bluuebunny/crossref_metadata_2025 huggingface dataset:
Flexible family visitation in the intensive care unit: nurses’ decision‐making
Authors: Ågård Anne Sophie , Lomborg Kirsten
Published: October 2010

Aims and objectives.  To identify and explore general strategies used by Danish intensive care unit nurses in everyday decision‐making about family visitation.

Background.  In the intensive care unit, relatives experience a strong commitment to watch over and protect the patient. Relatives can provide important help and support to their loved one. To do so, relatives need to be able to stay, preferably at the bedside. Managing a flexible visitation policy, nurses play an important role as gate‐keepers at the bedside requiring strong discretionary power. Little is known about the rationale for nurses’ decision making when allowing family members to stay by the patient’s bedside or asking them to leave the unit.

Design.  Explorative qualitative interview study.

Method.  In 2005 and 2008, we conducted a grounded theory study based on 11 semi‐structured interviews with intensive care unit nurses.

Results.  In the constantly shifting social context of the intensive care unit, nurses practiced clinical leadership balancing the needs of all parties involved, being mindful that the patient is their primary concern. To do so, they used three general strategies: Clarifying relations, Defining the situation and Guiding relatives in a concurrent and ongoing process, assessing when visiting is appropriate on a minute‐to‐minute basis.

Conclusion.  The study identifies and describes important professional considerations and values embedded in the nurses’ decision making about visitation. Detailed knowledge in this area will provide a concrete basis for internal discussion on specific everyday interactions with visiting relatives, as well as more general discussions on the possibilities for and implications of enhancing flexible family visitation.

Relevance to clinical practice.  To practice a contemporary visitation policy, the complexity of the task, the shifting context of the intensive care unit, the physical surroundings as well as possible limitations given by the staffing level should be acknowledged. The training of intensive care unit nurses should support adaptation to the clinical leadership role.
Dissemination of research into clinical nursing literature
Authors: Oermann Marilyn H , Shaw‐Kokot Julia , Knafl George J , Dowell Jo
Published: October 2010

Aim.  The purpose of our study was to describe the dissemination of research into the clinical nursing literature.

Background.  The literature provides a means of transferring knowledge from a research study through citations of the work by other authors.

Design.  This was a citation analysis study to explore the dissemination of research into the clinical nursing literature, beginning with the publication of an original research study and including all of the citations to that article through 2009.

Methods.  The authors searched five academic nursing research journal titles, using CINAHL, for original research reports that had clinical relevance and were published between 1990–1999. The search process yielded a final data set of 28 research articles. For each of the articles, the authors searched three databases, CINAHL, Web of Science® and Google Scholar, to determine the citation patterns from the date of publication to August 2009.

Results.  All of the research studies were cited in articles published in clinical journals although there was a wide range in the number of citations, from 3–80. The 28 research articles had a total of 759 citations; 717 (94·5%) of those citations were in articles published in clinical nursing journals. The median length of time between publication of the original study and the first citation was 1·5 years. Some of the studies were still being cited for 18 years after publication of the original work.

Conclusions.  All of the original research reports examined in this study were cited in articles in clinical journals, disseminating the research beyond the original work to reach clinicians.

Relevance to clinical practice.  Clinical nursing journals keep readers up‐to‐date and informed about new practices in nursing and serve another important role: they disseminate research that is clinically relevant by publishing original studies and papers that cite research reports.
A qualitative review: the stigma of tuberculosis
Authors: Juniarti Neti , Evans David
Published: October 2010

Background.  Tuberculosis is a major health problem internationally and brings with it a range of physical, economic and social consequences. There is a stigma associated with having tuberculosis because the disease is commonly viewed as a ‘dirty disease’. This stigma can have a negative impact on an individual and may delay the person seeking treatment.

Aims.  The aim of this review was to explore the stigma and impact of having tuberculosis or having a family member with tuberculosis.

Design.  Literature review.

Method.  A comprehensive search of the electronic databases was undertaken. Inclusion criteria for the review were studies that investigated people with tuberculosis or their families, focused on the stigma or impact of tuberculosis and reported descriptions of the experience. Data were synthesised using a thematic analysis.

Results.  The literature search identified thirty studies. Three themes emerged from the synthesis: shame, isolation and fear. The shame related to tuberculosis being viewed as a bad disease, a dirty disease. Isolation involved both the withdrawal from social contact and the shunning of contact by other people. Fear was a consequence of the many difficulties that accompany tuberculosis. These factors operated at three levels, on the individual level, the family level and the societal level.

Conclusion.  The stigma that accompanies tuberculosis can have a negative impact on the individual and family and may result in their withdrawal from society because of shame and fear. The review highlights the need for education to provide practical strategies for individuals and families and to educate communities where tuberculosis is endemic.

Relevance to clinical practice.  The review highlights the widespread ignorance of tuberculosis and need for education of the individual, family and community. This education should provide practical strategies to help people cope with tuberculosis. It also suggests that ensuring confidentiality should be an important component of management strategies.
My‐Mini‐Pet: a handheld pet‐nurturing game to engage students in arithmetic practices
Authors: Liao C.C.Y. , Chen Z‐H. , Cheng H.N.H. , Chen F‐C. , Chan T‐W.
Published: October 2010

In the last decade, more and more games have been developed for handheld devices. Furthermore, the popularity of handheld devices and increase of wireless computing can be taken advantage of to provide students with more learning opportunities. Games also could bring promising benefits – specifically, motivating students to learn/play, sustaining their interest, reflecting their learning/playing status, and facilitating the learning/playing progress. However, most of these have been designed for entertainment rather than education. Hence, in this study we incorporate game elements into a learning environment. The My‐Mini‐Pet system is a handheld pet‐nurturing game environment, in which students learn with an animal learning companion, their My‐Mini‐Pet. Three design strategies are adopted. First, the pet‐nurturing strategy, which simulates the relationship between the pet and its owner, the My‐Mini‐Pet becomes a motivator/sustainer of learning. Second, the pet appearance‐changing strategy, which externalizes the learning status of the student. In other words, the My‐Mini‐Pet plays the role of a reflector. Third, the pet feedback strategy, which links the behaviours of the student and his/her pet, the My‐Mini‐Pet acts as a facilitator of learning. A pilot study was also conducted to preliminarily investigate the effectiveness and experiences of the strategies on allowing the student to understand arithmetic practices. The results showed that the strategy was effective, encouraging the students to engage in learning activities. Furthermore, the game attracted the students’ attention and stimulated discussion between peers. Some implications about the further developments are also discussed.
Genetic and environmental interactions determine plant defences against herbivores
Authors: Ballhorn Daniel J. , Kautz Stefanie , Jensen Manfred , Schmitt Imke , Heil Martin , Hegeman Adrian D.
Published: October 2010

1. Plants express multiple defensive traits, but little is known about the genetic stability and phenotypic plasticity of these traits in nature. To investigate sources of variation and their potential ecological consequences for herbivores, we combined field observations of cyanogenic lima bean with laboratory experiments.

2. Field studies in South Mexico revealed a distinct variability of cyanogenic traits within and among wild lima bean populations. To differentiate among genetic variation and the impact of ambient conditions on plant phenotypes, we used seed‐grown plants as well as clones propagated from high‐ (HC) and low‐cyanogenic (LC) wild type plants.

3. In growth chamber experiments, we cultivated plants under three intensities each of drought and salt stress, nutrient supply, and light availability. We consecutively quantified cyanogenesis and total phenolics as chemical defences, soluble proteins as measure of leaf quality, and leaf mass per area and tissue hydration as physical defence‐associated traits.

4. Plant traits were genetically stable, as clones propagated from the HC‐ and LC‐mother plants maintained their cyanogenic features and also showed constancy of other leaf parameters tested.

5. In contrast to genetically heterogeneous seed‐grown plants, cyanogenesis and soluble protein concentration in clonal plants showed significant variation in response to reduced water supply, increased soil salinity, and fertilization. The other leaf traits, however, showed no significant phenotypic plasticity depending on treatment.

6. Among all traits analysed, genetic and phenotypic variation in cyanogenesis proved the best predictor of herbivore behaviour and development, as LC‐plants were preferred by adult Mexican bean beetles and allowed for faster larval development.

7.
Synthesis. We demonstrate that (i) functional analyses of plant responses to abiotic factors require methodical separation of genotypic variability and phenotypic plasticity, (ii) different abiotic parameters quantitatively affect the plants’ chemical phenotype and that (iii) changes of plant phenotype can have strong impacts on natural herbivores. Our results suggest that genetic variability and phenotypic plasticity of plant anti‐herbivore defences allow plant populations to rapidly respond to changing environmental conditions.
Participation in daytime activities among people with mild or moderate intellectual disability
Authors: Dusseljee J. C. E. , Rijken P. M. , Cardol M. , Curfs L. M. G. , Groenewegen P. P.
Published: October 2010

Background  Community participation has been defined as performing daytime activities by people while interacting with others. Previous studies on community participation among people with intellectual disability (ID) have mainly focused on the domestic life aspect. This study investigates the variation in community participation in the domains work, social contacts and leisure activities among people with ID in the Netherlands. A number of categories of people with ID were distinguished by: (1) gender; (2) age; (3) type of education; (4) severity of ID; and (5) accommodation type.

Methods  Data were gathered on 653 people with mild or moderate ID, of whom 513 by oral interviews and 140 by structured questionnaires filled in by representatives of those who could not be interviewed. Pearson chi‐square tests were used to test differences between categories of people with ID in the distributions of the participation variables. Additional logistic regression analyses were conducted to correct for differences between the categories in other variables.

Results  Most people with mild or moderate ID in the Netherlands have work or other daytime activities, have social contacts and have leisure activities. However, people aged 50 years and over and people with moderate ID participate less in these domains than those under 50 years and people with mild ID. Moreover, people with ID hardly participate in activities with people without ID.

Conclusion  High participation among people with a mild or moderate ID within the domains of work, social contact and leisure activities does not necessarily indicate a high level of interaction with the community, because the majority hardly interact with people without ID. Furthermore, older people with ID and people with a more severe level of ID seem to be more at risk for social exclusion.
The genetic architecture of domestication in the chicken: effects of pleiotropy and linkage
Authors: WRIGHT D. , RUBIN C.‐J. , MARTINEZ BARRIO A. , SCHÜTZ K. , KERJE S. , BRÄNDSTRÖM H. , KINDMARK A. , JENSEN P. , ANDERSSON L.
Published: October 2010

The extent of pleiotropy and epistasis in quantitative traits remains equivocal. In the case of pleiotropy, multiple quantitative trait loci are often taken to be pleiotropic if their confidence intervals overlap, without formal statistical tests being used to ascertain if these overlapping loci are statistically significantly pleiotropic. Additionally, the degree to which the genetic correlations between phenotypic traits are reflected in these pleiotropic quantitative trait loci is often variable, especially in the case of antagonistic pleiotropy. Similarly, the extent of epistasis in various morphological, behavioural and life‐history traits is also debated, with a general problem being the sample sizes required to detect such effects. Domestication involves a large number of trade‐offs, which are reflected in numerous behavioural, morphological and life‐history traits which have evolved as a consequence of adaptation to selective pressures exerted by humans and captivity. The comparison between wild and domestic animals allows the genetic analysis of the traits that differ between these population types, as well as being a general model of evolution. Using a large F2 intercross between wild and domesticated chickens, in combination with a dense SNP and microsatellite marker map, both pleiotropy and epistasis were analysed. The majority of traits were found to segregate in 11 tight ‘blocks’ and reflected the trade‐offs associated with domestication. These blocks were shown to have a pleiotropic ‘core’ surrounded by more loosely linked loci. In contrast, epistatic interactions were almost entirely absent, with only six pairs identified over all traits analysed. These results give insights both into the extent of such blocks in evolution and the development of domestication itself.
QTL for the species‐specific male and female genital morphologies in Ohomopterus ground beetles
Authors: SASABE MASATAKA , TAKAMI YASUOKI , SOTA TEIJI
Published: October 2010

Animals with internal fertilization often exhibit marked diversification in genital morphology among closely related species. However, our knowledge of the genetic architecture underlying genital evolution is still limited. We constructed genetic linkage maps and analysed quantitative trait loci (QTL) for F2 hybrids of two closely related species of the carabid beetles Carabus (Ohomopterus) iwawakianus and C. (O.) maiyasanus, which show matching male and female genital shapes within species, but marked differences in genital morphologies between species. The linkage maps comprised both amplified fragment length polymorphism and microsatellite markers. Composite interval mapping to detect QTL for three traits of male copulatory piece (length, width, weight) and two traits for female vaginal appendix (length, width) resulted in the detection of one to five significant QTL for each trait. The QTL explained large proportions of phenotypic variance. Thus, the interspecific difference in the genital morphologies appeared to be determined by relatively small numbers of genes with large genetic effects. QTL of different traits for the same or different sexes co‐occurred on five of eight linkage groups with significant QTL; in particular, three QTL for different male and female genital traits occurred almost at the same position. Each of the male genital traits showed uniform signs of additive genetic effects, suggesting that directional selection has led to species‐specific morphologies. However, the signs of additive genetic effects in each female genital trait were not uniform, suggesting that coevolution between sexes is not necessarily concerted. This result requires further assessment because the sample size of F2 females was small.
Effects of different mating scenarios on embryo viability in brown trout
Authors: JACOB ALAIN , EVANNO GUILLAUME , VON SIEBENTHAL BEAT A. , GROSSEN CHRISTINE , WEDEKIND CLAUS
Published: October 2010

Mating with attractive or dominant males is often predicted to offer indirect genetic benefits to females, but it is still largely unclear how important such non‐random mating can be with regard to embryo viability. We sampled a natural population of adult migratory brown trout (Salmo trutta), bred themin vitroin a half‐sib breeding design to separate genetic from maternal environmental effects, raised 2098 embryos singly until hatching, and exposed them experimentally to different levels of pathogen stress at a late embryonic stage. We found that the embryos’ tolerance to the induced pathogen stress was linked to the major histocompatibility complex (MHC) of their parents, i.e. certain MHC genotypes appeared to provide better protection against infection than others. We also found significant additive genetic variance for stress tolerance. Melanin‐based dark skin patterns revealed males with ‘good genes’, i.e. embryos fathered by dark coloured males had a high tolerance to infection. Mating with large and dominant males would, however, not improve embryo viability when compared to random mating. We used simulations to provide estimates of how mate choice based on MHC or melanin‐based skin patterns would influence embryos’ tolerance to the experimentally induced pathogen stress.
A novel copper‐responsive regulon in Mycobacterium tuberculosis
Authors: Festa Richard A. , Jones Marcus B. , Butler‐Wu Susan , Sinsimer Daniel , Gerads Russell , Bishai William R. , Peterson Scott N. , Darwin K. Heran
Published: October 2010

In this work we describe the identification of a copper‐inducible regulon in Mycobacterium tuberculosis (Mtb). Among the regulated genes was Rv0190/MT0200, a paralogue of the copper metalloregulatory repressor CsoR. The five‐locus regulon, which includes a gene that encodes the copper‐protective metallothionein MymT, was highly induced in wild‐type Mtb treated with copper, and highly expressed in an Rv0190/MT0200 mutant. Importantly, the Rv0190/MT0200 mutant was hyper‐resistant to copper. The promoters of all five loci share a palindromic motif that was recognized by the gene product of Rv0190/MT0200. For this reason we named Rv0190/MT0200 RicR for regulated in copper repressor. Intriguingly, several of the RicR‐regulated genes, including MymT, are unique to pathogenic Mycobacteria. The identification of a copper‐responsive regulon specific to virulent mycobacterial species suggests copper homeostasis must be maintained during an infection. Alternatively, copper may provide a cue for the expression of genes unrelated to metal homeostasis, but nonetheless necessary for survival in a host.
The structure of the catalytic domain of Tannerella forsythia karilysin reveals it is a bacterial xenologue of animal matrix metalloproteinases
Authors: Cerdà‐Costa Núria , Guevara Tibisay , Karim Abdulkarim Y. , Ksiazek Miroslaw , Nguyen Ky‐Anh , Arolas Joan L. , Potempa Jan , Gomis‐Rüth F. Xavier
Published: October 2010

Metallopeptidases (MPs) are among virulence factors secreted by pathogenic bacteria at the site of infection. One such pathogen is Tannerella forsythia, a member of the microbial consortium that causes peridontitis, arguably the most prevalent infective chronic inflammatory disease known to mankind. The only reported MP secreted by T. forsythia is karilysin, a 52 kDa multidomain protein comprising a central 18 kDa catalytic domain (CD), termed Kly18, flanked by domains unrelated to any known protein. We analysed the 3D structure of Kly18 in the absence and presence of Mg2+ or Ca2+, which are required for function and stability, and found that it evidences most of the structural features characteristic of the CDs of mammalian matrix metalloproteinases (MMPs). Unexpectedly, a peptide was bound to the active‐site cleft of Kly18 mimicking a left‐behind cleavage product, which revealed that the specificity pocket accommodates bulky hydrophobic side‐chains of substrates as in mammalian MMPs. In addition, Kly18 displayed a unique Mg2+ or Ca2+ binding site and two flexible segments that could play a role in substrate binding. Phylogenetic and sequence similarity studies revealed that Kly18 is evolutionarily much closer to winged‐insect and mammalian MMPs than to potential bacterial counterparts found by genomic sequencing projects. Therefore, we conclude that this first structurally characterized non‐mammalian MMP is a xenologue co‐opted through horizontal gene transfer during the intimate coexistence between T. forsythia and humans or other animals, in a very rare case of gene shuffling from eukaryotes to prokaryotes. Subsequently, this protein would have evolved in a bacterial environment to give rise to full‐length karilysin that is furnished with unique flanking domains that do not conform to the general multidomain architecture of animal MMPs.
The king is dead, long live the king! The restoration of BALANCE
Authors: Malhi Gin S
Published: October 2010

Malhi GS. The king is dead, long live the king! The restoration of BALANCE. Bipolar Disord 2010: 12: 681–684. © 2010 The Author. Journal compilation © 2010 John Wiley & Sons A/S.
Commentary: The Bipolar Affective Disorder: Lithium/Anticonvulsant Evaluation (BALANCE) Study
Authors: Baldessarini Ross J
Published: October 2010

Baldessarini RJ. Commentary: The Bipolar Affective Disorder: Lithium/Anticonvulsant Evaluation (BALANCE) Study. Bipolar Disord 2010: 12: 669–672. © 2010 The Author. Journal compilation © 2010 John Wiley & Sons A/S.
From BALANCE to DSM‐5: taking lithium seriously
Authors: Ghaemi S Nassir
Published: October 2010

Ghaemi SN. From BALANCE to DSM‐5: taking lithium seriously. Bipolar Disord 2010: 12: 673–677. © 2010 The Author. Journal compilation © 2010 John Wiley & Sons A/S.
Altered neural function in pediatric bipolar disorder during reversal learning
Authors: Dickstein Daniel P , Finger Elizabeth C , Skup Martha , Pine Daniel S , Blair James R , Leibenluft Ellen
Published: October 2010

Dickstein DP, Finger EC, Skup M, Pine DS, Blair JR, Leibenluft E. Altered neural function in pediatric bipolar disorder during reversal learning. Bipolar Disord 2010: 12: 707–719. © 2010 The Authors. Journal compilation © 2010 John Wiley & Sons A/S.

Objective:  Data documenting the functional impairment associated with the diagnosis of bipolar disorder (BD) in children and adolescents highlight the need for greater understanding of its pathophysiology. Toward that end, we demonstrated previously that BD youth have behavioral deficits on reversal learning tasks. On such tasks, participants must first acquire a stimulus/response relationship through trial‐and‐error learning, and then discern when the stimulus/reward relationship reverses. Here, we use event‐related functional magnetic resonance imaging (fMRI) to elucidate neural correlates of reversal learning deficits in euthymic BD youth compared to typically developing controls.

Method:  We compared euthymic pediatric BD participants (n = 16) versus age‐, sex‐, and IQ‐matched controls (n = 16). Our main outcome measure was blood oxygen level‐dependent (BOLD) signal measured with fMRI during an event‐related probabilistic reversal task.

Results:  Pediatric BD participants had significantly greater neural activity than controls in fronto‐parietal regions during the reversal phase, particularly in response to punished reversal errors (p < 0.05 corrected for multiple comparisons).

Conclusions:  Our current study suggests that during reversal learning, BD youths inefficiently recruit regions associated with processing response conflict and implementing alternative responses, including subdivisions of the frontal cortex and the parietal cortex. Such deficits are present in euthymic BD youth. Further work is necessary to evaluate the specificity of such alterations.
Development of the QoL.BD: a disorder‐specific scale to assess quality of life in bipolar disorder
Authors: Michalak Erin E , Murray Greg ,   CREST.BD
Published: October 2010

Michalak EE, Murray G, CREST.BD. Development of the QoL.BD: a disorder‐specific scale to assess quality of life in bipolar disorder. Bipolar Disord 2010: 12: 727–740. © 2010 The Authors. Journal compilation © 2010 John Wiley & Sons A/S.

Background:  There is wide recognition that symptom ratings alone are inadequate to measure outcomes in bipolar disorder (BD), and quality of life (QoL) has been proposed as an important separable construct. Although a literature on QoL in BD exists, there is no disorder‐specific measure of QoL in BD. In 2004, we embarked upon a four‐year mixed‐method program of research to develop such a measure that could function as an outcome tool in clinical trials of pharmacological or psychosocial treatment interventions, longitudinal monitoring, or routine clinical care.

Methods:  The project was informed by standard protocols for the development of disorder‐specific QoL measures. Two phases of scale development were pursued across four empirical studies. Item generation involved a qualitative investigation of individuals with BD, family members, and field experts (Study 1), as well as a literature review. Item reduction analyses were conducted using an intensive small‐N design with affected individuals (Study 2), a large field sample (Study 3), and a final small‐N item reduction study, again involving individuals with the disorder and field experts (Study 4).

Results:  Initial field testing of the Quality of Life in Bipolar Disorder (QoL.BD) scale supports use of the instrument as a feasible, reliable and valid disorder‐specific QoL measure for BD. Internal reliability of the QoL.BD is impressive, test‐retest reliability is appropriate, and the direction and magnitude of correlations with external measures are as expected. As a new instrument, the QoL.BD must be compared against existing options for measuring QoL in this population. Significantly, data suggest that the greater specificity of the QoL.BD relative to the Quality of Life Enjoyment and Satisfaction Questionnaire renders the new instrument more sensitive to clinical change in BD.

Conclusions:  Quality of life scales can provide important information additional to that provided by traditional assessments of outcome in BD. Our intensive, mixed‐method development of the QoL.BD has produced a useful additional measure of well‐being for this complex and often disabling condition.
Neurosurgical treatment of bipolar depression: defining treatment resistance and identifying surgical targets
Authors: Lipsman Nir , McIntyre Roger S , Giacobbe Peter , Torres Cristina , Kennedy Sidney H , Lozano Andres M
Published: October 2010

Lipsman N, McIntyre RS, Giacobbe P, Torres C, Kennedy SH, Lozano AM. Neurosurgical treatment of bipolar depression: defining treatment resistance and identifying surgical targets. Bipolar Disord 2010: 12: 691–701. © 2010 The Authors. Journal compilation © 2010 John Wiley & Sons A/S.

Objectives:  Bipolar disorder (BD) is a complex psychiatric disorder that is often underrecognized, misdiagnosed, and challenging to detect. During the past decade, substantial progress has been made in the development of pharmacotherapeutic and psychosocial interventions for various phases of BD. Notwithstanding these developments, the majority of BD individuals, and particularly patients with bipolar depression, receiving guideline concordant care do not experience syndromal or functional recovery, underscoring the need for novel treatments. Early success with deep brain stimulation (DBS) in the treatment of major depressive episodes as part of major depressive disorder (MDD) has provided the impetus to explore its application in other treatment‐resistant psychiatric disorders, notably BD. Herein, we provide the rationale for employing DBS as an alternative treatment avenue in individuals with bipolar depression.

Methods:  We conducted a PubMed literature search, focusing on English language articles beginning in 1950 to the present day, and employed the following search terms: bipolar disorder, neurosurgery, deep brain stimulation, neuroimaging, and circuitry. Search results were then manually reviewed and relevant articles selected for analysis. Relevance was determined by author consensus and overall manuscript quality. We also reviewed articles on currently available treatment options for BD in order to develop a coherent and practical definition of treatment resistance with a focus on surgical intervention.

Results:  Several lines of evidence indicate that although mania is the defining feature of bipolar I disorder, depressive symptoms and episodes dominate the longitudinal course, account for most of the illness burden including premature mortality, and are least responsive to contemporary treatments. Disease models in bipolar depression implicate abnormalities in the structure and function of discrete neural circuits that subserve affective processing and cognitive function with the subgenual cingulate cortex occupying a central role. Modulation of the cingulate cortex with DBS in treatment‐resistant MDD populations has proven to offer acute and sustained antidepressant effects, suggesting possible benefits for other mood disorder populations.

Conclusions:  A surgical intervention for bipolar depression would not only be a proof of concept regarding disease modeling but also an important and novel treatment avenue for individuals affected by bipolar depression.
Sustained unemployment in psychiatric outpatients with bipolar disorder: frequency and association with demographic variables and comorbid disorders
Authors: Zimmerman Mark , Galione Janine N , Chelminski Iwona , Young Diane , Dalrymple Kristy , Ruggero Camilo J
Published: October 2010

Zimmerman M, Galione JN, Chelminski I, Young D, Dalrymple K, Ruggero CJ. Sustained unemployment in psychiatric outpatients with bipolar disorder: frequency and association with demographic variables and comorbid disorders. Bipolar Disord 2010: 12: 720–726. © 2010 The Authors. Journal compilation © 2010 John Wiley & Sons A/S.

Objectives:  The negative impact of bipolar disorder on occupational functioning is well established. However, few studies have examined the persistence of unemployment, and no studies have examined the association between diagnostic comorbidity and sustained unemployment. In the present report from the Rhode Island Methods to Improve Diagnostic Assessment and Services (MIDAS) project, we described the amount of time unemployed in the five years before the evaluation in a large cohort of outpatients diagnosed with bipolar disorder, and determined the demographic and clinical correlates of sustained unemployment.

Methods:  A total of 206 patients diagnosed with DSM‐IV bipolar I or bipolar II disorder were interviewed with semi‐structured interviews assessing comorbid Axis I and Axis II disorders, demographic and clinical variables. The interview included an assessment of the amount of time missed from work due to psychiatric reasons during the past five years. Persistent unemployment was defined as missing up to two years or more from work.

Results:  Less than 20% of the patients reported not missing any time from work due to psychiatric reasons, and more than one‐third missed up to two years or more from work. Prolonged unemployment was associated with increased rates of current panic disorder and a lifetime history of alcohol abuse or dependence. Patients with prolonged unemployment were older and experienced more episodes of depression.

Conclusions:  Most patients presenting for the treatment of bipolar disorder have missed some time from work due to psychiatric reasons, and the persistence of employment problems is considerable. Comorbid psychiatric disorders are a potentially treatable risk factor for sustained unemployment. It is therefore of public health significance to determine if current treatments are effective in bipolar disorder patients with current panic disorder, and if not, to attempt to develop treatments that are effective.
Mood swing and mood stabilizer: how specific are these terms?
Authors: Safer Daniel J
Published: October 2010

Safer DJ. Mood swing and mood stabilizer: how specific are these terms? Bipolar Disord 2010: 12: 685–690. © 2010 The Author. Journal compilation © 2010 John Wiley & Sons A/S.

Background: In the DSM‐IIIR in 1987, the category title for depressive and bipolar disorders was changed fromaffective disorderstomood disorders. Within a short period of time thereafter,mood swingandmood stabilizerbecame very commonly used terms in psychiatry with bipolar implications.

Methods: Terms and definitions in recent texts, articles, and dictionaries pertaining to mood fluctuations have been reviewed.

Results: The termmoodwas seldom part of psychiatric terminology until the late 1970s.Mood swingandmood stabilizeras used in the psychiatric literature are primarily nonspecific and often misleading concepts—particularly as a basis for treatment decisions. Affective fluctuations and shifts to irritability and/or anger in persons with personality and depressive disorders are being viewed by many in the mental health field as cyclically biphasic—between depressed to elated—which is clearly at variance with research findings.

Conclusions: More data‐based research on mood variations is needed to authoritatively remedy this situation.
Transfusion practice in hip arthroplasty – a nationwide study
Authors: Jans Ø. , Kehlet H. , Hussain Z. , Johansson P. I.
Published: October 2010

Background and Objectives  The optimal transfusion strategy in hip arthroplasty remains controversial despite existing guidelines. The aim of this study was to evaluate the transfusion practice in patients undergoing primary total hip arthroplasty (THA) or revision total hip arthroplasty (RTHA) in Denmark.

Materials and Methods  We performed a retrospective cohort study of all patients undergoing THA or RTHA in Denmark in 2008. Primary outcomes were intercentre variation in red blood cell (RBC) transfusion rates and the timing of transfusion related to surgery.

Results  Six thousand nine hundred thirty‐two THA patients and 1132 RTHA patients were included for analysis of which 1674 (24%) THA and 689 (61%) RTHA patients received RBC transfusion. Of these, 47% of THA and 73% of RTHA patients received transfusion on the day of surgery. Transfusion rates between centres varied from 7 to 71% and between 26 and 85% in THA and RTHA patients, respectively. Patients receiving RBC transfusion had longer length of stay and for THA patients an increased odds‐ratio (5·5) of death within 90 days.

Conclusion  Despite established guidelines, RBC transfusion practice in hip arthroplasty remains highly variable between Danish hospitals. The effect of RBC transfusion on outcome after hip arthroplasty should be established in prospective randomized controlled trials.
Non‐D Rh antibodies appearing after apheresis platelet transfusion: stimulation by red cells or microparticles?
Authors: Kitazawa J. , Nollet K. , Morioka H. , Tanaka K. , Inomata M. , Kubuki Y. , Ohto H.
Published: October 2010

Background  Apheresis platelets (APs) have gained favour over whole blood‐derived platelets on the presumption that they are less likely to provoke alloimmunization to red‐blood‐cell antigens.

Case Reports  Non‐D Rh antibodies appeared in three patients after apheresis platelet transfusion. Anti‐C and anti‐E arose in two female patients with previous antigen exposure. Both anti‐c and anti‐E arose in a male recipient with no prior transfusion history.

Materials and Methods  Fifty APs were analysed for residual RBCs and RBC‐derived microparticles, using samples obtained from a local blood centre. Cells and microparticles were quantified with a flow cytometry gating scheme, using PE‐labelled anti‐CD235a (glycophorin A) and FITC‐labelled anti‐CD41a (platelet gp IIb/IIIa) to distinguish lineage.

Results  Apheresis platelets were found to contain a mean of 7·5 × 106 (95% C.I. [6·3–8·5 × 106]) RBCs on one manufacturer’s device and 5·2 × 106 (95% C.I. [4·0–6·3 × 106]) RBCs on another’s. RBC‐derived microparticles averaged 210·7 × 106 (95% C.I. [166·2–254·2 × 106]) on one manufacturer’s device and 232·3 × 106 (95% C.I. [194·3–272·9 × 106]) on another’s. These counts all correspond to volumes of < 1 μl.

Conclusion  Despite RBC contamination of APs below commonly accepted thresholds for Rh immunogenicity, AP transfusion can provoke non‐D Rh antibody formation. RBC‐derived microparticles, smaller but more numerous than RBCs, are volumetrically comparable and may be a hitherto underappreciated antibody stimulus. Further microparticle research will guide considerations of extended phenotypic matching of platelet components.
Gene expression profiling in wounded and systemic leaves of Fagus sylvatica reveals up‐regulation of ethylene and jasmonic acid signalling
Authors: Schlink K.
Published: October 2010

Wounding is a crucial threat to plants because of the physical damage caused and the possible entry of pathogens. Little is known about the wound reaction in forest trees. Therefore, leaves of young beech trees were wounded and the transcriptional response of wounded leaves and leaves directly above and below was analysed. A total of 123 genes exhibited significant regulation. The magnitude of regulation was slightly weaker in the downward leaves but the regulation pattern resembles that of the local and upward reactions. Thus, the signal was transduced in both vertical directions. Genes exhibiting major regulation lacked functional assignment or belonged to signalling, transcription and defence categories. Signalling included activation of transcripts in the calcium and ethylene pathways. There was also evidence for activation of jasmonic acid signalling, but no activation of jasmonic acid‐responsive PR (pathogenesis‐related) genes was observed. Moreover, repression of salicylic acid responsive defence was measured. Metabolic changes included induction of a core gene of the phenylpropanoid pathway, while energy metabolism exhibited down‐regulation. These results support the conclusion that young beech trees might give up leaves and/or reduce leaf energy content after an attack so as to deprive a putative herbivore of a nutrient supply, instead of investing much energy in leaf defence.
Quantitative trait loci for milk production and functional traits in two Danish Cattle breeds
Authors: Mai M.D. , Rychtářová J. , Zink V. , Lassen J. , Guldbrandtsen B.
Published: October 2010

Quantitative trait loci (QTL) in Danish Jersey and Danish Red cattle were independently mapped by least squares regression analysis. For Jersey breed, five grandsire families were genotyped for 186 markers on 16 chromosomes (BTAs). Eight traits analysed were milk yield (MY), fat percentage (FP), protein percentage (PP), clinical mastitis (CM), somatic cell score (SCS), maternal stillbirth, maternal calf size (MCS) and maternal calving difficulty. For Red breed, nine grandsire families were genotyped for 166 markers on 18 BTAs. Six traits analysed were MY, FP, PP, CM, SCS and female fertility. Nine and five QTL were detected in Jersey and Red breed, respectively, in across family tests. In Jersey breed, the results indicate QTL for CM and MCS on BTA 3. Additionally, there is an indication of QTL for MCS and FP on BTA 1 and a tentative evidence for a QTL for MY on BTA 26. There is a high risk of detected QTL being false positives. The detected QTL in Jersey breed indicate interesting results from a breeding perspective, but a practical application should await genome‐wide association studies.
Random regression analyses using B‐splines functions to model growth from birth to adult age in Canchim cattle*
Authors: Baldi F. , Alencar M.M. , Albuquerque L.G.
Published: October 2010

The objective of this work was to estimate covariance functions using random regression models on B‐splines functions of animal age, for weights from birth to adult age in Canchim cattle. Data comprised 49 011 records on 2435 females. The model of analysis included fixed effects of contemporary groups, age of dam as quadratic covariable and the population mean trend taken into account by a cubic regression on orthogonal polynomials of animal age. Residual variances were modelled through a step function with four classes. The direct and maternal additive genetic effects, and animal and maternal permanent environmental effects were included as random effects in the model. A total of seventeen analyses, considering linear, quadratic and cubic B‐splines functions and up to seven knots, were carried out. B‐spline functions of the same order were considered for all random effects. Random regression models on B‐splines functions were compared to a random regression model on Legendre polynomials and with a multitrait model. Results from different models of analyses were compared using the REML form of the Akaike Information criterion and Schwarz′ Bayesian Information criterion. In addition, the variance components and genetic parameters estimated for each random regression model were also used as criteria to choose the most adequate model to describe the covariance structure of the data. A model fitting quadratic B‐splines, with four knots or three segments for direct additive genetic effect and animal permanent environmental effect and two knots for maternal additive genetic effect and maternal permanent environmental effect, was the most adequate to describe the covariance structure of the data. Random regression models using B‐spline functions as base functions fitted the data better than Legendre polynomials, especially at mature ages, but higher number of parameters need to be estimated with B‐splines functions.
Genetic variations and sequences analysis of MTATP6 and MTATP8 genes among different Chinese pig breeds
Authors: Liu G. , Liu Y. , Zhang H. , Huang J. , Fang M.
Published: October 2010

To investigate the genetic variations of mtATP6 and mtATP8 genes among different Chinese pig breeds, two fragments of 425 and 743 bp containing the whole coding region of mtATP8 and mtATP6 genes were amplified with 805 individuals from 23 Chinese local pig breeds, three types of Chinese wild boars and three European pig breeds. Sequence comparison identified a total number of 17 substitutions including six variable sites in mtATP8 and eleven substitutions in mtATP6 gene. The restriction enzyme Fok I revealed four polymorphic sites (nt8086, 8176, 8514 and 7784), and four RFLP haplotype patterns (A, B, C and D) were identified in mtATP6 and mtATP8 genes among all tested samples. Our data showed AC combined haplotype originated from Asia and BD was regarded as European origin. The average frequency of Asian mtDNA haplotypes was 38.3% across the investigated European breeds but varied within each breeds (13.3∼76.7%). Phylogenetic analyses were performed also considering some published sequences in the databases; the sequences were divided into three distinct groups, denoted A, E1, and E2. The Asian AC haplotype existed among the European domestic pigs was fully consistent with the results of previous molecular studies and well‐documented history. This study will help us to better understand the genetic variations of mitochondrial genes among different Chinese pig breeds.
Epidemiological survey of vulvovaginal candidosis in Sfax, Tunisia
Authors: Amouri I. , Sellami H. , Borji N. , Abbes S. , Sellami A. , Cheikhrouhou F. , Maazoun L. , Khaled S. , Khrouf S. , Boujelben Y. , Ayadi A.
Published: October 2010

Vulvovaginal candidosis (VVC) is a common infection of the female genital tract affecting 75% women at least once in their lifetime. The aim of this study was to determine the incidence and potential risk factors associated with VVC and recurrent vulvovaginal candidosis (RVVC). A prospective study of women with vaginitis symptoms was conducted over 2 years in the regional clinic of population and family education in Sfax. A discriminant analysis was used to evaluate the association between the incidence of Candida vaginitis and potential risk factors. Sporadic and recurrent VVC were documented respectively in 48% and 6.1%. The most frequent factors associated with positive Candida culture were employed women, uncontrolled diabetes, history of genital infection and intrauterine device contraception. Increased episode numbers of VVC and condom/spermicidal contraception were positively associated with recurrences. Candida albicans was the predominantly isolated species (76.3%) followed by Candida glabrata (19.3%). Infection with C. glabrata occurred in 34% and 17.5% of patients with RVVC and VVC respectively. The discriminant investigation had provided further insights into the basis for prevention and control of RVVC. Increased prevalence of C. glabrata in patients with RVVC and observed risk factors should be taken into consideration to achieve success in the management of this infection.
Artemisinin inhibits extracellular matrix metalloproteinase inducer (EMMPRIN) and matrix metalloproteinase‐9 expression via a protein kinase Cδ/p38/extracellular signal‐regulated kinase pathway in phorbol myristate acetate‐induced THP‐1 macrophages
Authors: Wang Yue , Huang Zhou‐Qing , Wang Chang‐Qian , Wang Lian‐Sheng , Meng Shu , Zhang Ya‐Chen , Chen Ting , Fan Yu‐Qi
Published: October 2010

1. Overexpression of extracellular matrix metalloproteinase inducer (EMMPRIN) and matrix metalloproteinases (MMPs) by monocytes/macrophages has been proposed to play a significant role in atherosclerotic plaque progression and rupture. The aim of the present study was to explore whether artemisinin, a natural extract from Artemisia annua, could decrease EMMPRIN and MMP‐9 expression in phorbol myristate acetate (PMA)‐induced macrophages by regulating the protein kinase (PK) Cδ/c‐Jun N‐terminal kinase (JNK)/p38/extracellular signal‐regulated kinase (ERK) pathway.

2. Human monocytic THP‐1 cells were pretreated with 20–80 μg/mL artemisinin for 4 h or 1–10 μmol/L rottlerin for 1 h prior to stimulation with PMA (100 nmol/L) for another 48 h. Cells were collected to analyse the induction of EMMPRIN and MMP‐9. Upstream pathway analysis using the PKCδ inhibitor rottlerin detected activation of the PKCδ/JNK/p38/ERK pathway.

3. Artemisinin (20–80 μg/mL) significantly inhibited the induction of EMMPRIN and MMP‐9 at both the transcriptional and translational levels in a dose‐dependent manner in PMA‐induced macrophages. In addition, artemisinin (20–80 μg/mL) strongly blocked PKCδ/JNK/p38/ERK MAPK phosphorylation. The PKCδ inhibitor rottlerin (1–10 μmol/L) also significantly inhibited JNK/p38/ERK phosphorylation and decreased EMMPRIN and MMP‐9 mRNA and protein expression.

4. The results of the present study suggest that artemisinin inhibits EMMPRIN and MMP‐9 expression and activity by suppressing the PKCδ/ERK/p38 cascade in PMA‐induced macrophages.