bluuebunny/crossref_metadata_2025 huggingface dataset:
Analysis of birth‐related medical malpractice litigation cases in Japan: Review and discussion towards implementation of a no‐fault compensation system
Authors: Uesugi Nana , Yamanaka Michiko , Suzuki Toshihiro , Hirahara Fumiki
Published: July 2010

Aim:  We examined birth‐related malpractice civil litigation cases in Japan to clarify the actual status related to the implementation of an obstetrical no‐fault compensation system in 2009.

Material & Methods:  In this retrospective review, we analyzed legal and medical information from 64 cases with a delivery date after 1987 and a judgment date between April 1997 and March 2007.

Results:  The malpractice claim was accepted in 44 cases and rejected in 20 cases. The period from the delivery to the judgment date was lengthy (90.1 months overall). The average amount of damages awarded was ¥97 810 000 for cases of cerebral palsy (CP). Preterm births and less than 2500 g infants represented a higher incidence rate in the rejected cases. There were 32 cases (50.0%) with CP, 18 (28.1%) with infant death, 10 (15.6%) with neonatal death, and 4 (6.3%) with fetal death. Twenty‐three of 44 accepted cases (52.3%) and 11/20 rejected cases (55.0%) had a gestational age of more than 33 weeks at birth and weighed more than 2000 g. Forced deliveries were performed in 45/64 cases (70.3%), and augmentation/induction of labor was performed in 28/64 cases (43.8%). There were 13/16 (81.3%) accepted cases that underwent vacuum and/or forceps extraction after labor augmentation/induction.

Conclusions:  More than half of our cases could be sufficient for a no‐fault compensation system in Japan. Though the system is considered to have some problems that need to be solved, this finding suggests that many children and their families may benefit from the new system without having to file.
Clinical diagnosis and treatment of acute fatty liver of pregnancy: A literature review and 11 new cases
Authors: Wei Qiang , Zhang Li , Liu Xinghui
Published: July 2010

Aim:  To determine the clinical presentation, biochemical findings, complications, clinical diagnosis and management of patients with acute fatty liver of pregnancy (AFLP). The influence of the mode of delivery on maternal–perinatal mortality is analyzed and two methods of diagnostic imaging are compared.

Material & Methods:  Eleven cases of AFLP identified at the West China Second Hospital of Sichuan University from January 2003 to June 2008 were studied. To provide additional evidence, 342 cases of AFLP were reviewed retrospectively from original articles researched in the China National Knowledge Infrastructure between the same period.

Results:  All cases presented with a prodrome of nausea, vomiting, malaise and jaundice. Raised transaminases and serum bilirubin were found in all patients (100%), hypoglycemia was found in two patients (18.2%) and hypoproteinemia was found in five patients (45.5%). All cases were confirmed by diagnostic criteria and clinical assessment. Diagnostic imaging helped to confirm the diagnoses. Ultrasound was used to diagnose nine patients (81.8%), and two (18.2%) patients were diagnosed by computerized tomography. Except for one patient whose labor was induced with oxytocin because of fetal death before admission, all other pregnancies were terminated by cesarean section within 24 h of definitive diagnosis. All patients and neonates survived delivery. One (9.1%) maternal death and one (7.2%) fetal death occurred.

Conclusions:  Early diagnosis, termination of pregnancy by Cesarean section as soon as possible and comprehensive therapy are crucial for improving the prognoses of both mother and newborn.
Glutamate receptor phosphorylation and trafficking in pain plasticity in spinal cord dorsal horn
Authors: Liu Xue Jun , Salter Michael W.
Published: July 2010

Glutamate is the major excitatory neurotransmitter in the central nervous system. Considerable evidence suggests that both ionotropic and metabotropic glutamate receptors are involved in pain hypersensitivity. However, glutamate receptor‐based therapies are limited by side‐effects because the activities of glutamate receptors are essential for many important physiological functions. Here, we review recent key findings in molecular and cellular mechanisms of glutamate receptor regulation and their roles in triggering and sustaining pain hypersensitivity. Targeting these molecular mechanisms could form the basis for new therapeutic strategies for the treatment of chronic pain.
Environmental correlates of physical activity and dietary behaviours among young people: a systematic review of reviews
Authors: de Vet E. , de Ridder D. T. D. , de Wit J. B. F.
Published: July 2010

An extensive body of research exists on environmental influences on weight‐related behaviours in young people. Existing reviews aimed to synthesize this body of work, but generally focused on specific samples, behaviours or environmental influences and integration of findings is lacking. Hereto, we reviewed 18 reviews representing 671 unique studies, aiming to identify what environmental factors do and do not affect physical activity and dietary behaviours in children and adolescents. Eleven reviews focused exclusively on physical activity, six on diet, and one review focused on both physical activity and dietary behaviours with only small overlap in included studies. Physical activity was more consistently related to school and neighbourhood characteristics than to interpersonal and societal environments. In contrast, interpersonal factors played a pronounced role in dietary behaviours; no school, neighbourhood or societal factors were consistently related to dietary behaviours. This review of reviews adds to the literature by providing a comprehensive synthesis of factors related to physical activity and dietary behaviours that could be targeted in interventions. Moreover, by identifying factors that are unrelated to physical activity and dietary behaviours, this review may help to narrow the scope of future studies and environmental interventions.
HLA‐DRB1: genetic susceptibility and disability progression in a Spanish multiple sclerosis population
Authors: Romero‐Pinel L. , Pujal J. M. , Martínez‐Yélamos S. , Gubieras L. , Matas E. , Bau L. , Torrabadella M. , Azqueta C. , Arbizu T.
Published: July 2010

Background and objective: The association of HLA‐DRB1*15 with susceptibility to multiple sclerosis (MS) has been consistently reported although its effect on the clinical phenotype is still controversial. The objectives of this study are to investigate the influence of the HLA‐DRB1 alleles on the genetic susceptibility to MS and to study their impact on disability progression in a Spanish population.

Methods: HLA‐DRB1 typing was performed by PCR‐SSP in 380 patients with sporadic MS and 1088 unrelated healthy controls. Allelic frequencies were compared between groups. We studied the correlation between the different alleles and the progression of MS.

Results: The HLA‐DRB1*15 allele in patients with MS had a statistically significant higher frequency when compared with controls (18.9% in patients vs. 10.1% in controls, Odds ratio (OR) = 2.07, 95% CI = 1.64–2.60,P < 0.001). In the univariate analysis, the DRB1*01 and DRB1*04 alleles were associated with a worse prognosis when considering the time to reach an EDSS of 6, whereas the DRB1*03 was correlated with a better outcome. In the multivariate analysis, the alleles*01 and *04 were demonstrated to be independent factors to have a worse prognosis.

Conclusions: HLA‐DRB1*15 is associated with MS when comparing patients with unrelated healthy controls in a Spanish population. The HLA‐DRB1*01 and HLA‐DRB1*04 alleles are related to a worse prognosis when considering the time taken to reach severe disability.
Number and type of synapses on the distal dendrite of a rat striatal cholinergic interneuron: a quantitative, ultrastructural study
Authors: Sizemore Rachel J. , Reynolds John N. J. , Oorschot Dorothy E.
Published: July 2010

Knowledge of the innervation of interneurons within the striatum is critical to determining their role in the functioning of the striatal network. To this end, the synaptic innervation of a distal dendrite of a rat striatal cholinergic interneuron was quantified for the first time. These synaptic data were compared to three other dendrites from rat striatal interneurons and to published data from dendrites in the mammalian cerebral cortex. To label the cholinergic interneurons and their distal dendrites, a male Wistar rat was perfused and the striatum was double‐immunolabelled with an antibody to choline acetyltransferase (ChAT) and an antibody to m2 muscarinic receptor. After processing for transmission electron microscopy, a cholinergic interneuron was located and an m2‐labelled distal dendrite identified by tracing it through serial ultrathin sections to this double‐immunolabelled soma. Two interneuronal distal dendrites in the same tissue, and another from a second rat, were used for comparison. The widths and lengths of the four distal dendrites, the total number and type of synapses, and the number of synapses per μm for each distal dendrite were measured. Symmetric synapses were the most common type on all four dendrites. There were 0.73 synapses per μm on the distal dendrite of the identified striatal cholinergic interneuron. Two other interneuronal dendrites that were positive for the m2 muscarinic receptor antibody showed similar synaptic densities of 0.62 and 0.83 synapses per μm of distal dendrite, respectively. On a third unlabelled interneuronal distal dendrite located in the lateral striatum, there were 2.17 synapses per μm. This interneuron was thought to be a parvalbumin interneuron rather than a calretinin interneuron, which would more likely be medially located. These data suggest that the number of synapses per μm on the distal dendrite of the cholinergic interneuron, and possibly two other cholinergic interneurons, is three times lower than that of a likely parvalbumin interneuron in the rat striatum. The number of synapses per μm of distal dendrite for a striatal cholinergic interneuron is also lower than the published 1.22–3.3 synapses per μm of dendrite for neurons in the mammalian cerebral cortex. Such anatomical data are important for the construction of new generation computer models that are better able to emulate the operation of striatal cholinergic interneurons.
Selecting an optimal prognostic system for liver cirrhosis: the model for end‐stage liver disease and beyond
Authors: Huo Teh‐Ia , Lee Shou‐Dong , Lin Han‐Chieh
Published: July 2010

In comparison with the Child–Turcotte–Pugh (CTP) system, recent studies suggested that the model for end‐stage liver disease (MELD) may more accurately predict the survival for patients with cirrhosis. In the US, the liver allocation system was changed in 2002 from a status‐based algorithm utilizing CTP scores to one using continuous MELD severity scores as a reference system in prioritizing adult patients on the waiting list. Direct evidence that demonstrates the benefits of MELD is the fact that the mortality rates of transplant candidates on the waiting list have remarkably decreased after the implementation of the MELD. The MELD score is closely associated with the degree of portal hypertension as reflected by the hepatic venous pressure gradient. Hyponatraemia occurs as a result of advanced cirrhosis, and a serum sodium (Na) level <126 mEq/L at the time of listing for transplantation is a strong independent predictor of mortality. Several MELD‐derived prognostic models that incorporate serum Na into calculation have been proposed in the hopes of further improving the MELD's prognostic accuracy. Additionally, serum parameters such as creatinine and international normalized ratio are subject to interlaboratory variations and may need unifying standardizations. Patients with refractory complications of cirrhosis may need a priority MELD score to prioritize them on the waiting list. Appropriate modifications and the fine‐tuning of the MELD based on well‐designed prospective studies are necessary in solving the current controversial issues.
Cholinergic Mediation of Alcohol‐Induced Experimental Pancreatitis
Authors: Lugea Aurelia , Gong Jun , Nguyen Janie , Nieto Jose , French Samuel W. , Pandol Stephen J.
Published: July 2010

Objectives:  The mechanisms initiating pancreatitis in patients with chronic alcohol abuse are poorly understood. Although alcohol feeding has been previously suggested to alter cholinergic pathways, the effects of these cholinergic alterations in promoting pancreatitis have not been characterized. For this study, we determined the role of the cholinergic system in ethanol‐induced sensitizing effects on cerulein pancreatitis.

Methods:  Rats were pair‐fed control and ethanol‐containing Lieber‐DeCarli diets for 6 weeks followed by parenteral administration of 4 hourly intraperitoneal injections of the cholecystokinin analog, cerulein at 0.5 μg/kg. This dose of cerulein was selected because it caused pancreatic injury in ethanol‐fed but not in control‐fed rats. Pancreatitis was preceded by treatment with the muscarinic receptor antagonist atropine or by bilateral subdiaphragmatic vagotomy. Measurement of pancreatic pathology included serum lipase activity, pancreatic trypsin, and caspase‐3 activities, and markers of pancreatic necrosis, apoptosis, and autophagy. In addition, we measured the effects of ethanol feeding on pancreatic acetylcholinesterase activity and pancreatic levels of the muscarinic acetylcholine receptors m1 and m3. Finally, we examined the synergistic effects of ethanol and carbachol on inducing acinar cell damage.

Results:  We found that atropine blocked almost completely pancreatic pathology caused by cerulein administration in ethanol‐fed rats, while vagotomy was less effective. Ethanol feeding did not alter expression levels of cholinergic muscarinic receptors in the pancreas but significantly decreased pancreatic acetylcholinesterase activity, suggesting that acetylcholine levels and cholinergic input within the pancreas can be higher in ethanol‐fed rats. We further found that ethanol treatment of pancreatic acinar cells augmented pancreatic injury responses caused by the cholinergic agonist, carbachol.

Conclusion:  These results demonstrate key roles for the cholinergic system in the mechanisms of alcoholic pancreatitis.
Recovered Medical Error Inventory
Authors: Dykes Patricia C. , Rothschild Jeffrey M. , Hurley Ann C.
Published: July 2010

Purpose: To describe the development and psychometric testing of the Recovered Medical Error Inventory (RMEI).

Design and Methods: Content analysis of structured interviews with expert critical care registered nurses (CCRNs) was used to empirically derive a 25‐item RMEI. The RMEI was pilot tested with 345 CCRNs. The data set was randomly divided to use the first half for reliability testing and the second half for validation. A principal components analysis with Varimax rotation was conducted. Cronbach's alpha values were examined. A t test and Pearson correlation were used to compare scores of the two samples.

Findings: The RMEI consists of 25 items and two subscales. Evidence for initial reliability includes a total scale alpha of .9 and subscale alpha coefficients of .88 (mistake) and .75 (poor judgment).

Conclusions: The RMEI subscales have satisfactory internal consistency reliability and evidence for construct validity. Additional testing is warranted.

Clinical Relevance: A tool to measure CCRNs’ experiences with recovering medical errors allows quantification of nurse surveillance in promoting safe care and preventing unreimbursed hospital costs for treating nosocomial events.
Cardiovascular Conditions and the Evaluation of the Heart in Pregnancy‐Associated Autopsies
Authors: Herbst Jonathon , Winskog Calle , Byard Roger W.
Published: July 2010

Abstract:  Pregnancy‐associated death is defined as the death of a woman from any cause during pregnancy or in the year after delivery. This review concentrates on cardiac conditions that may result in pregnancy‐associated death including, but not limited to, acute myocardial infarction, endocarditis, peripartum cardiomyopathy, and prolonged QT syndrome. Lethal vascular conditions may also occur involving arterial dissection and thromboembolism, on occasion exacerbated by hypercoagulability, and altered hormonal and physiologic states. The autopsy evaluation of these patients includes a careful assessment of the medical history particularly for prior pregnancy‐related conditions, fetal loss, and episodes of unexplained collapse. A family history of sudden death at an early age may be significant. At autopsy, evaluation for underlying syndromes such as Marfan, or evidence of intravenous narcotism should be undertaken. Autopsy examination involves careful dissection of the heart and vessels with consideration of conduction tract studies and possible genetic evaluation for prolonged QT syndrome.
Age Estimation from the Teeth Using a Modified Demirjian System*
Authors: Blenkin Matthew R. B. , Evans Wendell
Published: July 2010

Abstract:  The estimation of age at time of death is often an important step in the identification of human remains. The purpose of this study was to test the applicability of the Demirjian system on a sample of the Sydney child population and to develop and test age‐prediction models using a large sample of Sydney children (1624 girls, 1637 boys). The use of the Demirjian standards resulted in consistent overestimates of chronological age in children under the age of 14 by as much as a mean of 0.99 years. Of the alternative predictive models derived from the Sydney sample, those that provided the most accurate age estimates are applicable for the age ranges 2–14 years, with R‐square = 0.94 and a 95% confidence interval of ±1.8 years. The Sydney‐based standards provided significantly different and more accurate estimates of age for that sample when compared to the published standards of Demirjian.
Root Morphology and Anatomical Patterns in Forensic Dental Identification: A Comparison of Computer‐Aided Identification with Traditional Forensic Dental Identification*
Authors: Van Der Meer Dirk T. , Brumit Paula C. , Schrader Bruce A. , Dove Stephen B. , Senn David R.
Published: July 2010

Abstract:  An online forensic dental identification exercise was conducted involving 24 antemortem–postmortem (AM–PM) dental radiograph pairs from actual forensic identification cases. Images had been digitally cropped to remove coronal tooth structure and dental restorations. Volunteer forensic odontologists were passively recruited to compare the AM–PM dental radiographs online and conclude identification status using the guidelines for identification from the American Board of Forensic Odontology. The mean accuracy rate for identification was 86.0% (standard deviation 9.2%). The same radiograph pairs were compared using a digital imaging software algorithm, which generated a normalized coefficient of similarity for each pair. Twenty of the radiograph pairs generated a mean accuracy of 85.0%. Four of the pairs could not be used to generate a coefficient of similarity. Receiver operator curve and area under the curve statistical analysis confirmed good discrimination abilities of both methods (online exercise = 0.978; UT‐ID index = 0.923) and Spearman’s rank correlation coefficient analysis (0.683) indicated good correlation between the results of both methods. Computer‐aided dental identification allows for an objective comparison of AM–PM radiographs and can be a useful tool to support a forensic dental identification conclusion.
The Reliability of Visually Comparing Small Frontal Sinuses*
Authors: Smith Victoria A. , Christensen Angi M. , Myers Sarah W.
Published: July 2010

Abstract: Several studies have investigated frontal sinus comparison for personal identification. One study addressed the statistical reliability of correct identification using automated digital methods and resulted in a 96% accuracy rate. Missed matches with the digital methods generally involved small, less featured sinuses. This study investigates the hypothesis that human examiners may be able to more accurately identify correct matches than digital methods, even when the comparisons involve small frontal sinuses. Participants were provided two sets of 28 radiographs and were instructed to identify matching radiographs and list the radiographs that did not have a corresponding match. Overall, error rates were low, with correct associations identified at a rate of 0.983. No incorrect associations (“false positives”) were made. Correct association rates were highest among participants “experienced” examining radiographs. Results support previous assertions that frontal sinus radiographs are a reliable means of personal identification even when the frontal sinuses are small.
Somatostatin receptor biology in neuroendocrine and pituitary tumours: part 1 – molecular pathways
Authors: Cakir Mehtap , Dworakowska Dorota , Grossman Ashley
Published: July 2010

Introduction

The somatostatin receptor as a GPCR

Anti‐tumour effects of somatostatin

Post‐receptor signalling pathways

Neuroendocrine tumours (NETs) may occur at many sites in the body although the majority occur within the gastroenteropancreatic axis. Non‐gastroenteropancreatic NETs encompass phaeochromocytomas and paragangliomas, medullary thyroid carcinoma, anterior pituitary tumour, broncho‐pulmonary NETs and parathyroid tumours. Like most endocrine tumours, NETs also express somatostatin (SST) receptors (subtypes 1–5) whose ligand SST is known to inhibit endocrine and exocrine secretions and have anti‐tumour effects. In the light of this knowledge, the idea of using SST analogues in the treatment of NETs has become increasingly popular and new studies have centred upon the development of new SST analogues. We attempt to review SST receptor (SSTR) biology primarily in neuroendocrine tissues, focusing on pituitary tumours. A full data search was performed through PubMed over the years 2000–2009 with keywords ‘somatostatin, molecular biology, somatostatin receptors, somatostatin signalling, NET, pituitary’ and all relevant publications have been included, together with selected publications prior to that date. SSTR signalling in non‐neuroendocrine solid tumours is beyond the scope of this review. SST is a potent anti‐proliferative and anti‐secretory agent for some NETs. The successful therapeutic use of SST analogues in the treatment of these tumours depends on a thorough understanding of the diverse effects of SSTR subtypes in different tissues and cell types. Further studies will focus on critical points of SSTR biology such as homo‐ and heterodimerization of SSTRs and the differences between post‐receptor signalling pathways of SSTR subtypes.
High fat diet‐induced liver steatosis promotes an increase in liver mitochondrial biogenesis in response to hypoxia
Authors: Carabelli Julieta , Burgueño Adriana L. , Rosselli Maria Soledad , Gianotti Tomas Fernández , Lago Nestor R. , Pirola Carlos J. , Sookoian Silvia
Published: July 2010

Mitochondrial DNA (mtDNA) copy number plays a key role in the pathophysiology of metabolic syndrome‐related phenotypes, but its role in non‐alcoholic fatty liver disease (NAFLD) is not well understood. We evaluated the molecular mechanisms that may be involved in the regulation of liver mtDNA content in a high‐fat‐induced rat model of NAFLD. In particular, we tested the hypothesis that liver mtDNA copy number is associated with liver expression of HIF‐1α. Rats were given either standard chow diet (SCD, n= 10) or high‐fat diet (HFD, n= 15) for 20 weeks. Subsequently, mtDNA quantification using nuclear DNA (nDNA) as a reference was carried out using real time quantitative PCR. HFD induced a significant increase in liver mtDNA/nDNA ratio, which significantly correlated with the liver triglyceride content (R: 0.29, P < 0.05). The liver mtDNA/nDNA ratio significantly correlated with the hepatic expression of HIF‐1α mRNA (R: 0.37, P < 0.001); liver HIF‐1α mRNA was significantly higher in the HFD group. In addition, liver cytochrome c oxidase subunit IV isoform 1 (COX4I1) mRNA expression was also positively correlated with liver mtDNA content. The hepatic expression of mRNA of transcriptional factors that regulate mitochondrial biogenesis, including peroxisome proliferator‐activated receptor gamma coactivator‐1α (PGC‐1α) and PGC‐1β, nuclear respiratory factor‐1 (NRF‐1), peroxisome proliferator‐activated receptor δ and Tfam, was not associated with the liver mtDNA content. Neither hepatocyte apoptosis nor oxidative stress was involved in the HIF‐1α‐mediated increase in mtDNA copy number. In conclusion, we found that HFD promotes an increase in liver mitochondrial biogenesis in response to hypoxia via HIF‐1α, probably to enhance the mitochondrial function as well as to accommodate the metabolic load.
A support vector machine for decision support in melanoma recognition
Authors: Gilmore Stephen , Hofmann‐Wellenhof Rainer , Soyer H. Peter
Published: July 2010

Please cite this paper as: A support vector machine for decision support in melanoma recognition. Experimental Dermatology 2010; 19: 830–835.

Abstract:  The early diagnosis of melanoma is critical to achieving reduced mortality and increased survival. Although clinical examination is currently the method of choice for melanocytic lesion assessment, difficulties may arise in the diagnosis of atypical lesions. From both the naked eye and dermoscopic perspective, dysplastic naevi often exhibit a prominent heterogeneity of structure that renders their clinical distinction from melanoma difficult. To address these problems in diagnosis, there exists a heightened interest among researchers regarding the utility of machine learning techniques in computerised image analysis. Here we report on the utility, for dermatologists, of support vector machine (SVM) technology in melanoma diagnosis, using an archive of 199 digital dermoscopic images of excised atypical melanocytic lesions. Our best validation models achieved an average sensitivity and specificity for melanoma diagnosis of 0.86 and 0.72, respectively. Applying the best model to our test set yielded a sensitivity of 0.89, a diagnostic odds ratio of 14.09 and an area under the receiver operated characteristic curve (AUC) of 0.76. Advantages of the procedure implemented are the simplicity of feature extraction and the computationally cheap and efficient nature of SVMs. The derived model generalises well with outcomes that compare favourably with competing algorithms and expert assessment. In line with the concept of the utility of decision support systems in clinical practice, we propose that to reduce the risk of missed melanomas, both the dermatologists’ assessment and the SVM diagnosis be incorporated into the clinical decision‐making process.
Improved quantitative evaluation of atopic dermatitis by camera calibration and rectification of a stereo image
Authors: Lee Onseok , Yu Jaeseung , Lee Gunwoo , Park Gyuman , Kim Mingi , Oh Chilhwan
Published: July 2010

Background/Purpose:The aim of this study was to establish a scientific assessment method to evaluate the severity of atopic dermatitis (AD) by calibrating part of a previously described stereo‐image optical topometer (SOT).

Methods:The old SOT was created using a non‐convergence model. However, this study utilizes a convergence model. Camera calibration and rectification were performed using images obtained from stereo cameras. We attempted to verify the efficacy of AD treatment by objectively measuring the improvement in a group of subjects. Twenty AD patients with a variety of disease types were divided into a control group and a treatment group.

Results:The scoring of the AD (SCORAD) index did not show any improvements in the treated patients. However, when comparing the advanced SOT and the old SOT, we observed a decreased variation for five parameters, indicating that the treated patients experienced improved outcomes compared with controls. Most notably, we found that the coefficient of variation of the advanced SOT was lower than that of the old SOT.

Conclusion:We conclude that the advanced SOT may be useful for evaluating AD. The use of an advanced stereo image system may yield more reliable results than the old SOT system.
Neonatal intensive care utilization and neonatal outcome of infants born to women aged 40 years and over in New Zealand
Authors: Battin M , Sadler L ,   on behalf of the Australia and New Zealand Neonatal Network
Published: July 2010

Background:  Increased maternal age is associated with pregnancy complications and there are few data available on neonatal outcome and utilization of neonatal resources. Our first aim was to use national New Zealand data to determine if the outcomes following admission to NICU are different for infants born to women aged 40 years and over, compared with those born to women under 40 years of age. The second aim was to document trends in the requirement of neonatal intensive care in infants born to women aged 40 years and older.

Method:  Eligible infants were identified from registration with the Australian and New Zealand Neonatal Network for 1995–2004 inclusive. The relationship between maternal age and neonatal outcome was tested using univariate and multivariate analysis, and trends in the number of infants in maternal age groups below 35 years, 35–39 years and over 40 years were determined.

Results:  On multivariate analysis using logistic regression, maternal age over 40 years was not found to be associated with a significant increase in the odds ratio for the composite poor outcome. However, over the 10‐year period, there was an increase in the number of admissions and the percentage of admissions of infants born to women over 40 years of age.

Conclusion:  Although the number of infants admitted for neonatal care following birth to women over 40 years of age has increased, these infants do not appear to have an increased risk of severe abnormal outcome.
Structures of Virtue and Vice
Authors: Daly Daniel J.
Published: July 2010

The paper argues for new concepts in theological ethics: structures of virtue and structures of vice. The Catholic tradition's development of the ‘structures of sin’ in the 1970's and 80's was a significant contribution to magisterial teaching. However, this concept should be updated in light of the trajectory and concepts of post-Vatican II theological ethics. The article proceeds in two parts. Part one recapitulates the development of the concept of structures of sin in the Catholic tradition from the Second Vatican Council to Pope Benedict XVI's recent social encyclical, Caritas in veritate. Part two reflects on the findings of part one, and proceeds to define and defend the concepts structure of virtue and structures of vice. These related concepts more accurately capture the moral nature of social structures. Social structures have the capacity to produce just or unjust outcomes, and to play a significant role in the character formation of persons. Therefore, the structures of virtue and structures of vice are offered as insightful ways of discussing the moral status of social structures.
Bede Jarrett, Sir Ernest Barker and the Political Significance of the Dominican Order
Authors: O'Brien Nick
Published: July 2010

This article seeks to reappraise the scholarly work of Bede Jarrett OP by drawing out his debt to Sir Ernest Barker. A shared interest in medieval political and social institutions, and in the constitution of the Dominican Order as a model of voluntary association, infused Jarrett's thinking with the tenets of English political pluralism and enabled him to produce a body of work that paid as much attention to concrete political form as to social ethics. As such his work establishes links with nineteenth and early twentieth-century Christian Socialism, as well as echoing certain current preoccupations within political theology.
Nonstandard Work Schedules and Partnership Quality: Quantitative and Qualitative Findings
Authors: Mills Melinda , Täht Kadri
Published: July 2010

This article questions existing findings and provides new evidence about the consequences of nonstandard work schedules on partnership quality. Using quantitative couple data from The Netherlands Kinship Panel Study (NKPS) (N = 3,016) and semistructured qualitative interviews (N = 34), we found that, for women, schedules with varying hours resulted in greater relationship dissatisfaction than for men. Men with young children who worked varying hours had less relationship conflict and spent more time with children. Parents used nonstandard schedules for tag‐team parenting or to maintain perceptions of full‐time motherhood. The lack of negative effects, particularly for night shifts, suggests that previous findings—largely U.S. ones—are not universal and may be attributed to wider cultural, industrial relations, and economic contexts.
The Timing of Cohabitation and Engagement: Impact on First and Second Marriages
Authors: Stanley Scott M. , Rhoades Galena K. , Amato Paul R. , Markman Howard J. , Johnson Christine A.
Published: July 2010

Using a multistate sample of marriages that took place in the 1990s, this study examined associations between premarital cohabitation history and marital quality in first (N = 437) and second marriages (N = 200) and marital instability in first marriages (intact N = 521, divorced N = 124). For first marriages, cohabiting with the spouse without first being engaged or married was associated with more negative interaction, higher self‐reported divorce proneness, and a greater probability of divorce compared to cohabiting after engagement or marriage (with patterns in the same direction for marital positivity). In contrast, there was a general risk associated with premarital cohabitation for second marriages on self‐reported indices of marital quality, with or without engagement when cohabitation began.
Pyruvate:ferredoxin oxidoreductase and bifunctional aldehyde–alcohol dehydrogenase are essential for energy metabolism under oxidative stress in Entamoeba histolytica
Authors: Pineda Erika , Encalada Rusely , Rodríguez‐Zavala José S. , Olivos‐García Alfonso , Moreno‐Sánchez Rafael , Saavedra Emma
Published: July 2010

The in vitro Entamoeba histolytica pyruvate:ferredoxin oxidoreductase (EhPFOR) kinetic properties and the effect of oxidative stress on glycolytic pathway enzymes and fluxes in live trophozoites were evaluated. EhPFOR showed a strong preference for pyruvate as substrate over other oxoacids. The enzyme was irreversibly inactivated by a long period of saturating O2 exposure (IC50 0.034 mm), whereas short‐term exposure (< 30 min) leading to > 90% inhibition allowed for partial restoration by addition of Fe2+. CoA and acetyl‐CoA prevented, whereas pyruvate exacerbated, inactivation induced by short‐term saturating O2 exposure. Superoxide dismutase was more effective than catalase in preventing the inactivation, indicating that reactive oxygen species (ROS) were involved. Hydrogen peroxide caused inactivation in an Fe2+‐reversible fashion that was not prevented by the coenzymes, suggesting different mechanisms of enzyme inactivation by ROS. Structural analysis on an EhPFOR 3D model suggested that the protection against ROS provided by coenzymes could be attributable to their proximity to the Fe–S clusters. After O2 exposure, live parasites displayed decreased enzyme activities only for PFOR (90%) and aldehyde dehydrogenase (ALDH; 68%) of the bifunctional aldehyde–alcohol dehydrogenase (EhADH2), whereas acetyl‐CoA synthetase remained unchanged, explaining the increased acetate and lowered ethanol fluxes. Remarkably, PFOR and ALDH activities were restored after return of the parasites to normoxic conditions, which correlated with higher ethanol and lower acetate fluxes. These results identified amebal PFOR and ALDH of EhADH2 activities as markers of oxidative stress, and outlined their relevance as significant controlling steps of energy metabolism in parasites subjected to oxidative stress.
Plant nuclear proteomics – inside the cell maestro
Authors: Erhardt Matthias , Adamska Iwona , Franco Octavio Luiz
Published: July 2010

The eukaryotic nucleus is highly dynamic and complex, containing several subcompartments, several types of DNA and RNA, and a wide range of proteins. Interactions between these components within the nucleus form part of a complex regulatory system that is only partially understood. Rapid improvements in proteomics applications have led to a better overall determination of nucleus protein content, thereby enabling researchers to focus more thoroughly on protein–protein interactions, structures, activities, and even post‐translational modifications. Whereas proteomics research is quite advanced in animals, yeast and Escherichia coli, plant proteomics is only at the initial phase, especially when a single organelle is targeted. For this reason, this review focuses on the plant nucleus and its unique properties. The most recent data on the nuclear subproteome will be presented, as well as a comparison between the nuclei of plants and mammals. Finally, this review also evaluates proteins, identified by proteomics, that may contribute to our understanding of how the plant nucleus works, and proposes novel proteomics technologies that could be utilized for investigating the cell maestro.
Emergency physician credentialing for resuscitative thoracotomy for trauma
Authors: Fitzgerald Mark , Tan Gim , Gruen Russell , Smit De Villiers , Martin Kate , Newton‐Brown Emma , Luckhoff Carl , Maini Amit
Published: July 2010

Objective:  A low case incidence and variable skill level prompted the development of a credentialing programme and specific surgical training in resuscitative thoracotomy for emergency physicians at The Alfred, a Level 1 Adult Victorian Major Trauma Service.

Methods:  A review of the incidence of traumatic pericardial tamponade and the objectives of resuscitative thoracotomy were undertaken.

Results:  A training programme involving pre‐reading of a 17 page teaching manual, a 40 min didactic lecture and a 2 h surgical skills station using anaesthetized pigs were developed. The specific indication for resuscitative thoracotomy for this programme is ultrasound demonstrated cardiac tamponade secondary to blunt or penetrating truncal trauma in a haemodynamically unstable patient with a systolic blood pressure of less than 70 mmHg despite pleural decompression and intravenous volume replacement. Cardiac electrical activity must be present. The primary aims of resuscitative thoracotomy taught are release of cardiac tamponade, control of haemorrhage and access for internal cardiac massage.

Conclusion:  Emergency physicians working in high‐volume Trauma Centres are expected to diagnose cardiac tamponade and on occasion decompress the pericardium. Specific training in the procedure should be undertaken.
A physiological view of the central and peripheral mechanisms that regulate the release of catecholamines at the adrenal medulla
Authors: De Diego A. M. G. , Gandía L. , García A. G.
Published: July 2010

Here we review the tight neural control of the differential secretion into the circulation, of the adrenal medullary hormones adrenaline and noradrenaline. One or the other catecholamines are differentially released on various stress conditions. This is specifically controlled by central nervous system nuclei at the cortex, hypothalamus and spinal cord. Different firing patterns of splanchnic nerves and nicotinic or muscarinic receptors cause the selective release of noradrenaline or adrenaline, to adapt the body to the ‘fight or flight’ reaction, or during severe hypoglycaemia, haemorrhage, cold, acute myocardial infarction or other severe stressful conflicts. Endogenously acetylcholine (ACh) released at the splanchnic nerve‐chromaffin cell synapse, acting on muscarinic and nicotinic receptors, causes membrane depolarization and action potentials (AP) in chromaffin cells. These changes vary with the animal species, the cell preparation (intact bisected adrenal, adrenal slices, or isolated fresh or cultured cells) or the recording technique (intracellular microelectrodes, patch‐clamp, perforated‐patch, cell‐attached). Conflicting results leave many open questions concerning the actions of ACh on chromaffin cell excitability. The use of adrenal slices and field electrical stimulation will surely provide new insights into these mechanisms. Chromaffin cells have been thoroughly used as models to study the relationship between Ca2+entry, cytosolic Ca2+signals, exocytosis and endocytosis, using patch‐clamp and amperometric techniques. Cells have been stimulated with single depolarizing pulses (DPs), DP trains and with simulated AP waveforms. These approaches have provided useful information but we have no data on APs generated by pulsatile secretory quanta of ACh, trying to mimic the intermittent and repetitive splanchnic nerve discharge of the neurotransmitter. We present some recent experiments using ultrashort ACh pulses (25 ms), that cause non‐desensitizing repetitive APs with each ACh pulse, at low ACh concentrations (30 μm). Ultrashort pulses of a high ACh concentration (1000 μm) causes a single AP followed by a prolonged depolarization. It could be interesting trying to correlate these ‘patterns of splanchnic nerve discharge’ with Ca2+signals and exocytosis. This, together with the use of adrenal slices and transmural electrical stimulation of splanchnic nerves will provide new physiologically sound data on the regulation of adrenal medullary secretion.
Secretory granule behaviour adjacent to the plasma membrane before and during exocytosis: total internal reflection fluorescence microscopy studies
Authors: Holz R. W. , Axelrod D.
Published: July 2010

Our current notions of different granule pools, granule interaction with the plasma membrane, and ultimately granule and plasma membrane soluble N‐ethylmaleimide‐sensitive‐factor attachement protein (SNARE) interactions, result largely from inferences based upon biochemical alterations of secretion kinetics. Another view of events comes from studies using total internal reflection fluorescence microscopy (TIRFM) to investigate granule behaviour immediately adjacent to the plasma membrane. The motions of secretory (chromaffin) granules in bovine chromaffin cells visualized by TIRFM are highly restricted, as if granules are caged or tethered. These small motions are regulated by ATP and Ca2+, two factors that increase priming of the secretory response. There is no evidence that granules decrease their motion immediately before secretion. To the contrary, there is a tendency for granules to increase their motions and travel within a few hundred milliseconds of fusion. Hence, the notion of a long‐lived docked state as a prelude to fusion does not encompass the physical reality of molecular scale motions, multiple tethering states and significant travel immediately preceding the exocytotic event. Increased travel may increase the probability of granules interacting productively with the plasma membrane constituents, thereby, increasing the probability of fusion.
Risk factors for incident open‐angle glaucoma: a population‐based 20‐year follow‐up study
Authors: Ekström Curt
Published: July 2010

Purpose:  To study the effect of potential risk factors on the development of open‐angle glaucoma (OAG) in a population in which pseudoexfoliation (PEX) is a common finding.

Methods:  In 1984–1986, a population‐based survey of 760 people aged 65–74 years was conducted in the municipality of Tierp, Sweden. From 1988 to 2006, a follow‐up study of the 530 people with normal visual fields has been in progress. To increase the cohort, 273 ophthalmic outpatients were enroled. Reliable visual fields were available for 679 people, representing 6 126 person‐years at risk. A time‐weighted mean intraocular pressure (IOP) for all visits was calculated.

Results:  Sixty‐four subjects developed definite OAG, 29 of whom were exposed to PEX. Risk factors associated with OAG were higher age, a positive family history, increased IOP and PEX. The age‐standardized rate ratio (SRR) was 14.8 times (95% confidence interval [CI] 7.92–27.8) greater in subjects with mean IOP ≥20 mmHg than in those with mean IOP <20 mmHg. When subjects with IOP <20 mmHg at baseline were affected by PEX, the SRR increased 5.01‐fold (95% CI 1.97–12.8), compared with the unaffected group. However, when mean IOP at follow‐up was taken into account, there was no relationship between OAG and PEX as a distinct risk factor. Among participants in the population survey, 69% of all cases were attributable to a mean IOP ≥20 mmHg.

Conclusion:  Increased IOP and PEX were serious risk factors for incident OAG. The effect of PEX was mediated by increased IOP.
Bifocals in children with Down syndrome (BiDS) – visual acuity, accommodation and early literacy skills
Authors: Nandakumar Krithika , Leat Susan J.
Published: July 2010

Acta Ophthalmol. 2010: 88: e196–e204

Purpose:  Reduced accommodation is seen in children and young adults with Down syndrome (DS), yet providing bifocals has not become a routine clinical management. This study investigates the impact of bifocals on visual function, visual perceptual and early literacy skills in a group of school children with DS.

Methods:  In this longitudinal study, each child was followed for 5 months with single‐vision (SV) lenses after which bifocals were prescribed if required, based on their accommodative response. Visual acuity (VA), accommodation, perceptual and literacy skills were measured after adaptation to bifocals and 5 months later. Educational progress and compliance with spectacle wear were assessed through school and parental reports.

Results:  Fourteen children and young adults with DS participated in the study. Eighty‐five percent required bifocals with additions ranging from +1.00 D to +3.50 D. The mean near logMAR VA improved with bifocals (p = 0.007) compared to SV lenses. Repeated measures anova showed that there was more accurate focus (less accommodative lag) through the bifocals (p = 0.002), but no change in the accommodation exerted through the distance portion compared to SV lenses (p = 0.423). There was a main effect of time on sight words (p = 0.013), Word Identification (p = 0.047), Visual Closure (p = 0.006) and Visual Form Constancy (p = 0.001).

Conclusion:  Bifocals provide clearer near vision in DS children with reduced accommodation. This is shown by improved VA and decreased lag of accommodation. The results indicate that the improvement in VA results in improved scores in early literacy skills. Better compliance with bifocals over SV lenses was seen.
Multidisciplinary Optimization of a Car Component Under NVH and Weight Constraints Using RSM
Authors: Azadi Mohammad , Azadi Shahram , Zahedi Farshad , Moradi Mahmoud
Published: July 2010

One of the important challenges in the auto industry is to reduce the mass of the vehicle while meeting structural performance requirements for Crashworthiness, Noise, Vibration and Harshness (NVH) etc. In this paper, a multidisciplinary optimization (MDO) of a car back-bonnet is investigated by using the Response Surface Method (RSM). Firstly, a car body is fully surface modeled in CATIA and meshed in HYPERMESH software. Then, modal analysis of the finite element model is performed by NASTRAN software to find natural frequencies. Frequency map of that component is extracted and compared with a reference map to detect defects. Design of Experiments (DOE) methodologies is used for a screening of the design space and for the generation of approximation models using RSM techniques. Therefore, to optimize the model, improvement of the NVH behavior and minimization of the weight are imposed.