Phenotypic plasticity of two primitive wheat species (Triticum monococcum L. and Triticum dicoccum S.) was studied in response to early chilling stress. Selection pressure differentials, gradients and plasticity costs on plant morphogenesis, growth and reserve carbohydrate consumption were estimated. Regression analysis was applied to investigate differential developmental changes and patterns between treatments. Four‐day‐old seedlings of T. monococcum and T. dicoccum, differing in plant stature and reserve carbohydrates, were given an early chilling temperature (4 °C for 42 day) and compared with control plants grown at 23 °C. Early chilling stress resulted in a significant increase in leaf mass ratio (LMR) and relative growth rate (RGR), a reduction in flag leaf size, total biomass, specific leaf area (SLA) and reserve carbohydrate storage at flowering, together with advanced onset of flowering. Selection pressure within the early chilling environment favoured early flowering, smaller SLA, higher LMR and lower reserve carbohydrates, suggesting the observed responses were adaptive. Furthermore, a regression of daily cumulative plant biomass derived from a crop growth simulation model (CERES‐Wheat) on crop vegetation period revealed a divergent developmental pattern in early‐chilled plants. Using selection pressure gradient analysis, we found similar responses among these traits, except for SLA and sucrose, indicating that these two traits have indirect effects on fitness. Thus, the total effects of SLA and reserve sucrose on relative fitness seem to be buffered via the rapid growth rate in chilled plants. While lower SLA may reduce early chilling stress effects at an individual leaf level, a higher LMR and use of reserve carbohydrates indicated that compensatory growth of chilled plants during the recovery period relied on the concerted action of altered resource allocation and reserve carbohydrate consumption. However, a significant cost of plasticity was evident only for flowering time, LMR and fructan levels in the early chilling environment. Our results demonstrate that morphological and intrinsic developmental (ontogenetic) patterns in two Triticum species respond to early chilling stress.
Sentinel lymph node biopsy in patients with Merkel cell carcinoma: An emerging role and the Westmead hospital experience
Authors: Howle Julie , Veness Michael
Published: February 2012

Background:  Merkel cell carcinoma (MCC) is an aggressive cutaneous malignancy which has a high rate of nodal metastasis. Sentinel lymph node biopsy (SLNB) enables the identification of occult nodal metastases. We sought to calculate the rates of positive and false negative SLNB and to evaluate the impact of SLNB on the staging and management of patients with MCC at our institution.

Methods:  A total of 16 patients with stage I or II MCC who had undergone SLNB were identified from a prospectively maintained database of 114 patients with MCC who presented to Westmead Hospital, Sydney, Australia between 2000 and 2010. Data on patient characteristics, tumour and treatment details and patient follow up were extracted from a computer database and patient medical records.

Results:  Eight patients (50%) had a positive SLNB and eight had a negative SLNB. The median follow up from diagnosis was 19.5 months (range 4–40) with most patients (69%) alive without evidence of disease at the time of last follow up. All eight patients with a positive SLNB subsequently underwent nodal treatment. This consisted of radiotherapy in five and completion lymphadenectomy and adjuvant radiotherapy in three. None of the eight patients who had a negative SLNB underwent any nodal treatment following SLNB. Two of these patients developed nodal relapse, giving a false negative rate of 20%.

Conclusion:  Half of our patients were upstaged and underwent nodal treatment as a result of their SLNB. Given the high rate of SLNB positivity, we believe that SLNB has a role in the management of MCC. As there is a risk of a false negative SLNB, close observation of the regional nodal basins is warranted in patients who have had a negative SLNB. Further studies are required to investigate the impact of SLNB on survival.
Successful treatment of a severe persistent case of pemphigoid gestationis with antepartum and postpartum intravenous immunoglobulin followed by azathioprine
Authors: Gan Desmond Chia Chin , Welsh Belinda , Webster Michael
Published: February 2012

We report a case of pemphigoid gestationis affecting a 37‐year‐old woman in both her pregnancies. In her second pregnancy she failed to respond to high‐dose oral prednisolone. She was treated successfully with intravenous immunoglobulin (2 g/kg each infusion cycle) as a steroid‐sparing agent during both the antepartum and postpartum period. The baby was born at the 36th week of gestation. No complications were noted for either mother or baby. After ceasing intravenous immunoglobulin, azathioprine (up to a dose of 1 mg/kg/day) was used to adequately control her pemphigoid gestationis.
Adaptation as a mechanism for gain control in cockroach ON and OFF olfactory receptor neurons
Authors: Burgstaller Maria , Tichy Harald
Published: February 2012

In many sensory systems adaptation acts as a gain control mechanism that optimizes sensory performance by trading increased sensitivity to low stimulus intensity for decreased sensitivity to high stimulus intensity. Adaptation of insect antennal olfactory receptor neurons (ORNs) has been studied for strong odour concentrations, either pulsed or constant. Here, we report that during slowly oscillating changes in the concentration of the odour of lemon oil, the ON and OFF ORNs on the antenna of the cockroach Periplaneta americana adapt to the actual odour concentration and the rate at which concentration changes. When odour concentration oscillates rapidly with brief periods, adaptation improves gain for instantaneous odour concentration and reduces gain for the rate of concentration change. Conversely, when odour concentration oscillates slowly with long periods, adaptation increases gain for the rate of change at the expense of instantaneous concentration. Without this gain control the ON and OFF ORNs would, at brief oscillation periods, soon reach their saturation level and become insensitive to further concentration increments and decrements. At long oscillation periods, on the other hand, the cue would simply be that the discharge begins to change. Because of the high gain for the rate of change, the cockroach will receive creeping changes in odour concentration, even if they persist in one direction. Gain control permits a high degree of precision at small rates when it counts most, without sacrificing the range of detection and without extending the measuring scale.
Clonidine does not improve quality of ropivacaine axillary brachial plexus block in children
Authors: Trifa Mehdi , Ben Khalifa Sonia , Jendoubi Ali , Zribi Najeh , Regaya Tarek , Engelhardt Thomas
Published: February 2012

Background:  The addition of clonidine to peripheral nerve blocks is controversial in children.

Objective:  The aim of our study was to evaluate the effect of clonidine added to ropivacaine in pediatric axillary brachial plexus block (ABPB).

Methods:  Children aged 1–6 years, scheduled to undergo forearm or hand surgery, were recruited into this prospective, double‐blind controlled trial. Patients were randomly allocated to receive an ABPB either with ropivacaine 0.2% 0.4 ml·kg−1 plus saline in 1 ml (RS) or ropivacaine 0.2% 0.4 ml·kg−1 plus clonidine 1 μg·kg−1 in 1 ml (RC). Primary endpoints were quality of postoperative analgesia as assessed by pain scores and total 24‐h postoperative analgesia requirements. Secondary outcomes were time to first analgesia request and duration of motor blockade.

Results:  Sixty patients were recruited (n = 30 per group) into the study. Pain scores were comparable throughout the first 24 h between the two groups. Ten children in the (RS) and six in (RC) groups required supplementary analgesia during the first 24 h (P = 0.24). Children who required further analgesia did so after 288 ± 94 min in the (RS) and 437 ± 204 min in the (RC) group (P = 0.06). There was no difference in the duration of motor block [186 ± 71 and 154 ± 56 min, P = 0.12 for (RS) and (RC), respectively].

Conclusion:  Ropivacaine (0.2% 0.4 ml·kg−1) for ABPB provides sufficient postoperative analgesia in children scheduled for forearm or hand surgery. The addition of clonidine to ABPB does not improve overall postoperative analgesia but may increase the time to first analgesia request.
Variable and complex food web structures revealed by exploring missing trophic links between birds and biofilm
Authors: Kuwae Tomohiro , Miyoshi Eiichi , Hosokawa Shinya , Ichimi Kazuhiko , Hosoya Jun , Amano Tatsuya , Moriya Toshifumi , Kondoh Michio , Ydenberg Ronald C. , Elner Robert W.
Published: February 2012

Ecology Letters(2012)15: 347–356

Food webs are comprised of a network of trophic interactions and are essential to elucidating ecosystem processes and functions. However, the presence of unknown, but critical networks hampers understanding of complex and dynamic food webs in nature. Here, we empirically demonstrate a missing link, both critical and variable, by revealing that direct predator‐prey relationships between shorebirds and biofilm are widespread and mediated by multiple ecological and evolutionary determinants. Food source mixing models and energy budget estimates indicate that the strength of the missing linkage is dependent on predator traits (body mass and foraging action rate) and the environment that determines food density. Morphological analyses, showing that smaller bodied species possess more developed feeding apparatus to consume biofilm, suggest that the linkage is also phylogenetically dependent and affords a compelling re‐interpretation of niche differentiation. We contend that exploring missing links is a necessity for revealing true network structure and dynamics.
Evidence‐based recommendations for the development of obesity prevention programs targeted at preschool children
Authors: Summerbell C. D. , Moore H. J. , Vögele C. , Kreichauf S. , Wildgruber A. , Manios Y. , Douthwaite W. , Nixon C. A. , Gibson E. L. ,   ToyBox‐study group
Published: February 2012

The ToyBox intervention was developed using an evidence‐based approach, using the findings of four reviews. These reviews included three critical and narrative reviews of educational strategies and psychological approaches explaining young children's acquisition and formation of energy‐balance related behaviours, and the management of these behaviours, and also a systematic review of behavioural models underpinning school‐based interventions in preschool and school settings for the prevention of obesity in children aged 4–6 years.

This paper summarises and translates the findings from these reviews into practical evidence based recommendations for researchers and policy‐makers to consider when developing and implementing interventions for the prevention of overweight and obesity in young (aged 4–6 years) children.

The recommendations focus on two behaviours, physical activity and sedentary behaviour, and healthy eating, and include general recommendations, intervention approaches, interventions content, and simple messages. The review also briefly examines the role that the commercial sector plays in hindering or facilitating attempts to create healthy food environments for children. This paper also recognises that childhood obesity is not an issue for the education sector alone; it needs to be tackled at a multi sectoral level, recognizing the particularly important role of local governments, nongovernment organizations and the media.