bluuebunny/crossref_metadata_2025 huggingface dataset:
The Predictive Value of Flow‐Mediated Dilation and Carotid Artery Intima‐Media Thickness for Occult Coronary Artery Disease
Authors: Mutlu Bulent , Tigen Kursat , Gurel Emre , Ozben Beste , Karaahmet Tansu , Basaran Yelda
Published: August 2011

Background: Multidetector row computed tomography (MDCT) is an attractive noninvasive alternative to assess overall coronary artery disease (CAD) burden and may reveal coronary plaques, which may be underestimated by conventional coronary angiography. The aim of this study was to determine whether brachial artery flow‐mediated dilation (FMD) and carotid artery intima‐media thickness (CIMT) might accurately predict patients with occult coronary plaques whose conventional coronary angiographies revealed normal coronary arteries (NCA). Methods: Thirty‐five patients with angiographically NCA were consecutively recruited into the study. They underwent MDCT and were divided into NCA group (18 patients; 8 male; 47 ± 9 years) and occult CAD group (17 patients; 11 male; 50 ± 10 years) according to presence of coronary plaque. Nineteen consecutive patients with evident CAD (16 male; 54 ± 7 years) and 19 healthy subjects (10 male; 50 ± 6 years) were included as control groups. FMD and CIMT were measured by brachial and carotid artery ultrasonography. Results: Occult CAD group had significantly lower FMD and insignificantly higher CIMT than NCA group whereas they had significantly higher FMD and insignificantly lower CIMT than evident CAD group. NCA group had significantly lower CIMT than evident CAD group. Receiver operating characteristic curve analysis demonstrated FMD < 8% (sensitivity: 94.4%; specificity: 73.0%; PPV: 77.3%; NPV: 93.1%) and CIMT ≥ 0.65 cm (sensitivity: 72.2%; specificity: 62.2%; PPV: 65.0%; NPV: 69.7%) could predict patients with CAD. FMD and CIMT were independent predictors of CAD (P < 0.001; OR: 45.630; 95%CI: 5.38–386.983 and P = 0.015; OR: 14.226; 95%CI: 1.666–121.467, respectively). Conclusion: FMD and CIMT might predict patients with occult CAD and be helpful in selecting patients for MDCT. (Echocardiography 2011;28:1141‐1147)
A Warm Footbath Improves Coronary Flow Reserve in Patients with Mild‐to‐Moderate Coronary Artery Disease
Authors: Yoon Se‐Jung , Park Jong‐Kwan , Oh Seungjin , Jeon Dong Woon , Yang Joo Young , Hong Suk‐Min , Kwak Min‐Sub , Choi Yoon‐Suk , Rim Se‐Joong , Youn Ho‐Joong
Published: August 2011

Backgrounds: Recent studies have shown that thermal therapy by means of warm waterbaths and sauna has beneficial effects in chronic heart failure. However, a comprehensive investigation of the hemodynamic effects of thermal vasodilation on coronary arteries has not been previously undertaken. In this study, we studied the effect of a warm footbath (WFB) on coronary arteries in patients with coronary artery disease (CAD), as well as any adverse effect. Methods: We studied 21 patients (33.3% men, mean age 60.8 ± 13.5 years) with CAD. Coronary flow Doppler examination of the left anterior descending coronary artery and coronary flow reserve (CFR) were performed and measured using adenosine before and after a WFB. Results: Systolic and diastolic blood pressure and heart rate did not change with the WFB. Mean velocity of diastolic coronary flow significantly increased (diastolic mean flow velocity: 18.3 ± 7.1 cm/sec initial, 21.5 ± 8.0 cm/sec follow‐up, P = 0.002) and CFR significantly improved (1.6 ± 0.4 vs. 2.2 ± 0.5, P < 0.001) after WFB. The WFB was well accepted and no relevant adverse effects were observed. The change of CFR after WFB correlated well with diastolic function (E’, r = 0.51, P = 0.031; E/E’, r =–0.675, P = 0.002). Conclusions: A WFB significantly improved CFR without any adverse effects in patients with mild‐to‐moderate CAD and can be applied with little risk of a coronary artery event if appropriately performed. (Echocardiography 2011;28:1119‐1124)
Mitral Valve Regurgitation in Patients Supported on Continuous Flow Pumps
Authors: Topilsky Yan , Hasin Tal , McGregor Christopher G.A , Park Soon J.
Published: August 2011

(Echocardiography 2011;28:E202‐E204)
Echocardiography Can Be More Sensitive than Thoracic Computed Tomography in Detecting a Thrombus in the Inflow Cannula of a Continuous Left Ventricular Assist Device
Authors: Aissaoui Nadia , Paluszkiewicz Lech , Koertke H. Heinrich , Morshuis Michiel , Gummert Jan
Published: August 2011

(Echocardiography 2011;28:E215‐E216)
Malignant Fibrous Histiocytoma of the Heart
Authors: Rashidi Armin , Silverberg Marc L. , McCray Robert D.
Published: August 2011

(Echocardiography 2011;28:E217‐E218)
Approaches to Normalization of Spinal Cord Volume: Application to Multiple Sclerosis
Authors: Healy Brian C. , Arora Ashish , Hayden Douglas L. , Ceccarelli Antonia , Tauhid Shahamat S. , Neema Mohit , Bakshi Rohit
Published: August 2011

BACKGROUND AND PURPOSE

To determine the proper method for the normalization of spinal cord volume.

MATERIALS AND METHODS

A group of 34 multiple sclerosis (MS) patients (28 relapsing and 6 progressive) and 15 healthy controls had whole spinal cord 3‐mm thick T2‐weighted axial fast spin‐echo magnetic resonance imaging (MRI) images obtained at 3T. For each participant, four volumes were measured (C2‐3 volume, cervical cord volume, thoracic cord volume, and whole cord volume). The volumes were normalized by the number of slices and three potential measures of body size (intracranial volume [ICV], body mass index, and body surface area) using the proportional method.

RESULTS

All raw volumes and volumes normalized by number of slices or ICV were significantly lower in progressive MS patients compared to relapsing MS patients/healthy controls (P < .05). In addition, C2‐3 volume and cervical cord volume were significantly correlated with Expanded Disability Status Scale score (P < .05). All regional volumes showed high intercorrelation, and normalization by the number of slices significantly increased some correlations. Regarding reliability, whole cord volume regardless of normalization technique had lower coefficient of variation than C2‐3 volume.

CONCLUSIONS

Since normalization factor had limited impact on reliability and the ability to detect differences, normalization by the number of slices is recommended.
Evidence‐based Community Consultation for Traumatic Brain Injury
Authors: Lynch Catherine A. , Houry Debra E. , Dai Dajun , Wright David W.
Published: August 2011

ACADEMIC EMERGENCY MEDICINE 2011; 18:972–976 © 2011 by the Society for Academic Emergency Medicine

Objectives:  The objective was to determine if geospatial techniques can be used to inform targeted community consultation (CC) and public disclosure (PD) for a clinical trial requiring emergency exception from informed consent (EFIC).

Methods:  Data from January 2007 to December 2009 were extracted from a Level I trauma center’s trauma database using the National Trauma Registry of the American College of Surgeon (NTRACS). Injury details, demographics, geographic codes, and clinical data necessary to match core elements of the clinical trial inclusion criteria (Glasgow Coma Scale [GCS] 3–12 and blunt head injury) were collected on all patients. Patients’ home zip codes were geocoded to compare with population density and clustering analysis.

Results:  Over a 2‐year period, 179 patients presented with moderate to severe traumatic brain injury (TBI). Mapping the rate and frequency of TBI patients presenting to the trauma center delineated at‐risk populations for moderate to severe head injury. Four zip codes had higher incidences of TBI than the rest, with one zip code having a very high rate of 80 per 100,000 population.

Conclusions:  Geospatial techniques and hospital data records can be used to characterize potential subjects and delineate a high‐risk population to inform directed CC and public disclosure strategies.
VeinViewer‐assisted Intravenous Catheter Placement in a Pediatric Emergency Department
Authors: Chapman Laura L. , Sullivan Brenna , Pacheco Amanda L. , Draleau Charlene P. , Becker Bruce M.
Published: August 2011

ACADEMIC EMERGENCY MEDICINE 2011; 18:966–971 © 2011 by the Society for Academic Emergency Medicine

Objectives:  Peripheral intravenous catheter (PIV) placement is a common, painful, and frequently difficult procedure in children. The VeinViewer is a device that delineates subcutaneous veins using near‐infrared light and video technology. To the best of our knowledge, the benefit of this device for PIV placement in children in the emergency department (ED) has not been studied.

Methods:  The authors enrolled a prospective, randomized sample of children aged 0 to 17 years who required a nonemergent PIV in a tertiary care pediatric ED. Participants were randomized to standard PIV cannulation (SC) or PIV cannulation with the VeinViewer (VV). The primary outcome measure was time to PIV placement. Secondary outcome measures included number of PIV attempts and pain scores as reported by the child, parent or guardian, and nurse using a 100‐mm visual analog scale (VAS).

Results:  A total of 323 patients completed the study: 174 boys and 149 girls. Age, sex, and body mass index (BMI) were not different between groups. There were no differences in time to PIV placement, number of PIV attempts, or pain scores for the overall study group. However, a planned subgroup analysis of children age 0 to 2 years (n = 107) did yield significant results for the geometric mean time to place the PIV (121 seconds [VV] vs. 167 seconds [SC], p = 0.047) and for nurses’ perception of pain (median VAS 34 [VV] vs. 46 [SC], p = 0.01).

Conclusions:  While no results were significant for the overall study group, subgroup analysis of children age 0 to 2 years suggests that the VeinViewer may decrease the time to PIV placement.
A Comparison of Demirjian’s Four Dental Development Methods for Forensic Age Assessment*,†
Authors: Flood Sara J. , Mitchell Warren J. , Oxnard Charles E. , Turlach Berwin A. , McGeachie John
Published: August 2011

Abstract:  The aim of this study was to determine the comparative accuracy of Demirjian’s four dental development methods for forensic age estimation in the Western Australian population. A sample comprising 143 individuals aged 4.6 to 14.5 years were assessed using Demirjian’s four methods for dental development (original 7‐tooth: M2, M1, PM2, PM1, C, I2, and I1; revised 7‐tooth: M2, M1, PM2, PM1, C, I2, and I1; 4‐tooth: M2, M1, PM2, and PM1; and an alternate 4‐tooth: M2, PM2, PM1, and I1). When comparing all four methods, the 4‐tooth method overestimated age in both males and females by 0.04 and 0.25 years, respectively. The original 7‐tooth was least accurate for males, while the original 7‐tooth, the revised 7‐tooth, and the alternate 4‐tooth were unsuitable for females. Therefore, we recommend the 4‐tooth method to be used for forensic age estimation in Western Australian males and females, as it has the lowest overall mean deviation and the highest accuracy.
A Study of Sexual Dimorphism in the Femur Among North Indians*
Authors: Srivastava Rashmi , Saini Vineeta , Rai Rajesh K. , Pandey Shashikant , Tripathi Sunil K.
Published: August 2011

Abstract:  Determination of sex of unknown skeleton remains is the most important step in the identification process. Racial and regional differences in the populations create and maintain specificity in their dimorphic characteristics. Moreover, considering continued secular changes in the population structure, constant revision of osteometric standards becomes mandatory. In an effort to establish osteometric standards for the femur of contemporary North Indian populations, 122 adult femora of known sex (M: 94; F: 28) were collected in the Department of Forensic Medicine, IMS, BHU, Varanasi. Eight standard parameters were measured and analyzed by discriminant function analysis using SPSS 16. The accuracy of sex prediction ranged from 70.5% to 83.6% with single variables. In stepwise analysis, epicondylar breadth, proximal breadth, and antero‐posterior diameter of the lateral condyle were found to be the most discriminating variables providing an accuracy of 90.2%. The results clearly indicate the importance of the ends of femur in the determination of sex.
Validation of the Seratec® SeraQuant™ for the Quantitation of Prostate‐Specific Antigen Levels on Immunochromatographic Membranes
Authors: Laux Dale L. , Barnhart Justin P.
Published: August 2011

Abstract:  Use of immunochromatographic membranes for the detection of prostate‐specific antigen (PSA) has become commonplace in forensic laboratories. Experiments were designed to test the newly developed Seratec® SeraQuant™ for accuracy, precision, and consistency in the quantitation of PSA. PSA standards were diluted with buffers and run on the instruments. Values obtained were examined for accuracy (was the correct value obtained?) and precision (were multiple sample values consistent?). To test for variation between instruments, large volumes of diluted PSA standard were run repeatedly on six units and the values obtained were plotted against the known PSA values to obtain a standard curve for each instrument. Fifty membranes having negative or weak positive results were then run on the six units, and the adjusted values were recorded and compared. Results of these experiments indicate that the instruments are accurate and precise in the quantitation of low levels of PSA.
An Inconclusive Digital Audio Authenticity Examination: A Unique Case
Authors: Koenig Bruce E. , Lacey Douglas S.
Published: August 2011

Abstract:  This case report sets forth an authenticity examination of 35 encrypted, proprietary‐format digital audio files containing recorded telephone conversations between two codefendants in a criminal matter. The codefendant who recorded the conversations did so on a recording system he developed; additionally, he was both a forensic audio authenticity examiner, who had published and presented in the field, and was the head of a professional audio society’s writing group for authenticity standards. The authors conducted the examination of the recordings following nine laboratory steps of the peer‐reviewed and published 11‐step digital audio authenticity protocol. Based considerably on the codefendant’s direct involvement with the development of the encrypted audio format, his experience in the field of forensic audio authenticity analysis, and the ease with which the audio files could be accessed, converted, edited in the gap areas, and reconstructed in such a way that the processes were undetected, the authors concluded that the recordings could not be scientifically authenticated through accepted forensic practices.
Experimental and Casework Validation of Ambient Temperature Corrections in Forensic Entomology*,†
Authors: Johnson Aidan P. , Wallman James F. , Archer Melanie S.
Published: August 2011

Abstract:  This paper expands on Archer (J Forensic Sci 49, 2004, 553), examining additional factors affecting ambient temperature correction of weather station data in forensic entomology. Sixteen hypothetical body discovery sites (BDSs) in Victoria and New South Wales (Australia), both in autumn and in summer, were compared to test whether the accuracy of correlation was affected by (i) length of correlation period; (ii) distance between BDS and weather station; and (iii) periodicity of ambient temperature measurements. The accuracy of correlations in data sets from real Victorian and NSW forensic entomology cases was also examined. Correlations increased weather data accuracy in all experiments, but significant differences in accuracy were found only between periodicity treatments. We found that a >5°C difference between average values of body in situ and correlation period weather station data was predictive of correlations that decreased the accuracy of ambient temperatures estimated using correlation. Practitioners should inspect their weather data sets for such differences.
Sudden and Unexpected Death from Pituitary Tumor Apoplexy
Authors: Shields Lisa B.E. , Balko M. Gregory , Hunsaker III John C.
Published: August 2011

Abstract:  Pituitary tumor apoplexy refers to a clinical syndrome precipitated by the expansion of a pituitary adenoma by hemorrhage or infarction. Individuals may present with myriad signs, including sudden onset of severe headache, visual changes, altered mental status, cranial nerve palsies, and hormonal dysfunction. This disorder constitutes a medical emergency and warrants an expedited evaluation, diagnosis, and treatment to prevent the potential sequelae of permanent visual loss, endocrine abnormalities, or death. We report a case of sudden death from undiagnosed pituitary tumor apoplexy. The decedent was evaluated by medical personnel on three occasions in the week prior to her death for severe headache, nausea, vomiting, and photophobia. Postmortem examination demonstrated a hemorrhagic infarction of a pituitary adenoma with necrosis and expansion out of the sella turcica. The recognition of and treatment for a patient with pituitary tumor apoplexy requires a rapid multidisciplinary effort. Failure of prompt diagnosis may be fatal and require a medico‐legal death investigation for sudden and unexpected death.
Robot‐assisted laparoscopic hysterectomy in obese and morbidly obese women: surgical technique and comparison with open surgery
Authors: GEPPERT BARBARA , LÖNNERFORS CELINE , PERSSON JAN
Published: August 2011

Objective. Comparison of surgical results on obese patients undergoing hysterectomy by robot‐assisted laparoscopy or laparotomy. Setting. University hospital. Methods. All women (n=114) with a BMI ≥30 kg/m2 who underwent a simple hysterectomy as the main surgical procedure between November 2005 and November 2009 were identified. Robot‐assisted procedures (n=50) were separated into an early (learning phase) and a late (consolidated phase) group; open hysterectomy was considered an established method. Relevant data was retrieved from prospective protocols (robot) or from computerized patient charts (laparotomy) until 12 months after surgery. Complications leading to prolonged hospital stay, readmission/reoperation, intravenous antibiotic treatment or blood transfusion were considered significant. The surgical technique used for morbidly obese patients is described. Results. Women in the late robot group (n=25) had shorter inpatient time (1.6 compared to 3.8 days, p<0.0001), less bleeding (100 compared to 300 mL, p<0.0001) and fewer complications (2/25 compared to 23/64, p=0.006) than women with open surgery (n=64) but a longer operating time (136 compared to 110 minutes, p=0.0004). For women with a BMI ≥35 kg/m2, surgical time in the late robot group and the laparotomy group was equal (136 compared to 128 minutes, p=0.31). Conclusions. Robot‐assisted laparoscopic hysterectomy in a consolidated phase in obese women is associated with shorter hospital stay, less bleeding and fewer complications compared to laparotomy but, apart from women with BMI ≥35, a longer operative time.
Maternal weight gain in twin–twin transfusion syndrome
Authors: MORIKAWA MAMORU , YAMADA TAKASHI , HIRAYAMA‐KATO EMI , YAMADA TAKAHIRO , OKUYAMA KAZUHIKO , MINAKAMI HISANORI
Published: August 2011

Objective. To examine the association between maternal weight gain and twin–twin transfusion syndrome (TTTS). Design. Retrospective observational study in two tertiary care centers. Population. All 124 women with monochorionic diamniotic twin pregnancies who gave birth at ≥16 gestational weeks between 2002 and 2010. Methods. Analysis of chronological relation between maternal weight gain per week (weekly gain) and the diagnosis of TTTS. Main outcome measure. Sonographic diagnosis of TTTS. Results. A weekly weight gain ≥1.4 kg occurred in 45 women, preceded the diagnosis of TTTS in 22 (78.6%) of the 28 women with TTTS, and was associated with TTTS [women with one weekly weight gain ≥1.4 kg vs. women with no weekly weight gains ≥1.4 kg who were diagnosed as having TTTS: 48.9% (22/45) vs. 7.6% (6/79); RR, 6.44; 95%CI, 2.82–14.69]. At given gestational weeks between 16 and 27, the mean (±SD) prospective risk of the development of TTTS within three weeks was 52.0±33.8% among women who showed a weekly weight gain ≥1.4 kg for the first time, whereas the risk of the development of TTTS within one week was 1.6±1.7% among women who never showed a weekly weight gain ≥1.4 kg. Conclusions. Excessive maternal weight gain ≥1.4 kg/week is likely to occur during the development of TTTS.
Multiple habitat associations: the role of offsite habitat in determining onsite avian density and species richness
Authors: Dallimer Martin , Skinner Andrew M. J. , Davies Zoe G. , Armsworth Paul R. , Gaston Kevin J.
Published: August 2011

Many animal populations continue to decline despite occurring in protected areas or on sympathetically managed sites. Frequently, this is because a specific habitat patch may not fulfil all the niche requirements of a threatened species. For instance, species often move between, and make use of, multiple habitat types for breeding, roosting and feeding within the same landscape. These cross‐habitat interactions present a challenge for conservation. Here we quantify how the habitat associations of individual species and assemblages occurring within two distinct but adjacent habitat types (moorland and farmland) determine a suite of density and richness indicators, using the bird community of the English uplands as a case study. There was a clear association between onsite avian density and richness and offsite habitat structure (e.g. vegetation height, percent cover of dominant plant species, land management practices). Although such effects are not universal across all species and assemblages, where present (for five farmland and three moorland indicators) the increase in explanatory power offered by including offsite habitat structure can be large. By constructing scenarios of possible changes to management practice on both moorland and farmland, we demonstrate a real conservation benefit can be obtained by altering management in offsite habitats. For example, reducing burning intensity on moorland can result in a five‐fold increase in snipe Gallinago gallinago density on farmland, without an alteration in farmland habitat. For one species (Eurasian curlew Numenius arquata), we demonstrate the frequency with which birds move between and utilise farmland and moorland during the breeding season, and therefore the importance of both habitat types to maintaining population densities. The multiple habitat dependency phenomenon quantified here is common and not restricted to birds. The successful conservation of many threatened species will thus depend on coordinated cross‐habitat management.
Investigation into the dosage of dietary sphingomyelin concentrate in relation to the improvement of epidermal function in hairless mice
Authors: HARUTA‐ONO Yuko , UENO Hiroshi , UEDA Noriko , KATO Ken , YOSHIOKA Toshimitsu
Published: August 2011

We previously found that dietary sphingomyelin (SPM) concentrate from bovine milk improved epidermal function. In this study, we investigated the dosage of dietary SPM concentrate from bovine milk in relation to the improvement of epidermal function. Thirteen‐week‐old hairless male mice were separated into four experimental groups, each fed one of four types of experimental diet: the control group, the low SPM group, the medium SPM group and the high SPM group. The mice were each fed the experimental diet for 6 weeks. The stratum corneum hydration and the transepidermal water loss (TEWL) were measured using a Corneometer and a Tewameter at 3 weeks and 6 weeks. After the feeding period, ceramides in the stratum corneum were analyzed. We found that the stratum corneum hydration in all the SPM groups was significantly higher than that in the control group, whereas TEWL in all the SPM groups was significantly lower than that in the control group. Ceramides increased significantly in mice fed the medium SPM diet and statistically tended to increase in mice fed the high SPM diet. Our results indicate that a daily intake of 17 mg SPM concentrate is enough to improve epidermal function in hairless mice.
A Modeling Framework for the Design of Collector Wells
Authors: Moore Rhett , Kelson Vic , Wittman Jack , Rash Vern
Published: August 2011

We present results of a design study performed for the Saylorville Wellfield in Iowa, which is owned and operated by the Des Moines Water Works. The purpose of this study was to estimate wellfield capacity and provide a preliminary design for two radial collector wells to be constructed in the outwash aquifer along the Des Moines River near Saylorville, Iowa. After a field investigation to characterize the aquifer, regional two‐dimensional and local three‐dimensional, steady‐state groundwater flow modeling was performed to locate and design the wells. This modeling was the foundation for design recommendations based on the relative performance of 12 collector well designs with varying lateral numbers, elevations, screen lengths, and orientations. For each site, alternate designs were evaluated based on model estimates of the capacity, the percent of surface water captured, and the production per unit length of screen. Many of our results are consistent with current design practices based on experience and intuition, but our methods allow for a quantitative approach for comparing alternate designs. Although the results are site‐specific, the framework for evaluating the hydraulic design of the Saylorville radial collector wells is broadly applicable and could be used at other riverbank filtration sites. In addition, many of the conclusions from this design study may apply at other sites where construction of radial collector wells is being considered.
Post‐operative pain following coblation or monopolar electrocautery tonsillectomy in children: a prospective, single‐blinded, randomised comparison
Authors: Parker N.P. , Walner D.L.
Published: August 2011

Clin. Otolaryngol. 2011, 36, 468–474

Objective:  To compare post‐operative pain following tonsillectomy by either coblation or monopolar electrocautery in children.

Design:  A parallel‐designed, prospective, single‐blinded, randomised trial.

Setting:  Ambulatory surgical facility.

Study participants:  Eighty otherwise healthy paediatric patients undergoing coblation or electrocautery tonsillectomy by a fellowship‐trained paediatric otolaryngologist.

Main outcome measures:  (i) The number of post‐operative days with severe pain based on subjective qualification by the caretaker, (ii) post‐operative days with pain rated ≥5 on a scale of 1–10, (iii) post‐operative days requiring oral paracetamol/acetaminophen with codeine solution and (iv) post‐operative days until resumption of a regular diet were assessed and recorded daily using a post‐operative pain survey as a form of daily diary that was returned at the 2‐week follow‐up visit.

Results:  Patients were consecutively enrolled into two groups of 40 patients. Average ages were 5.2 years for coblation tonsillectomy and 6.0 years for electrocautery tonsillectomy. The average number of post‐operative days with severe pain was 4.2 for coblation and 5.9 for electrocautery (P = 0.006), days rating pain ≥5 were 3.6 for coblation and 4.8 for electrocautery (P = 0.037), days of codeine use were 2.5 for coblation and 2.9 for electrocautery (P = 0.324), and days until resumption of a regular diet were 5.2 for coblation and 6.2 for electrocautery (0.329).

Conclusions:  Coblation tonsillectomy may reduce post‐operative pain and the time until resumption of a regular diet compared to electrocautery tonsillectomy.
Use of Staurenghi lens angiography in the management of posterior uveitis
Authors: Reeves Graham M. B. , Kumar Nishant , Beare Nicholas A. V. , Pearce Ian A.
Published: August 2011

Purpose:  Retinal vasculitis is an important component of posterior uveitis. It may be difficult to detect either clinically or with conventional angiography. We assessed the role of Staurenghi lens angiography (SLA) in the diagnosis and management of patients with posterior uveitis.

Methods:  A total of 26 patients attending the St Paul’s Eye Unit uveitis clinic with posterior uveitis underwent wide‐angle (150 degree) retinal angiography with the Heidelberg Retina Angiograph 2 Scanning Laser Ophthalmoscope using the Staurenghi SLO 230 contact lens. We determined the percentage of patients in whom this imaging modality assisted in diagnosing and quantifying the extent of vasculitis, planning treatment or monitoring disease activity.

Results:  Staurenghi lens angiography assisted in diagnosing and quantifying the extent of vasculitis in 62% of patients, and in planning laser photocoagulation or immunosuppression titration in 62% of patients and enhanced disease monitoring in 35% of patients. In 31% of cases, SLA revealed vasculitis that was not evident clinically.

Conclusion:  Staurenghi lens angiography is a valuable tool in the management of patients with posterior uveitis and can be used for the diagnosis, treatment and follow‐up of these patients.
Investigation of genome structure of a cinnamyl alcohol dehydrogenase locus in a basal angiosperm hardwood species, Liriodendron tulipifera L., reveals low synteny
Authors: XU Yi , SCHLARBAUM Scott E. , LIANG Haiying
Published: August 2011

Abstract  Basal angiosperms contain a wide diversity of floral and growth forms and gave rise to the largest recent angiosperm lineages. As none of the basal angiosperm genomes has been sequenced, examining large bacterial artificial chromosome (BAC) inserts remains the main approach to providing a first glimpse of the structure and organization of their genomes. In this study, we sequenced a 126.9‐kbp BAC contig harboring a cinnamyl alcohol dehydrogenase gene (LtuCAD1) in a basal angiosperm species, Liriodendron tulipifera L., an important timber tree species with significant ecological and economic values. A key enzyme in lignin biosynthesis, CAD catalyzes the final step in the synthesis of monolignols. We carried out phylogenetic analyses of seven full‐length CAD family genes (LtuCAD1–7) obtained from a comprehensive Liriodendron expressed sequence tag dataset. The phylogenetic tree suggests that LtuCAD1 is the primary CAD gene involved in lignifications as it is the only Liriodendron CAD grouped with the bona fide CADs class. As well as the LtuCAD1, the BAC contig contained fragmented sequences for one integrase, eight hypothetical proteins, two gag‐pol polyproteins, one RNase H family protein, and one chromatin binding protein. Comparative analysis with other angiosperm species suggests that the genomic segment in this BAC has undergone frequent arrangement. This study is our initial step in identifying and understanding lignin biosynthesis genes from basal angiosperm species. Such knowledge can help bridge the information gap between hardwood (angiosperm) and softwood (gymnosperm) species and benefit potential breeding and biotechnology application for enhanced production of biomass and digestibility in L. tulipifera.
A novel molecular approach for rapid assessment of soil nematode assemblages – variation, validation and potential applications
Authors: Donn Suzanne , Neilson Roy , Griffiths Bryan S. , Daniell Tim J.
Published: August 2011

1.Nematode assemblages are commonly used as an indicator of ecosystem health; however, conventional approaches to assemblage analyses are restricted by time‐consuming processing and declining availability of expertise. Molecular methods offer a rapid and cost‐effective alternative.

2.We have designed a molecular profiling system, using directed terminal‐restriction fragment length polymorphism (dT‐RFLP), to characterise nematode assemblages by relative abundance of feeding guilds.

3.An arable soil was first characterised by cloning and sequencing of small subunit ribosomal DNA, and an enzyme digest selected to discriminate between feeding guilds. This yielded 14 different terminal‐restriction fragments (T‐RFs) from the sequence set, assigned to five nematode feeding guilds.

4.Robustness of the dT‐RFLP methodology was tested. The greatest amount of variation between replicates occurred at the PCR stage, with little variability between replicate digests from the same PCR product or capillary runs.

5.dT‐RFLP revealed changes in assemblage composition owing to organic amendments of dairy‐cattle slurry and municipal green compost. The proportion of microbial feeding nematodes was higher in compost and slurry plots than in the no amendment control in the first sampling after organic amendment. Plant feeding nematodes composed a significantly greater proportion of the control assemblage during the growing season and post‐harvest.

6.The increased throughput of molecular analysis compared with microscopy increases the feasibility of studies involving large‐scale sampling and makes nematode assemblage analysis more attractive as an indicator of soil health for environmental assessment.
Sources of pre-admission medication information: observational study of accuracy and availability
Authors: Fitzsimons Michelle , Grimes Tamasine , Galvin Mairead
Published: August 2011

Objective

To identify the accessibility of sources of pre-admission medication (PAM) information, to quantify agreement between the PAM list and the ‘gold-standard’ PAM list (GS-PAML) and to categorise disagreements.

Methods

A random selection of patients with chronic illness admitted via accident and emergency to one of two study hospitals in the Republic of Ireland were recruited. For each patient, a GS-PAML was compiled and PAM lists were obtained from each relevant source, including patient own medications, general practitioner (GP) referral letter, past inpatient prescription (Kardex) and discharge summary, nursing home letter and personal communication with GP staff, community pharmacy staff and nursing home staff. Data were collected regarding availability for use of each source and allergy status. The GS-PAML was compared to each PAM, and disagreements were identified and categorised.

Key findings

Data were collected for 134 patients. Community pharmacy and nursing home staff were most accessible to researchers when undertaking the medication history (>90%), followed by GP staff (66%). Except for nursing home sources, agreement between PAML and GS-PAML was low (2–17% of patients, 44–77% of medications). The community pharmacy PAML most frequently agreed with the GS-PAML (17% of patients, 77% of medications) followed by GP staff (10% of patients, 69% of medications). Previous (within the last 6 months) discharge summaries (3% of patients, 49% of medications) and GP referral letters (2% of patients, 44% medications) agreed least frequently. Nursing home (100%) and GP (91%) staff provided most accurate allergy information. Drug omission (>35%) was the most common disagreement for all sources except nursing home staff. GP staff and community pharmacy PAMLs contained a considerable proportion of commission discrepancies.

Conclusion

Community pharmacy and GP staff were identified as the most available and accurate sources of PAM information and should be prioritised when undertaking admission medication reconciliation in a busy clinical environment.
Clozapine repackaged into dose administration aids: a common practice in Australian hospitals
Authors: Perks Stephen , Robertson Sherryl , Haywood Alison , Glass Beverley
Published: August 2011

Objectives

Clozapine is an atypical antipsychotic used in the treatment of schizophrenia. Due to the patient profile there is a high rate of repackaging of clozapine into dose administration aids (DAAs). Because of reports from hospital pharmacists about discoloration of returned clozapine tablets that have been repackaged into DAAs, the aim of this study was to evaluate the chemical, physical and photostability of these tablets repackaged into a DAA.

Method

Clozapine tablets were repackaged into DAAs and evaluated for physicochemical stability over a 6-week period at a controlled room temperature (25 ± 1°C; 60 ± 1.5% relative humidity (RH)) and accelerated conditions (40 ± 1°C; 75 ± 1.5% RH). In addition, photostability studies were performed according to the International Committee on Harmonisation (ICH) guidelines.

Key findings

Chemical stability was confirmed for all storage conditions, including for those photostability (ICH conditions), with the clozapine content occurring within the British Pharmacopoeial (BP) range of 90–110%. Although the physical stability was confirmed for all tests at room temperature (weight uniformity, hardness, friability, disintegration and dissolution), under accelerated conditions the disintegration test did not meet BP requirements. However, the subsequent dissolution test was successful with 85% of clozapine dissolving in 45 min.

Conclusions

This study illustrates that clozapine, when correctly repackaged, maintains its physical and chemical stability for 6 weeks. As no discoloration of the tablets was observed, it is assumed that the reports received were as a result of improper handling by patients. Based on these findings, it is recommended that patients be advised on the correct handling and storage of their DAAs.
A naturalistic study of alexithymia among psychiatric outpatients treated in an integrated group therapy program
Authors: Ogrodniczuk John S. , Sochting Ingrid , Piper William E. , Joyce Anthony S.
Published: August 2011

Objectives. Alexithymia is common among psychiatric outpatients and can complicate treatment. There has been little research into whether alexithymia can be modified by psychological intervention, and whether change in alexithymia is related to other areas of improvement. The purpose of the present study was to examine whether participation in an integrated group therapy program could effect change in alexithymia, and whether such change is related to improvement in interpersonal functioning.

Design and methods. Sixty‐eight consecutively admitted psychiatric outpatients to a comprehensive group therapy program were evaluated at baseline, post‐therapy, and 3‐month follow‐up using the Toronto Alexithymia Scale 20, the Beck Depression Inventory, and the Inventory of Interpersonal Problems‐28. Associations among variables were evaluated with correlations and among group comparisons with t test, ANOVA, chi‐square tests, and logistic regression. Change in alexithymia was examined using repeated measures ANOVA, controlling for change in depressive symptoms.

Results. Alexithymia, particularly difficulty identifying feelings, decreased significantly during the treatment period. Post‐therapy levels of alexithymia were maintained during the 3 months following treatment completion. Changes in alexithymia were significantly associated with changes in interpersonal problems, both during therapy and during the follow‐up period.

Conclusions. The results of our study suggest that a comprehensive, integrated group therapy program can affect change in alexithymia, and that such change can be maintained once therapy is completed. Also, modifying alexithymia may contribute to improvement in interpersonal functioning.
Awareness and regulation of emotions in deaf children
Authors: Rieffe Carolien
Published: August 2011

In this study, deaf children's understanding of their own emotions was compared with that of hearing peers. Twenty‐six deaf children (mean age 11 years) and 26 hearing children, matched for age and gender, were presented with various tasks that tap into their emotion awareness and regulation (coping) regarding the four basic emotions (happiness, anger, sadness, and fear). The findings suggest that deaf children have no difficulties in identifying their own basic emotions and the elicitors, or multiple emotions of opposite valence (happy and sad). Yet, they did show an impaired capacity to differentiate between their own emotions within the negative spectrum, which suggests a more generic evaluation of the situation. Deaf children's emotion regulation strategies showed a strong preference for approaching the situation at hand, but almost no deaf child reported the use of an avoidant tactic in order to diminish the negative impact of the situation. Overall, deaf children's emotion regulation strategies seemed less effective than those of their hearing peers. The implications for deaf children's emotional development are discussed.
Itokawa Dust Particles: A Direct Link Between S-Type Asteroids and Ordinary Chondrites
Authors: Nakamura Tomoki , Noguchi Takaaki , Tanaka Masahiko , Zolensky Michael E. , Kimura Makoto , Tsuchiyama Akira , Nakato Aiko , Ogami Toshihiro , Ishida Hatsumi , Uesugi Masayuki , Yada Toru , Shirai Kei , Fujimura Akio , Okazaki Ryuji , Sandford Scott A. , Ishibashi Yukihiro , Abe Masanao , Okada Tatsuaki , Ueno Munetaka , Mukai Toshifumi , Yoshikawa Makoto , Kawaguchi Junichiro
Published: August 2011

Laboratory analysis of samples returned from an asteroid establishes a direct link between asteroids and meteorites and provides clues to the complex history of the asteroid and its surface.
CsgA Production by Escherichia coli O157:H7 Alters Attachment to Abiotic Surfaces in Some Growth Environments
Authors: Goulter-Thorsen R. M. , Taran E. , Gentle I. R. , Gobius K. S. , Dykes G. A.
Published: August 2011

The role of curli expression in attachment of
Escherichia coli
O157:H7 to glass, Teflon, and stainless steel (SS) was investigated through the creation of
csgA
knockout mutants in two isolates of
E. coli
O157:H7. Attachment assays using epifluorescence microscopy and measurements of the force of adhesion of bacterial cells to the substrates using atomic force microscopy (AFM) force mapping were used to determine differences in attachment between wild-type (wt) and
csgA
-negative (Δ
csgA
) strains following growth in four different media. The hydrophobicity of the cells was determined using contact angle measurements (CAM) and bacterial adhesion to hydrocarbons (BATH). The attachment assay results indicated that Δ
csgA
strains attached to glass, Teflon, and SS surfaces in significantly different numbers than their wt counterparts in a growth medium-dependent fashion (
P
< 0.05). However, no clear correlation was seen between attachment numbers, surface type, or growth medium. No correlation was seen between BATH and CAM results (
R
2
< 0.70). Hydrophobicity differed between the wt and Δ
csgA
in some cases in a growth medium- and method-dependent fashion (
P
< 0.05). AFM force mapping revealed no significant difference in the forces of adhesion to glass and SS surfaces between wt and Δ
csgA
strains (
P
> 0.05) but a significantly greater force of adhesion to Teflon for one of the two wt strains than for its Δ
csgA
counterpart (
P
< 0.05). This study shows that CsgA production by
E. coli
O157:H7 may alter attachment behavior in some environments; however, further investigation is required in order to determine the exact relationship between CsgA production and attachment to abiotic surfaces.
Characterization of Multidrug-Resistant Escherichia coli Isolates from Animals Presenting at a University Veterinary Hospital
Authors: Karczmarczyk Maria , Abbott Yvonne , Walsh Ciara , Leonard Nola , Fanning Séamus
Published: August 2011

In this study, we examined molecular mechanisms associated with multidrug resistance (MDR) in a collection ofEscherichia coliisolates recovered from hospitalized animals in Ireland. PCR and DNA sequencing were used to identify genes associated with resistance. Class 1 integrons were prevalent (94.6%) and contained gene cassettes recognized previously and implicated mainly in resistance to aminoglycosides, β-lactams, and trimethoprim (aadA1,dfrA1-aadA1,dfrA17-aadA5,dfrA12-orfF-aadA2,blaOXA-30-aadA1,aacC1-orf1-orf2-aadA1,dfr7). Class 2 integrons (13.5%) contained thedfrA1-sat1-aadA1gene array. The most frequently occurring phenotypes included resistance to ampicillin (97.3%), chloramphenicol (75.4%), florfenicol (40.5%), gentamicin (54%), neomycin (43.2%), streptomycin (97.3%), sulfonamide (98.6%), and tetracycline (100%). The associated resistance determinants detected includedblaTEM,cat,floR,aadB,aphA1,strA-strB,sul2, andtet(B), respectively. TheblaCTX-M-2gene, encoding an extended-spectrum β-lactamase (ESβL), andblaCMY-2, encoding an AmpC-like enzyme, were identified in 8 and 18 isolates, respectively. The mobility of the resistance genes was demonstrated using conjugation assays with a representative selection of isolates. High-molecular-weight plasmids were found to be responsible for resistance to multiple antimicrobial compounds. The study demonstrated that animal-associated commensalE. coliisolates possess a diverse repertoire of transferable genetic determinants. Emergence of ESβLs and AmpC-like enzymes is particularly significant. To our knowledge, theblaCTX-M-2gene has not previously been reported in Ireland.
Mechanisms of Fluoroquinolone Resistance in Escherichia coli Isolates from Food-Producing Animals
Authors: Karczmarczyk Maria , Martins Marta , Quinn Teresa , Leonard Nola , Fanning Séamus
Published: August 2011

Eleven multidrug-resistant
Escherichia coli
isolates (comprising 6 porcine and 5 bovine field isolates) displaying fluoroquinolone (FQ) resistance were selected from a collection obtained from the University Veterinary Hospital (Dublin, Ireland). MICs of nalidixic acid and ciprofloxacin were determined by Etest. All showed MICs of nalidixic acid of >256 μg/ml and MICs of ciprofloxacin ranging from 4 to >32 μg/ml. DNA sequencing was used to identify mutations within the quinolone resistance-determining regions of target genes, and quantitative real-time PCR (qRT-PCR) was used to evaluate the expression of the major porin, OmpF, and component genes of the AcrAB-TolC efflux pump and its associated regulatory loci. Decreased MIC values to nalidixic acid and/or ciprofloxacin were observed in the presence of the efflux pump inhibitor phenylalanine-arginine-β-naphthylamide (PAβN) in some but not all isolates. Several mutations were identified in genes coding for quinolone target enzymes (3 to 5 mutations per strain). All isolates harbored GyrA amino acid substitutions at positions 83 and 87. Novel GyrA (Asp87 → Ala), ParC (Ser80 → Trp), and ParE (Glu460 → Val) substitutions were observed. The efflux activity of these isolates was evaluated using a semiautomated ethidium bromide (EB) uptake assay. Compared to wild-type
E. coli
K-12 AG100, isolates accumulated less EB, and in the presence of PAβN the accumulation of EB increased. Upregulation of the
acrB
gene, encoding the pump component of the AcrAB-TolC efflux pump, was observed in 5 of 11 isolates, while 10 isolates showed decreased expression of OmpF. This study identified multiple mechanisms that likely contribute to resistance to quinolone-based drugs in the field isolates studied.
Pathways Involved in Reductant Distribution during Photobiological H
2
Production by Rhodobacter sphaeroides
Authors: Kontur Wayne S. , Ziegelhoffer Eva C. , Spero Melanie A. , Imam Saheed , Noguera Daniel R. , Donohue Timothy J.
Published: August 2011

We used global transcript analyses and mutant studies to investigate the pathways that impact H
2
production in the photosynthetic bacterium
Rhodobacter sphaeroides
. We found that H
2
production capacity is related to the levels of expression of the nitrogenase and hydrogenase enzymes and the enzymes of the Calvin-Benson-Bassham pathway.