bluuebunny/crossref_metadata_2025 huggingface dataset:
Readmission to an acute psychiatric unit within 28 days of discharge: identifying those at risk
Authors: Callaly Thomas , Hyland Mary , Trauer Tom , Dodd Seetal , Berk Michael
Published: August 2010

Objective.To examine factors that could help identify those most at risk of readmission to an acute psychiatric in-patient unit within 28 days of a discharge.
Method.A detailed file audit was conducted comparing 54 consecutive patients who had been readmitted within 28 days of discharge with 61 patients, chosen at random, who had not been readmitted during the same period.
Results.Readmission within 28-days of discharge was associated with having been admitted in the previous year (P = 0.004), receiving the Disability Support Pension (P = 0.015), not having a discharge plan sent to the patient’s GP on discharge from the index admission (P = 0.05), receiving follow-up by the mental health team within 7 days of discharge (P = 0.007) and being unemployed (P = 0.015).
Conclusions.Targeting those with previous admissions for focussed discharge planning may help organisations reduce the numbers of unnecessary early readmissions.
What is known about the topic?Readmission within 28-days of discharge is being increasingly used by service funders and organisations as an indicator of the effectiveness of community care and of the organisation’s ability to provide continuous care across programs. Previous studies, mainly conducted in the US in the mid-90s, often reach contradictory conclusions and their relevance to the Australian setting is limited.
What does this paper add?This paper uses data from an Australia mental health service. It identifies patient and service characteristics associated with rapid re-admission and provides a baseline to evaluate strategies to reduce the readmission rate.
What are the implications for practitioners?This paper highlights the importance of careful discharge planning and communication with general practitioners particularly in relation to patients who have had previous admissions.
Barriers to comorbidity service delivery: the complexities of dual diagnosis and the need to agree on terminology and conceptual frameworks
Authors: Canaway Rachel , Merkes Monika
Published: August 2010

This paper draws from a literature review commissioned as part of a larger project evaluating comorbidity treatment service models, which was funded by the Australian Government Department of Health and Ageing as part of the National Comorbidity Initiative. The co-occurrence of mental health and substance use disorders (comorbidity) is a common and complex problem. This paper outlines conceptual and practical complexities and barriers associated with comorbidity treatment service delivery, particularly around the variable nature of comorbidity, and the impacts of the separation of the mental health (MH) and alcohol and other drug (AOD) sectors with their differing institutional cultures, aetiological concepts, philosophical underpinnings, educational requirements, administrative arrangements, and screening and treatment approaches. Issues pertaining to the lack of consistent definitions and conceptual frameworks for comorbidity are discussed, particularly in relation to the reported lack of communication, collaboration, and linkages between the sectors. It is suggested that the adoption of consistent terminology and conceptual frameworks may provide a valuable step towards consistency in service provision and research and could lead to improved capacity to address the many issues relating to comorbidity service provision and treatment efficacy.
What is known about the topic?The co-occurrence of mental health and substance use disorders (comorbidity) is a common and complex problem. However, the service system is not sufficiently developed and coordinated to serve clients with comorbid problems well.
What does this paper add?This paper summarises the issues pertaining to conceptual and practical complexities and barriers associated with comorbidity treatment service delivery, including the different aetiologies of comorbidity and types and settings of service providers.
What are the implications for practitioners?There is a need for practitioners and other stakeholders to agree on consistent terminology and framework(s) relevant to comorbidity to overcome the barriers and complexities that currently limit service delivery and access to treatment.
Do doctors, nurses and managers have different thinking styles?
Authors: Sladek Ruth M. , Bond Malcolm J. , Phillips Paddy A.
Published: August 2010

A study of the preferred thinking styles among senior health professionals is reported. A total of 49 medical consultants, 50 senior nurses and 53 health managers from two public teaching hospitals in Adelaide, Australia, were invited via a personal letter to complete a questionnaire comprising measures of thinking style (the Rational Experiential Inventory) and cognitive style (two dimensions of the Myers–Briggs Type Indicator®). Managers reported a higher preference for ‘rational’ reasoning than nurses, whereas medical consultants reported a lower preference for ‘experiential’ reasoning than both managers and nurses. Cognitive style was largely homogenous. Although generalisation of the findings may be limited due to small sample sizes and the self-selection of participants, an understanding of the thinking styles of senior health professionals will likely inform the design and evaluation of future change strategies. What is known about the topic?Research outcomes cannot change population health unless they are adopted, but changing the practices of healthcare workers to reduce ‘know–do’ gaps is not simple. Although there is some evidence to support professionally-oriented strategies such as educational outreach, audit and feedback and reminders, success is sometimes limited, potentially reflecting the limited use of theory in informing the choice of implementation strategies. Non-theoretical approaches may obscure the behavioural determinants of, and mechanisms for, change, making it impossible to generalise lessons learned form one situation to other contexts. What does this paper add?This paper highlights the growing recognition of the need for theory in this important field, and examines a psychological theory for its potential use. Findings provide useful preliminary descriptive data about thinking dispositions within and between three key groups of healthcare decision-makers: senior consultants, senior nurses and managers. It adds to a modest but accumulating research base that explores the tenets of a specified theory among healthcare professionals, reporting reliable differences between individuals in terms of cognitive processing (i.e. how they prefer to think). What are the implications for practitioners?Those faced with implementing change should consider theoretically-driven approaches in their selection of strategies. Based on the theory explored herein, two versions of a message, each targeting a different cognitive processing mode, should be more successful than one version only. This should be true for all three professional groups, and represents a testable strategy for future research.
The reported benefits of telehealth for rural Australians
Authors: Moffatt Jennifer J. , Eley Diann S.
Published: August 2010

Objective.A literature review was conducted to identify the reported benefits attributed to telehealth for people living and professionals working in rural and remote areas of Australia. Data sources.Scopus and relevant journals and websites were searched using the terms: telemedicine, telehealth, telepsychiatry, teledermatology, teleradiology, Australia, and each state and territory. Publications since 1998 were included. Study selection.The initial search resulted in 176 articles, which was reduced to 143 when research reporting on Australian rural, regional or remote populations was selected. Data synthesis.A narrative review was conducted using an existing ‘benefits’ framework. Patients are reported to have benefited from: lower costs and reduced inconvenience while accessing specialist health services; improved access to services and improved quality of clinical services. Health professionals are reported to have benefited from: access to continuing education and professional development; provision of enhanced local services; experiential learning, networking and collaboration. Discussion.Rural Australians have reportedly benefited from telehealth. The reported improved access and quality of clinical care available to rural Australians through telemedicine and telehealth may contribute to decreasing the urban–rural health disparities. The reported professional development opportunities and support from specialists through the use of telehealth may contribute to improved rural medical workforce recruitment and retention. What is known about the topic?An extensive international literature has reported on the efficacy of telehealth, and to a lesser extent the clinical outcomes and cost-effectiveness of telemedicine. Systematic reviews conclude that the quality of the studies preclude definitive conclusions being drawn about clinical and cost-effectiveness, although there is some evidence of effective clinical outcomes and the potential for cost-benefits. Little attention has been paid to the benefits reported for people who live in rural and remote Australia, despite this being a rationale for the use of telehealth in rural and remote locations. What does this paper add?Patients in rural and remote locations in Australia are reported to benefit from telehealth by increased access to health services and up-skilled health professionals. Health professionals are reported to benefit from telehealth by up-skilling from increased contact with specialists and increased access to professional development. The review findings suggest that one strategy, the increased use of telehealth, has the potential to reduce the inequitable access to health services and the poorer health status that many rural Australians experience, and contribute to addressing the on-going problem of the recruitment and retention of the rural health workforce. What are the implications for practitioners?The use of telehealth appears to be a path to up-skilling for rural and remote practitioners.
Evaluation of the impact of implementation of a Medical Assessment and Planning Unit on length of stay
Authors: Brand Caroline A. , Kennedy Marcus P. , King-Kallimanis Bellinda L. , Williams Ged , Bain Christopher A. , Russell David M.
Published: August 2010

Objective.The Medical Assessment and Planning Unit (MAPU) model provides a multidisciplinary and ‘front end loading’ approach to acute medical care. The objective of this study was to evaluate the impact of a 10-bed MAPU in Royal Melbourne Hospital (RMH) on hospital length of stay.
Methods.A pre-post study design was used. Cases were defined as all general medical patients admitted to the RMH between 1 August 2003 and 31 January 2004. MAPU patients were defined as general medical patients who had been discharged from RMH MAPU unit as part of their RMH inpatient admission. Historical controls were defined as all general medical patients admitted to the RMH between 1 August 2002 and 31 January 2003.
Results.There was a reduction in median length of stay that did not reach statistical significance. During the study period, median emergency department length of stay for MAPU patients was 10.3 h compared with 13.2 h for non-MAPU patients who were admitted directly to general wards.
Conclusions.The reductions in length of stay are likely to be of clinical significance at the emergency department (ED) level. The MAPU model also contributes to providing care appropriate care for older admitted patients.
What is known about the topic?There is increasing interest in models of acute medical management in public hospitals in Australia. One of the key factors driving interest in these models has been the need to improve patient flow to improve hospital efficiency and contribute to reducing bed access block. There are very little published data pertaining to the effectiveness of these models of care.
What does the paper add?The paper reports non-statistical, but probably important clinical reductions in hospital and ED length of stay using a before and after cohort analysis. It highlights the difficulties evaluating these models of care in the absence of well designed controlled studies and suggests evaluation of length of stay needs to be powered to detect small changes in ED efficiency rather than overall hospital length of stay.
What are the implications for practitioners?Practitioners in the area can draw on the results of this paper to design an acute medical planning unit and develop an evaluation framework.
L’expression des déplacements chez l’enfant sourd en langue des signes française
Authors: Sallandre Marie-Anne , Courtin Cyril , Fusellier Souza Ivani , L'Huillier Marie-Thérèse
Published: August 2010

L’expression des déplacements a fait l’objet de nombreuses recherches en acquisition des langues vocales et de quelques travaux dans plusieurs langues des signes, mais pas en langue des signes française (LSF). Ce travail est donc une première étude des déplacements en LSF par comparaison au français oral. Le corpus, issu de données plus vastes, est composé de trois études de cas provenant des productions d’un adulte sourd et de deux enfants sourds de 8 ans. L’analyse qualitative montre une densité sémantique importante dans les énoncés en LSF marquée par l’utilisation de deux structures à fort degré d’iconicité appelées transferts. Les transferts personnels expriment plutôt la manière tandis que les transferts situationnels expriment simultanément la trajectoire et la manière, alors qu’en français, le verbe exprime le plus souvent la trajectoire seule, la manière devant être exprimée par un élément externe. De plus, les sujets sourds enchaînent quasi systématiquement deux structures pour exprimer deux points de vue sur un même déplacement, ce qui ne se retrouve pas fréquemment en français. Ainsi, cette première étude montre peu de différences entre les sujets enfants et adulte en LSF, mais des différences notables entre français et LSF.
Prosodie et acquisition de la langue des signes française
Authors: Limousin Fanny , Blondel Marion
Published: August 2010

L’étude présentée ici vise à déterminer les paramètres gestuels de la prosodie et leur évolution dans deux études longitudinales, celle d’une enfant sourde (LSF) et celle d’une enfant entendante bilingue (français-LSF), entre 8 et 25 mois. Nous proposons que l’intensité, la fréquence et la durée sont des paramètres prosodiques pertinents pour l’étude des gestes vocaux, manuels et non-manuels. Nous soulignons les tendances dans les changements progressifs de la structure prosodique observés dans ces deux études de cas : un changement continu dans la combinaison des articulations manuelles et non-manuelles avec des frontières d’unités dessinées de façon de plus en plus précise et une maîtrise de plus en plus grande des valeurs contrastées de durée, d’amplitude et de tension musculaire. L’acquisition précoce présente des séquences spécifiques qu’on ne retrouve pas chez l’adulte et offre ainsi un effet loupe sur les patrons prosodiques émergents.
Giant planar Hall effect in pulsed laser deposited permalloy films
Authors: Roy Arnab , Anil Kumar P S
Published: August 2010

Ni80Fe20 thin films with high orientation were grown on Si(1 0 0) using pulsed laser ablation. The anisotropic magnetoresistance (AMR) and the planar Hall measurements show a 2.5% resistance anisotropy and a 45% planar Hall voltage change for magnetic field sweep of 10 Oe. The planar Hall sensitivity dR/dH was found to be 900 Ω T−1 compared with a previously reported maximum of 340 Ω T−1 in the same system. Also these films are found to withstand repeated thermal cycling up to 110 °C and the Hall sensitivity remains constant within this temperature range. This combination of properties makes the system highly suitable for low magnetic field sensors, particularly in geomagnetic and biosensor applications. To elucidate this, we have demonstrated that these sensors are sensitive to Earth's magnetic field. These results are compared with the sputter deposited films which have a very low AMR and planar Hall voltage change as compared with the films grown by PLD. The possible reasons for these contrasting characteristics are also discussed.
Dielectric function and optical properties of Al-rich AlInN alloys pseudomorphically grown on GaN
Authors: Sakalauskas E , Behmenburg H , Hums C , Schley P , Rossbach G , Giesen C , Heuken M , Kalisch H , Jansen R H , Bläsing J , Dadgar A , Krost A , Goldhahn R
Published: August 2010

A detailed discussion of the optical properties of Al-rich Al1−x
In
x
N alloy films is presented. The (0 0 0 1)-oriented layers with In contents between x = 0.143 and x = 0.242 were grown by metal-organic vapour phase epitaxy on thick GaN buffers. Sapphire or Si(1 1 1) served as the substrate. High-resolution x-ray diffraction revealed pseudomorphic growth of the nearly lattice-matched alloys; the data analysis yielded the composition as well as the in-plain strain. The complex dielectric function (DF) between 1 and 10 eV was determined from spectroscopic ellipsometry measurements. The sharp onset of the imaginary part of the DF defines the direct absorption edge, while clearly visible features in the high-photon energy range of the DF, attributed to critical points (CPs) of the band structure, indicate promising crystalline quality of the AlInN layers. It is demonstrated that the experimental data can be well reproduced by an analytical DF model. The extracted characteristic transition energies are used to determine the bowing parameters for all CPs of the band structure. In particular, strain and the high exciton binding energies for the Al-rich alloys are taken into account in order to assess the splitting between the valence band with
symmetry and the
conduction band at the centre of the Brillouin zone. Finally, the compositional dependence of the high-frequency dielectric constants is reported.
Nanotube attachment for prevention of interfacial delamination
Authors: Mukhopadhyay Sharmila M , Karumuri Anil K
Published: August 2010

A new approach to suppressing interfacial delamination in composites has been investigated. It involves growing strongly attached nanotubes on the surface of the core phase prior to matrix infiltration. Unusually durable interfaces between epoxy and graphite have been demonstrated using this technique. Two types of graphitic core materials have been studied: complex cellular foams having open-interconnected porosity and highly oriented pyrolitic graphite (HOPG) providing a model flat interface. When untreated foam is infiltrated with epoxy, the resulting composite is brittle, and shatters before 10% compression. However, when carbon nanotubes (CNTs) are grown on the foam prior to epoxy infiltration, the specimen becomes pliable, and visibly flattens out rather than fracturing. Model studies on a flat graphite–epoxy interface were performed by joining two HOPG specimens with a thin layer of epoxy, and testing the flexural response of the ‘seam’ using the three-point bend test. The untreated HOPG sandwich fails easily, whereas nanotube-attached HOPG sandwich shows an over three times increase in flexural load-carrying capacity, close to that of seamless monolithic graphite having identical dimensions. Microscopic evaluations of fractured interfaces indicate that, in all geometries, CNT grafting prevents delamination at the graphite–epoxy interface, and forces any crack(s) to propagate through the graphitic phase. This added inter-laminar strength and toughness can be related to the hierarchical morphology of the interface created by CNT attachment, and unprecedented composite structures can be envisioned.
High temperature blocking force measurements of soft lead zirconate titanate
Authors: Webber Kyle G , Aulbach Emil , Rödel Jürgen
Published: August 2010

Piezoelectric actuators outperform other technological solutions in the area of high-speed, high-force and high-accuracy displacement, but are only able to generate strains of about 0.2%. The load capability is generally quantified in terms of a blocking force, which is the force sustained under electric field at zero displacement. Stress–strain curves in a temperature regime from room temperature up to 150 °C on electrically loaded soft lead zirconate titanate (PZT) are generated to determine the blocking stress. The ensuing nonlinear behaviour is discussed in terms of ferroelectric and ferroelastic switching and contrasted to idealized linear constitutive behaviour as often assumed by manufacturers. The blocking stress is shown to increase with temperature due to an additional stiffening effect as a function of electric field. The actual mechanical work done is found to be larger than in the idealized case where linear constitutive behaviour is assumed.
A study of conduction of ZnO film/p-Si heterojunction fabricated by photoinduced electrodeposition under illumination
Authors: Lee Jong Duk , Park Chang Young , Kim Hyeon Soo , Lee Jeoung Ju , Choo Yeon-Gyu
Published: August 2010

Thin ZnO films were directly grown on p-Si(1 0 0) substrates by photoinduced electrodeposition under illumination. In this case, p-Si wafer behaves as a photocathode. At the initial deposition stage, it has been found that the ZnO films grew through three-dimensional instantaneous nucleation followed by diffusion-limited growth mode. In this study, we report that the conductivity type of ZnO films can be changed from n-type to p-type by varying the relative concentration of oxygen in ZnO films through the thermal treatment in air ambient without any doping process. The electrical properties of ZnO/p-Si heterojunctions were investigated via current–voltage (I–V) characteristics. These heterojunctions showed good diode-like, rectifying I–V characteristics and the turn-on voltages of the n-ZnO/p-Si and p-ZnO/p-Si heterojunctions were found to be 0.56 and 0.46 V. From the analysis of temperature dependence of the I–V characteristics, these heterojunctions exhibited that the charge carriers are mainly transported by the activation of the carriers across the barrier height but in a low voltage region under forward bias, transported through the multi-step tunnelling-assisted carrier capture-emission mechanism.
Electrical properties of polymer/expanded graphite nanocomposites with low percolation
Authors: Goyal R K , Samant S D , Thakar A K , Kadam A
Published: August 2010

Expanded graphite (EG)-filled poly(phenylene sulfide) (PPS) nanocomposites prepared by a simple method exhibited an electrical conductivity percolation threshold of 1 wt% (0.6 vol%). In contrast to this, the percolation threshold of micrometre-sized graphite flake filled PPS composites prepared by the same method was 5 wt%. The electrical conductivity for 2 wt% nanocomposites increased 14 orders of magnitude higher than that of pure PPS. The dielectric constants and dissipation factor of nanocomposites were measured in a frequency range from 100 kHz to 15 MHz. The dielectric constant of the nanocomposites with more than 1 wt% EG showed a strong dependence on EG content and frequencies. The dielectric constants for 2 wt% and 10 wt% nanocomposites measured at 1 MHz were increased more than 102 and 105 times, respectively. Similarly, the dissipation factor was increased. Scanning electron microscopy showed a three-dimensional conducting network of EG across the PPS matrix which may be the reason for the significant improvement in electrical properties. The significantly increased electrical conductivity, dielectric constant and dissipation factor of the nanocomposites are favourable for their use in antistatic and electromagnetic interference shielding applications.
Deficiency in the Multicopy Sycp3-Like X-Linked Genes Slx and Slxl1 Causes Major Defects in Spermatid Differentiation
Authors: Cocquet Julie , Ellis Peter J. I. , Yamauchi Yasuhiro , Riel Jonathan M. , Karacs Thomas P. S. , Rattigan Áine , Ojarikre Obah A. , Affara Nabeel A. , Ward Monika A. , Burgoyne Paul S.
Published: August 2010

The human and mouse sex chromosomes are enriched in multicopy genes required for postmeiotic differentiation of round spermatids into sperm. The gene Sly is present in multiple copies on the mouse Y chromosome and encodes a protein that is required for the epigenetic regulation of postmeiotic sex chromosome expression. The X chromosome carries two multicopy genes related to Sly: Slx and Slxl1. Here we investigate the role of Slx/Slxl1 using transgenically-delivered small interfering RNAs to disrupt their function. We show that Slx and Slxl1 are important for normal sperm differentiation and male fertility. Slx/Slxl1 deficiency leads to delay in spermatid elongation and sperm release. A high proportion of delayed spermatids are eliminated via apoptosis, with a consequent reduced sperm count. The remaining spermatozoa are abnormal with impaired motility and fertilizing abilities. Microarray analyses reveal that Slx/Slxl1 deficiency affects the metabolic processes occurring in the spermatid cytoplasm but does not lead to a global perturbation of sex chromosome expression; this is in contrast with the effect of Sly deficiency which leads to an up-regulation of X and Y chromosome genes. This difference may be due to the fact that SLX/SLXL1 are cytoplasmic while SLY is found in the nucleus and cytoplasm of spermatids.
Circoletto: visualizing sequence similarity with Circos
Authors: Darzentas Nikos
Published: August 2010

Summary: We present Circoletto, an online visualization tool based on Circos, which provides a fast, aesthetically pleasing and informative overview of sequence similarity search results.

Availability and implementation: Online version and downloadable software package for offline use (source code in PERL) freely available at http://bat.ina.certh.gr/tools/circoletto/

Contact:  ndarz@certh.gr
Detecting two-locus associations allowing for interactions in genome-wide association studies
Authors: Wan Xiang , Yang Can , Yang Qiang , Xue Hong , Tang Nelson L. S. , Yu Weichuan
Published: August 2010

Motivation: Genome-wide association studies (GWASs) aim to identify genetic susceptibility to complex diseases by assaying and analyzing hundreds of thousands of single nucleotide polymorphisms (SNPs). Although traditional single-locus statistical tests have identified many genetic determinants of susceptibility, those findings cannot completely explain genetic contributions to complex diseases. Marchini and coauthors demonstrated the importance of testing two-locus associations allowing for interactions through a wide range of simulation studies. However, such a test is computationally demanding as we need to test hundreds of billions of SNP pairs in GWAS. Here, we provide a method to address this computational burden for dichotomous phenotypes.

Results: We have applied our method on nine datasets from GWAS, including the aged-related macular degeneration (AMD) dataset, the Parkinson's disease dataset and seven datasets from the Wellcome Trust Case Control Consortium (WTCCC). Our method has discovered many associations that were not identified before. The running time for the AMD dataset, the Parkinson's disease dataset and each of seven WTCCC datasets are 2.5, 82 and 90 h on a standard 3.0 GHz desktop with 4 G memory running Windows XP system. Our experiment results demonstrate that our method is feasible for the full-scale analyses of both single- and two-locus associations allowing for interactions in GWAS.

Availability:  http://bioinformatics.ust.hk/SNPAssociation.zip

Contact:  nelsontang@cuhk.edu.hk; eeyu@ust.hk;

Supplementary information:  Supplementary data are available at Bioinformatics online.
The acoustic identification and enumeration of scyphozoan jellyfish, prey for leatherback sea turtles (Dermochelys coriacea), off central California
Authors: Graham Tanya R. , Harvey James T. , Benson Scott R. , Renfree Josiah S. , Demer David A.
Published: August 2010

Graham, T. R., Harvey, J. T., Benson, S. R., Renfree, J. S., and Demer, D. A. 2010. The acoustic identification and enumeration of scyphozoan jellyfish, prey for leatherback sea turtles (Dermochelys coriacea), off central California. – ICES Journal of Marine Science, 67: 1739–1748. Acoustic-sampling techniques were developed to estimate the abundance and distribution of scyphozoan jellyfish, prey for leatherback turtles foraging off central California. Acoustic data were analysed from regions where jellyfish were present or absent from corresponding net tows. Empirical data on bell-diameter distribution (mean 26.2 cm; s.d. 10.6) were used to estimate target strength (TS; dB re 1 m2) at 18, 38, 70, 120, and 200 kHz using a distorted-wave Born approximation scattering model. TS measurements of in situ animals at 38 and 200 kHz averaged −63.9 and −70.5 dB, compared with the model estimates of −54.9 and −64.0 dB, respectively. The model estimates of TS at 18, 70, and 120 kHz were −53.9, −59.9, and −61.8 dB, respectively. Using these TS estimates, an algorithm was developed to extract jellyfish echoes from total acoustic backscatter. Echo-integration methods applied to regions where net catches contained jellyfish resulted in an estimate of mean numerical abundance of 3217 jellyfish (s.d. 2276) with a mean density of 251 522 jellyfish nautical mile−2 (s.d. 57 504) and a mean concentration of 0.003 jellyfish m−3 (s.d. 0.002). The novel methods developed will help characterize prey resources for leatherback turtles off central California.
Changes in fish stocks in an Estonian estuary: overfishing by cormorants?
Authors: Vetemaa Markus , Eschbaum Redik , Albert Anu , Saks Lauri , Verliin Aare , Jürgens Kristiina , Kesler Martin , Hubel Kalvi , Hannesson Rögnvaldur , Saat Toomas
Published: August 2010

Vetemaa, M., Eschbaum, R., Albert, A., Saks, L., Verliin, A., Jürgens, K., Kesler, M., Hubel, K., Hannesson, R., and Saat, T. 2010. Changes in fish stocks in an Estonian estuary: overfishing by cormorants? – ICES Journal of Marine Science, 67: 1972–1979. In Estonia, the cormorant Phalacrocorax carbo sinensis is a newcomer, and its numbers have increased rapidly since 1985. In the shallow protected (no fishery) Käina Bay in Väinameri (West Estonia), the colony was established in 1995. Gillnet sampling indicated that roach was the most abundant spawning fish species in 1995. Ten years later, when the study was repeated, the catch per unit effort was already more than 100 times lower than in 1995. The number of spawning perch decreased tenfold from 1995 to 2005. During the same period, commercial fishing effort in the entire Väinameri area decreased several times. The change in fish abundance in the Käina Bay and in the coastal fish-monitoring areas in the archipelago sea nearby, together with an analysis of food of cormorants, indicates that the decline in fish abundance might be related to the increased numbers of cormorants. The conclusion is drawn that the establishment of a cormorant colony could have seriously damaged or even prevented normal functioning of historically important spawning grounds and affected fish recruitment to adjacent areas. Therefore, expanding bird colonies might play a role similar to an expanding fishing fleet, by overexploiting the resource.
Anesthesia Management for Robotically Assisted Endoscopic Coronary Artery Bypass Grafting on Beating Heart
Authors: Wang Gang , Gao Changqing , Zhou Qi , Chen Tingting
Published: August 2010

Objective

To outline the initial anesthetic experience for robotically assisted coronary artery bypass grafting surgery on beating heart using the da Vinci surgical system.

Methods

Between February 2007 and September 2009, 76 patients received the surgery with the da Vinci S Surgical System. The crucial issue of anesthesia for the surgery is to deal with the hemodynamic compromise, hypoxia and hypercarbia relevant to one-lung ventilation (OLV), and intrathoracic insufflation of CO2 with positive pressure (CO2 pneumothorax).

Results

After initiation of OLV and CO2 pneumothorax, PaO2 and mixed venous saturation showed a significant decrease. Meanwhile, the SpO2 decreased to 92% in 14 of the 76 patients. In these patients, application of continuous positive airway pressure setting 5 to 15 cm H2O to the collapsed lung resulted in an increase in PaO2 from 59 ± 12 to 115 ± 23 mm Hg (P < 0.05). Moreover, at the beginning of CO2 pneumothorax, the most dramatic fall in mean arterial pressure and cardiac index was showed with an increase in mean pulmonary artery pressure and heart rate. The hemodynamic compromise was counteracted by transfusion and inotropes/vasopressors. Postoperatively, the average extubation time was 7.5 ± 3.1 hours, and median intensive care unit length of stay was 21 hours. One patient remained in the intensive care unit for 3 days for treatment of a postoperative pneumonia. There were two cases of new onset postoperative atrial fibrillation. All patients were discharged home 4 to 7 days after surgery.

Conclusions

Anesthetic management for the procedures requires detailed knowledge of OLV and CO2 pneumothorax in addition to expertise required in conventional cardiac surgery.
Robot-Assisted Mitral Valve Repair a Single Institution Review
Authors: Bhamidipati Castigliano M. , Mehta Gaurav S. , Sarwar Muhammad F. , Sooppan Renganaden , Dilip Karikehalli A. , Lutz Charles J.
Published: August 2010

Objective

Mitral valve repair (MVR) is the definitive therapy for mitral myxomatous degeneration. Median sternotomy has been the traditional approach to repair until the advent of the da Vinci Surgical System (Intuitive Surgical, Inc., Sunnyvale, CA). Minimally invasive surgical approaches for mitral repair have been slow to gain acceptance in cardiac surgery. We review the MVR results from our single-institution academic robotic program.

Methods

From August 2004 through April 2008, patients who underwent a robotic-assisted (RA) MVR were identified. RA technique included a 4-cm right minithoracotomy, femoral cardiopulmonary bypass with transthoracic aortic occlusion, and RA-MVR. Repair types were combinations of quadrangular/triangular leaflet resection, sliding plasty, chordal transfer/replacement, and edge-to-edge approximation, with band annuloplasty in all cases. Postrepair echocardiography and morbidity follow-ups were completed in all patients. Our primary outcome was adequacy of repair, and secondary outcome was major complications.

Results

There were 43 patients (29 male and 14 female) who underwent RA-MVR for severe (4 +) mitral regurgitation during the 4-year review. Average operative time was 272.26 minutes. Only one patient had mild postoperative mitral regurgitation, whereas 20 had trace and 22 had no regurgitation after repair. Mean ventilator time was 32.1 hours, and length of stay was 5.7 days. One third of the patients (33%) received postoperative-packed red blood cell transfusions (average: 2.4 units per patient). Twenty-eight percent of patients developed atrial fibrillation after repair. Most of the patients (95.3%) were discharged home. There were no 30-day mortalities.

Conclusions

Based on our small single-institution experience, RA-MVR provides an effective treatment for severe mitral valve regurgitation. Although procedure durability is slowly being established, preliminary results are promising. Careful programmatic advances with an integrated team approach can facilitate acceptable postoperative outcomes and excellent MVR.
Long-term Monitoring for Patients after Surgical Ablation of Atrial Fibrillation Are All Devices the Same?
Authors: Henry Linda , Ad Niv
Published: August 2010

In recent years, the nonmedical management of atrial fibrillation (AF) has rapidly evolved, with more options available to address the arrhythmia. Determining the successful return of sinus rhythm and the medical management after ablation requires the selection of the correct diagnostic method. In May 2007, the Heart Rhythm Society in conjunction with the Society for Thoracic Surgeons, the European Heart Rhythm Association, and the European Cardiac Arrhythmia Society identified the need for programs to adopt a consistent method of follow-up and monitoring. Choosing the right monitor for the determination of the success, postsurgical ablation that meets the Heart Rhythm Society guidelines for monitoring especially for asymptomatic patients is imperative. Therefore, we reviewed the current devices available to assist practitioners in determining which monitor best meets their needs The criteria selected to perform the review include (1) ease of use for patients (compliance), (2) ability of the monitor to perform internal analysis, (3) the monitor has >24 hours of storage capability, and (4) external support. Our selection criteria revealed six cardiac rhythm monitors currently available for use. This review compared the different arrhythmia monitors from an established monitoring program perspective to assist practitioners in choosing a monitor that meets their practice needs for determining the return to sinus rhythm postsurgical ablation.
Prospective, Randomized Study Comparing Two Different Minimized versus Conventional Cardiopulmonary Bypass Systems
Authors: Schoenebeck Jeannette , Haddad Munif , Wegscheider Karl , Joubert-Huebner Elrina , Reichenspurner Hermann , Detter Christian
Published: August 2010

Objective

Conventional cardiopulmonary bypass (CCPB) is a major trigger of inflammatory response. We aimed to assess the impact of two different minimized cardiopulmonary bypass systems (mini-CPB) with and without Bioline-coating compared with CCPB regarding organ function, inflammatory response, and early clinical outcome.

Methods

In a prospective, randomized study, 120 patients underwent elective coronary artery bypass grafting and were randomized into three groups: mini-CPB using a Bioline-coated (group A, n = 40) or an uncoated (group B, n = 40) circuit, or CCPB (group C, n = 40). Cytokines (interleukin-6, interleukin-8, and tumor necrosis factor-alpha), myocardial markers (creatine kinase [CK], CK-MB, and troponin-T), hematocrit, and platelet counts were measured up to 48 hours postoperatively. Early clinical outcome was assessed at 3 months postoperatively.

Results

Demographics, number of distal anastomoses, ventilation time, blood loss, intensive care unit, and hospital stay were comparable (P = not significant). Extracorporeal circulation and cross-clamp time were significantly longer in group A and B versus C (P < 0.005). No significant differences could be found in the release of interleukin-6, interleukin-8, and tumor necrosis factor-alpha among groups. Myocardial markers were significantly reduced in group A and B versus group C (P < 0.001). Hematocrit and platelet counts did not differ among the groups. No differences could be found in early clinical outcome up to 3 months.

Conclusions

This study showed significant better myocardial preservation with lower CK-MB and troponin-T levels in both mini-CPB groups. No significant differences could be found in terms of inflammation, hematologic effects, and early clinical outcome.
Third-Generation Continuous Flow Left Ventricular Assist Devices
Authors: Nguyen Duc Q. , Thourani Vinod H.
Published: August 2010

Tremendous advances have been made in the treatment of end-stage heart failure patients with left ventricular assist devices (LVADs). An important factor playing a role in the improved clinical outcomes is the development of continuous flow, rotary LVADs. New technology using magnetic levitation and hydrodynamic suspension to eliminate contact bearings offers the potential of more durable and efficacious mechanical circulatory blood pumps. Clinical trials evaluating these novel “third-generation” LVADs are in progress.
Totally Endoscopic Robotic Ventricular Septal Defect Repair
Authors: Gao Changqing , Yang Ming , Wang Gang , Wang Jiali , Xiao Cangsong , Zhao Yue
Published: August 2010

Objective

Recent advances in robotic instrumentation have facilitated totally endoscopic intracardiac procedures. However, totally endoscopic robotic ventricular septal defect (VSD) repair has not been reported in the literatures to our knowledge. We report our first three cases of closed chest VSD repair using da Vinci S Surgical System.

Methods

Three female patients underwent totally endoscopic robotic VSD repair. Echocardiography demonstrated that the perimembranous VSD sizes in three patients were 6, 8, and 8 mm, respectively, and a patent foramen ovale in one patient.

Results

All the VSD repair and right atrial closure were completed with the da Vinci robot. Mean cardiopulmonary bypass and mean cross-clamp times were 70 and 22 minutes, respectively. No blood transfusions were received. Postoperative transesophagel echocardiogram (TEE) demonstrated intact ventricular septum. The mean hospital stay was 5 days. The patients returned to normal function without any complications.

Conclusions

With a limited number of cases, the study showed that totally endoscopic robotic VSD repair in adult patients is feasible and safe.
Surgical Removal of Duct Occluder Device under Mild Hypothermia without Cardiopulmonary Bypass
Authors: Mohite Prashant N. , Kuthe Sachin A. , Thingnam Shyam K. , Rohit Manoj K. , Mahajan Sachin , Mahajan Rajiv
Published: August 2010

Because the use of percutaneous intervention is increasing for the closure of the patent ductus arteriosus, the procedure-related complications are also on rise, with migration of the device being most common. The routine practice is to remove the migrated duct occluder device under cardiopulmonary bypass. Amplatzer duct occluder used in a 4-month-old infant dislodged into the descending thoracic aorta. It was removed by the posterolateral thoracotomy under mild hypothermia through juxtaductal aortotomy between the aortic cross-clamps. The use of cardiopulmonary bypass is thus avoided.
A Completely Detachable Aortic Clamping Instrument for Minimally Invasive Cardiac Surgery
Authors: Glauber Mattia , Karimov Jamshid H.
Published: August 2010

A minimally invasive cardiac surgery is becoming more popular and is still undergoing a refinement of surgical techniques and dedicated instrumentarium as well. New specifically designed instruments are quintessence of safe surgery with improving operative outcomes and comfortable operator-oriented working conditions. In this article, we attempt to present our early clinical experience with a new aortic clamping instrument specifically developed for limited single-access minimally invasive valve surgery.
A ChIP-seq defined genome-wide map of vitamin D receptor binding: Associations with disease and evolution
Authors: Ramagopalan Sreeram V. , Heger Andreas , Berlanga Antonio J. , Maugeri Narelle J. , Lincoln Matthew R. , Burrell Amy , Handunnetthi Lahiru , Handel Adam E. , Disanto Giulio , Orton Sarah-Michelle , Watson Corey T. , Morahan Julia M. , Giovannoni Gavin , Ponting Chris P. , Ebers George C. , Knight Julian C.
Published: August 2010

Initially thought to play a restricted role in calcium homeostasis, the pleiotropic actions of vitamin D in biology and their clinical significance are only now becoming apparent. However, the mode of action of vitamin D, through its cognate nuclear vitamin D receptor (VDR), and its contribution to diverse disorders, remain poorly understood. We determined VDR binding throughout the human genome using chromatin immunoprecipitation followed by massively parallel DNA sequencing (ChIP-seq). After calcitriol stimulation, we identified 2776 genomic positions occupied by the VDR and 229 genes with significant changes in expression in response to vitamin D. VDR binding sites were significantly enriched near autoimmune and cancer associated genes identified from genome-wide association (GWA) studies. Notable genes with VDR binding included IRF8, associated with MS, and PTPN2 associated with Crohn's disease and T1D. Furthermore, a number of single nucleotide polymorphism associations from GWA were located directly within VDR binding intervals, for example, rs13385731 associated with SLE and rs947474 associated with T1D. We also observed significant enrichment of VDR intervals within regions of positive selection among individuals of Asian and European descent. ChIP-seq determination of transcription factor binding, in combination with GWA data, provides a powerful approach to further understanding the molecular bases of complex diseases.
The sensitivity of memory consolidation and reconsolidation to inhibitors of protein synthesis and kinases: Computational analysis
Authors: Zhang Yili , Smolen Paul , Baxter Douglas A. , Byrne John H.
Published: August 2010

Memory consolidation and reconsolidation require kinase activation and protein synthesis. Blocking either process during or shortly after training or recall disrupts memory stabilization, which suggests the existence of a critical time window during which these processes are necessary. Using a computational model of kinase synthesis and activation, we investigated the ways in which the dynamics of molecular positive-feedback loops may contribute to the time window for memory stabilization and memory maintenance. In the models, training triggered a transition in the amount of kinase between two stable states, which represented consolidation. Simulating protein synthesis inhibition (PSI) from before to 40 min after training blocked or delayed consolidation. Beyond 40 min, substantial (>95%) PSI had little effect despite the fact that the elevated amount of kinase was maintained by increased protein synthesis. However, PSI made established memories labile to perturbations. Simulations of kinase inhibition produced similar results. In addition, similar properties were found in several other models that also included positive-feedback loops. Even though our models are based on simplifications of the actual mechanisms of molecular consolidation, they illustrate the practical difficulty of empirically measuring “time windows” for consolidation. This is particularly true when consolidation and reconsolidation of memory depends, in part, on the dynamics of molecular positive-feedback loops.
Crystallization and preliminary X-ray studies of a galactose-specific lectin from the seeds of bitter gourd (Momordica charantia)
Authors: Chandran Thyageshwar , Sharma Alok , Vijayan M.
Published: August 2010

A galactose-specific lectin from the seeds of bitter gourd (Momordica charantia) is a four-chain type II ribosome-inactivating protein (RIP) resulting from covalent association through a disulfide bridge between two identical copies of a two-chain unit. The available structural information on such four-chain RIPs is meagre. The bitter gourd lectin was therefore crystallized for structural investigation and the crystals have been characterized. It is anticipated that the structure of the orthorhombic crystals will be analysed using molecular replacement by taking advantage of its sequence, and presumably structural, homology to normal two-chain type II RIPs.
Crystallization and preliminary X-ray analysis of PaaAC, the main component of the hydroxylase of theEscherichia coliphenylacetyl-coenzyme A oxygenase complex
Authors: Grishin Andrey M. , Ajamian Eunice , Zhang Linhua , Cygler Miroslaw
Published: August 2010

TheEscherichia coli paaoperon encodes enzymes of the phenylacetic acid-utilization pathway that metabolizes phenylacetate in the form of a coenzyme A (CoA) derivative. The phenylacetyl-coenzyme A oxygenase complex, which has been postulated to contain five components designated PaaABCDE, catalyzes ring hydroxylation of phenylacetyl-CoA. The PaaAC subcomplex shows low sequence similarity to other bacterial multicomponent monooxygenases (BMMs) and forms a separate branch on the phylogenetic tree. PaaAC, which catalyzes the hydroxylation reaction, was purified and crystallized in the absence of a bound ligand as well as in complexes with CoA, 3-hydroxybutyryl-CoA, benzoyl-CoA and the true substrate phenylacetyl-CoA. Crystals of the ligand-free enzyme belonged to space groupP212121and diffracted to 2.65 Å resolution, whereas complexes with CoA and its derivatives crystallized in space groupP41212 and diffracted to ∼2.0 Å resolution. PaaAC represents the first crystallized BMM hydroxylase that utilizes a CoA-linked substrate.