bluuebunny/crossref_metadata_2025 huggingface dataset:
Sustaining Clinical Programs During Difficult Economic Times: A Case Series from the Hospital Elder Life Program
Authors: SteelFisher Gillian K. , Martin Lauren A. , Dowal Sarah L. , Inouye Sharon K.
Published: September 2011

Objectives

To explore strategies used by clinical programs to justify operations to decision‐makers using the example of the Hospital Elder Life Program (HELP), an evidence‐based, cost‐effective program to improve care for hospitalized older adults.

Design

Qualitative study design using 62 in‐depth, semistructured interviews conducted with HELP staff members and hospital administrators between September 2008 and August 2009.

Setting

Nineteen HELP sites in hospitals across the United States and Canada that had been recruiting patients for at least 6 months.

Participants

HELP staff and hospital administrators.

Measurements

Participant experiences sustaining the program in the face of actual or perceived financial threats, with a focus on factors they believe are effective in justifying the program to decision‐makers in the hospital or health system.

Results

Using the constant comparative method, a standard qualitative analysis technique, three major themes were identified across interviews. Each focuses on a strategy for successfully justifying the program and securing funds for continued operations: interact meaningfully with decision‐makers, including formal presentations that showcase operational successes and informal means that highlight the benefits of HELP to the hospital or health system; document day‐to‐day, operational successes in metrics that resonate with decision‐maker priorities; and garner support from influential hospital staff that feed into administrative decision‐making, particularly nurses and physicians.

Conclusion

As clinical programs face financially challenging times, it is important to find effective ways to justify their operations to decision‐makers. Strategies described here may help clinically effective and cost‐effective programs sustain themselves and thus may help improve care in their institutions.
Mind‐Mindedness as a Multidimensional Construct: Appropriate and Nonattuned Mind‐Related Comments Independently Predict Infant–Mother Attachment in a Socially Diverse Sample
Authors: Meins Elizabeth , Fernyhough Charles , de Rosnay Marc , Arnott Bronia , Leekam Susan R. , Turner Michelle
Published: September 2011

In a socially diverse sample of 206 infant–mother pairs, we investigated predictors of infants’ attachment security at 15 months, with a particular emphasis on mothers’ tendency to comment appropriately or in a non‐attuned manner on their 8‐month‐olds’ internal states (so‐called mind‐mindedness). Multinomial logistic regression analyses showed that higher scores for appropriate mind‐related comments and lower scores for non‐attuned mind‐related comments distinguished secure‐group mothers from their counterparts in the insecure‐avoidant, insecure‐resistant, and insecure‐disorganized groups. Higher scores for appropriate mind‐related comments and lower scores for non‐attuned mind‐related comments also independently predicted dichotomous organized/disorganized attachment. General maternal sensitivity predicted neither attachment security nor organization, although sensitivity was found to relate to dichotomous secure/insecure attachment specifically in the context of low socioeconomic status. The findings highlight how appropriate and non‐attuned mind‐related comments make independent contributions to attachment and suggest that mind‐mindedness is best characterized as a multidimensional construct.
Detection of bacterial contamination in prestorage culture‐negative apheresis platelets on day of issue with the Pan Genera Detection test
Authors: Jacobs Michael R. , Smith Daniel , Heaton W. Andrew , Zantek Nicole D. , Good Caryn E. ,   PGD Study Group
Published: September 2011

BACKGROUND: Bacterial contamination is currently the most important infectious risk associated with transfusion of platelet (PLT) products. Prestorage culture has reduced but not eliminated this problem.

STUDY DESIGN AND METHODS: Eighteen hospitals studied the Pan Genera Detection (PGD) test, a rapid, lateral‐flow immunoassay for the detection of Gram‐positive and Gram‐negative bacteria. The PGD test was performed on day of issue on apheresis PLTs released by collection centers as culture negative. Confirmatory bacterial culture was performed when PGD tests were repeatedly reactive, with three sites performing culture on all doses studied.

RESULTS: PGD tests on nine of 27,620 (1:3069, 95% confidence interval [CI] 1:6711 to 1:1617; or 326 per million, 95% CI 149‐618 per million) apheresis PLT doses were repeatedly reactive and verified as bacterially contaminated by confirmatory culture. Bacterial species isolated included coagulase‐negative staphylococci (n = 6), Bacillus sp. (n = 2), and Enterococcus faecalis (n = 1). The ages of these contaminated doses were Day 3 (n = 4), Day 4 (n = 2), and Day 5 (n = 3). Two contaminated doses with nonreactive PGD tests were detected among 10,424 doses at hospitals where concurrent culture was performed, and one other was identified via a transfusion reaction investigation. There were 142 PGD false positives (0.51%).

CONCLUSIONS: The PGD test detected bacterial contamination in 1:3069 (9 of 27,620) doses released as negative by prestorage culture in PLTs as young as 3 days old. Three contaminated doses, two clinically insignificant, had nonreactive PGD tests, while 0.51% of tests were false positives. Application of this test on day of issue can interdict contaminated units and prevent transfusion reactions.
Proteomic analyses of human plasma: Venus versus Mars
Authors: Silliman Christopher C. , Dzieciatkowska Monika , Moore Ernest E. , Kelher Marguerite R. , Banerjee Anirban , Liang Xiayuan , Land Kevin J. , Hansen Kirk C.
Published: September 2011

BACKGROUND: Plasma is vital for the resuscitation of injured patients and to restore necessary procoagulants, especially Factors (F)II, FV, FVII, FX, and FXIII; however, female plasma has been implicated in the majority of transfusion‐related acute lung injury (TRALI) cases and male‐only plasma transfusion regimens have significantly decreased the incidence of TRALI. Little is known about the human plasma proteome, and no comparisons have been made between male and female plasma; therefore, we hypothesize that there are significant differences between plasma from male and female donors.

STUDY DESIGN AND METHODS: Five units of fresh‐frozen plasma each were collected from nulliparous female donors and male donors, and the proteome was analyzed by depleting the 14 most common proteins by immunoaffinity columns followed by protein separation by one dimension gel electrophoresis, tryptic digestion of the proteins, analysis of the peptides by liquid chromatography–tandem mass spectrometry, and identification employing human protein sequence databases.

RESULTS: Female plasma versus male plasma contained pregnancy zone protein (419‐ to 580‐fold), FV (twofold), α1‐antitrypsin (twofold), β2‐microglobulin (twofold), and Complement Factors H and C4B (1.5‐ to 2‐fold) at significantly higher concentrations than males and males contained significant increases in Fc‐binding protein (twofold), protein Z–dependent protease inhibitor (twofold), phosphatidylinositol glycan–specific phospholipase (fourfold), protein S‐100 (threefold), and transgelin‐2 (14‐fold) versus females (p < 0.005). The increases in FV, α1‐antitrypsin, and β2‐microglobulin were confirmed by an activity assay or immunoblots.

CONCLUSION: We conclude that there are proteomic differences between male and female plasma, which could be exploited to improve clinical outcomes in transfused patients.
Storage of thawed plasma for a liquid plasma bank: impact of temperature and methylene blue pathogen inactivation
Authors: Thiele Thomas , Kellner Sarah , Hron Gregor , Wasner Christina , Nauck Matthias , Zimmermann Kathrin , Wessel Antje , Warkentin Theodore E. , Greinacher Andreas , Selleng Kathleen
Published: September 2011

BACKGROUND: Rapid transfusion of fresh‐frozen plasma (FFP) is desired for treating coagulopathies, but thawing and issuing of FFP takes more than 40 minutes. Liquid storage of plasma is a potential solution but uncertainties exist regarding clotting factor stability. We assessed different storage conditions of thawed FFP and plasma treated by methylene blue plus light (MB/light) for pathogen inactivation.

STUDY DESIGN AND METHODS: Fifty thawed apheresis plasma samples (approx. 750 mL) were divided into three subunits and either stored for 7 days at 4°C, at room temperature (RT), and at 4°C after MB/light treatment. Clotting factor activities (Factor [F] II, FV, FVII through FXIII, fibrinogen, antithrombin, von Willebrand factor antigen, Protein C and S) were assessed after thawing and on Days 3, 5, and 7. Changes were classified as “minor” (activities within the reference range) and “major” (activities outside the reference range).

RESULTS: FFP storage at 4°C revealed major changes for FVIII (median [range], 56% [33%‐114%]) and Protein S (51% [20%‐88%]). Changes were more pronounced when plasma was stored at RT (FVIII, 59% [37%‐123%]; FVII, 69% [42%‐125%]; Protein S, 20% [10%‐35%]). MB/light treatment of thawed FFP resulted in minor changes. However, further storage for 7 days at 4°C revealed major decreases for FVIII (47% [12%‐91%]) and Protein S (49% [18%‐95%]) and increases for FVII (150% [48%‐285%]) and FX (126% [62%‐206%]).

CONCLUSION: Storage of liquid plasma at 4°C for 7 days is feasible for FFP as is MB/light treatment of thawed plasma. In contrast, storage of thawed plasma for 7 days at RT or after MB/light treatment at 4°C affects clotting factor stability substantially and is not recommended.
Fairness and Nanotechnology Concern
Authors: McComas Katherine A , Besley John C.
Published: September 2011

Research suggests that fairness perceptions matter to people who are asked to evaluate the acceptability of risks or risk management. Two separate national random surveys (n = 305 and n = 529) addressed Americans’ concerns about and acceptance of nanotechnology risk management in the context of the degree to which they view scientists and risk managers as fair. The first survey investigated general views about scientists across four proposed dimensions of fairness (distributional, procedural, interpersonal, and informational). The results show that respondents who believe that the outcomes of scientific research tend to result in unequal benefits (distributional fairness) and that the procedures meant to protect the public from scientific research are biased (procedural fairness) were more concerned about nanotechnology. Believing scientists would treat them with respect (interpersonal fairness) and ensure access to information (informational fairness) were not significant predictors of concern. The second study also looked at these four dimensions of fairness but focused on perceptions of risk managers working for government, universities, and major companies. In addition to concern, it also examined acceptance of nanotechnology risk management. Study 2 results were similar to those of study 1 for concern; however, only perceived informational fairness consistently predicted acceptance of nanotechnology risk management. Overall, the study points to the value of considering fairness perceptions in the study of public perceptions of nanotechnology.
The Impact of Pharmacologic Sympathetic and Parasympathetic Blockade on Atrial Electrogram Characteristics in Patients with Atrial Fibrillation
Authors: HABEL NICOLE , MÜLLER JOACHIM G. , ZNOJKIEWICZ PIERRE , THOMPSON NATHANIEL , CALAME JAMES , CALAME SUSAN , NOORI ARSHIA , GALLO ANNEMARIE , LUSTGARTEN DANIEL L. , SOBEL BURTON E. , SPECTOR PETER S.
Published: September 2011

Background:
 Ablation of atrial autonomic inputs exerts antifibrillatory effects. However, because ablation destroys both myocardium and nerve cells, the effect of autonomic withdrawal alone remains unclear. We therefore examined the effects of pharmacologic autonomic blockade (PAB) on frequency and fractionation in patients with atrial fibrillation (AF).

Methods:
 Esmolol and atropine were administered and electrograms were recorded simultaneously from both atria and the coronary sinus. In 17 patients, AF was recorded for 5 minutes and dominant frequency (DF) and continuous activity (CA) were compared before and during PAB.

Results:
 Examination of the pooled data (537 sites, 17 patients) revealed a statistically significant decrease in mean DF (5.61–5.43Hz, P < 0.001) during PAB. Site‐by‐site analysis showed that 67% of sites slowed (0.45 ± 0.59 Hz), whereas 32% accelerated (0.49 ± 0.59Hz). Fractionation was reduced: median CA decreased from 31% to 26% (P < 0.001). In patient‐by‐patient analysis, mean DF/median CA decreased in 13 of 17 patients and increased in four. The spatial heterogeneity of DF decreased in nine of 17 patients (spatial coefficient of variation of DF at “nondriver sites” decreased by a mean of 2%).

Conclusion:
 PAB decreases DF and CA in the majority of sites. Given the complexity of interactions between atrial cells during AF, the effects of PAB on DF and fractionation are more heterogeneous than the effects of PAB on isolated cells. (PACE 2011; 34:1460–1467)
Effect of Alumina and Silica on the Hydration Behavior of Magnesia‐Based Refractory Castables
Authors: Silva Wagner M. , Aneziris Christos G. , Brito Modestino A. M.
Published: September 2011

Samples taken from the core of real‐sized castable pieces were studied under TGA, DTA, SEM, and XRD techniques after hydration during normal dry‐out process. The TGA was also performed at bulk samples, and the effect of volume on the hydration process was evaluated. The castables consisted of dead‐burned magnesia with additions of calcined and/or tabular aluminas, or microsilica to the matrix. The addition of alumina in combination with magnesia increased the hydration rate during the drying of the castable due to a lower permeability of the casted piece. Addition of microsilica, on the other hand, reduced damage due to hydration. The microsilica promotes the formation of a low crystallinity chrysotile precursor, due to its reaction with the magnesium hydroxide formed after the hydration of the surface of magnesia grains. This phase alleviates the stress generally associated to hydroxide formation, which otherwise leads to structural spalling.
Electrochemical Properties and Intermediate‐Temperature Fuel Cell Performance of Dense Yttrium‐Doped Barium Zirconate with Calcium Addition
Authors: Sun Ziqi , Fabbri Emiliana , Bi Lei , Traversa Enrico
Published: September 2011

Although BaZr0.8Y0.2O3−δ (BZY) possesses large bulk proton conductivity and excellent chemical stability, its poor sinterability and grain boundaries block proton conduction. In this work, the effect of Ca as a co‐dopant and as a sintering aid (as CaO), on the sinterability, proton conductivity, and fuel cell performance of BZY was investigated. The addition of 4 mol% CaO significantly improved the BZY sinterability: BZY pellets with densities of 92.7% and 97.5% with respect to the theoretical density were obtained after sintering at 1500°C and 1600°C, respectively. The improved BZY sinterability by CaO addition resulted also in a large proton conductivity; at 600°C, the total conductivity of BZY–CaO was 2.14 × 10−3 S/cm, in wet Ar. Anode‐supported fuel cells with 25 μm‐thick BZY–CaO electrolyte membranes were fabricated by a dual‐layer co‐firing technique. The peak power density of the fuel cell with a BZY–Ni/BZY–4CaO/BZY–LSCF (La0.6Sr0.4Fe0.8Co0.2O3−δ) configuration was 141 mW/cm2 at 700°C, several times larger than the reported values of BZY electrolyte membrane fuel cells sintered with the addition of CuO or ZnO, demonstrating promising features for practical fuel cell applications.
Enhanced Grain Boundary Mobility in Yttria‐Stabilized Cubic Zirconia under an Electric Current
Authors: Kim Seung‐Wan , Kim Soo Gil , Jung Jae‐Il , Kang Suk‐Joong L. , Chen I‐Wei
Published: September 2011

Grain growth in 8 mol% Y2O3‐stabilized zirconia ceramics (8YSZ) under an electric current has been investigated. Enhanced grain growth on the cathode side starts at 1150°C, well below the conventional sintering temperature, while grain growth is dormant on the anode side until 1400°C. In fully dense samples, the grain size undergoes an abrupt transition, differing by a factor of more than 10 on the two sides. Porous samples also experience faster densification on the cathode side, but grain growth is postponed until full density is first reached. Estimated grain boundary diffusivity on the cathode side has an apparent activation energy about 1 eV lower than that of normal grain boundary diffusion. These results are attributed to supersaturated oxygen vacancies accumulated on the cathode side, causing cation reduction that lowers their migration barrier.
The Correlation between Spurling Test and Imaging Studies in Detecting Cervical Radiculopathy
Authors: Shabat Shay , Leitner Yossi , David Rami , Folman Yoram
Published: September 2011

BACKGROUND

Cervical spine symptoms are a major cause of visits to general or spinal orthopedic surgeons or even primary care physicians. Although in this era the imaging studies can precisely rule out or diagnose pathologies in the spine, all of these studies have limitations. Computerized tomography (CT) scan consists of radiation exposure to the patients and it should be done with caution. Magnetic resonance imaging (MRI) is a highly effective imaging tool, but in many countries it is still costly. The goal of our study was to determine whether a simple clinical test can help the clinician to identify the patients who need to be sent for these imaging studies.

METHODS

Two hundred fifty‐seven patients with clinical cervical radiculopathy underwent complete physical examination that also included the Spurling test. After that, all patients were sent to imaging studies of the cervical spine (CT and/or MRI). Correlation between the physical examination using the Spurling test to the imaging studies was done.

RESULTS

Sensitivity of the Spurling test to nerve root pathology was 95% and specificity was 94%.

CONCLUSION

This paper demonstrate that patients with positive Spurling test have probable nerve root pressure and should be sent for further imaging studies. In patients with negative Spurling test, the possibility of nerve root pressure is less likely.
A Prospective Comparison of Procedural Sedation and Ultrasound‐guided Interscalene Nerve Block for Shoulder Reduction in the Emergency Department
Authors: Blaivas Michael , Adhikari Srikar , Lander Lina
Published: September 2011

ACADEMIC EMERGENCY MEDICINE 2011; 18:922–927 © 2011 by the Society for Academic Emergency Medicine

Objectives: Emergency physicians (EPs) are beginning to use ultrasound (US) guidance to perform regional nerve blocks. The primary objective of this study was to compare length of stay (LOS) in patients randomized to US‐guided interscalene block or procedural sedation to facilitate reduction of shoulder dislocation in the emergency department (ED). The secondary objectives were to compare one‐on‐one health care provider time, pain experienced by the patient during reduction, and patient satisfaction between the two groups.

Methods: This was a prospective, randomized study of patients presenting to the ED with shoulder dislocation. The study was conducted at an academic Level I trauma center ED with an annual census of approximately 80,000. Patients were eligible for the study if they were at least 18 years of age and required reduction of a shoulder dislocation. A convenience sample of patients was randomized to either traditional procedural sedation or US‐guided interscalene nerve block. Procedural sedation was performed with etomidate as the sole agent. Interscalene blocks were performed by hospital‐credentialed EPs using sterile technique and a SonoSite MicroMaxx US machine with a high‐frequency linear array transducer. Categorical variables were evaluated using Fisher’s exact test, and continuous variables were analyzed using the Wilcoxon rank sum test.

Results: Forty‐two patients were enrolled, with 21 patients randomized to each group. The groups were not significantly different with respect to sex or age. The mean (±SD) LOS in the ED was significantly higher in the procedural sedation group (177.3 ± 37.9 min) than in the US‐guided interscalene block group (100.3 ± 28.2 minutes; p < 0.0001). The mean (±SD) one‐on‐one health care provider time was 47.1 (±9.8) minutes for the sedation group and 5 (±0.7) minutes for the US‐guided interscalene block group (p < 0.0001). There was no statistically significant difference between the two groups in patient satisfaction or pain experienced during the procedure. There were no significant differences between groups with respect to complications such as hypoxia or hypotension (p = 0.49).

Conclusions: In this study, patients undergoing shoulder dislocation reduction using US‐guided interscalene block spent less time in the ED and required less one‐on‐one health care provider time compared to those receiving procedural sedation. There was no difference in pain level or satisfaction when compared to procedural sedation patients.
Altered distribution of interstitial cells and innervation in the rat urinary bladder following spinal cord injury
Authors: Johnston Louise , Cunningham Rebecca M.J. , Young John S. , Fry Christopher H. , McMurray Gordon , Eccles Rachel , McCloskey Karen D.
Published: September 2011

Changes in the distribution of interstitial cells (IC) are reportedly associated with dysfunctional bladder. This study investigated whether spinal cord injury (SCI) resulted in changes to IC subpopulations (vimentin‐positive with the ultrastructural profile of IC), smooth muscle and nerves within the bladder wall and correlated cellular remodelling with functional properties. Bladders from SCI (T8/9 transection) and sham‐operated rats 5 weeks post‐injury were used for ex vivo pressure–volume experiments or processed for morphological analysis with transmission electron microscopy (TEM) and light/confocal microscopy. Pressure‐volume relationships revealed low‐pressure, hypercompliance in SCI bladders indicative of decompensation. Extensive networks of vimentin‐positive IC were typical in sham lamina propria and detrusor but were markedly reduced post‐SCI; semi‐quantitative analysis showed significant reduction. Nerves labelled with anti‐neurofilament and anti‐vAChT were notably decreased post‐SCI. TEM revealed lamina propria IC and detrusor IC which formed close synaptic‐like contacts with vesicle‐containing nerve varicosities in shams. Lamina propria and detrusor IC were ultrastructurally damaged post‐SCI with retracted/lost cell processes and were adjacent to areas of cellular debris and neuronal degradation. Smooth muscle hypertrophy was common to SCI tissues. In conclusion, IC populations in bladder wall were decreased 5 weeks post‐SCI, accompanied with reduced innervation, smooth muscle hypertrophy and increased compliance. These novel findings indicate that bladder wall remodelling post‐SCI affects the integrity of interactions between smooth muscle, nerves and IC, with compromised IC populations. Correlation between IC reduction and a hypercompliant phenotype suggests that disruption to bladder IC contribute to pathophysiological processes underpinning the dysfunctional SCI bladder.
Everolimus is an active agent in medullary thyroid cancer: a clinical and in vitro study
Authors: Faggiano A. , Ramundo V. , Dicitore A. , Castiglioni S. , Borghi M. O. , Severino R. , Ferolla P. , Crinò L. , Abbruzzese A. , Sperlongano P. , Caraglia M. , Ferone D. , Hofland L. , Colao A. , Vitale G.
Published: September 2011

Everolimus, an mTOR inhibitor, which has been demonstrated to induce anti‐tumour effects in different types of neuroendocrine tumours, has never been evaluated in patients with medullary thyroid cancer (MTC). The aim of this study was to evaluate the in vitro and in vivo effects of everolimus in combination with octreotide in MTC. Two patients with progressive metastatic MTC and high calcitonin levels were treated with everolimus 5–10 mg/day. Both patients were under treatment with octreotide LAR at the study entry. An in vitro study was also performed to assess everolimus effects on MTC cell lines (TT and MZ‐CRC‐1 cells). A tumour response was observed in both patients. Serum calcitonin decreased by 86% in patient 1 and by 42% in patient 2. In TT and MZ‐CRC‐1 cells, everolimus induced a significant dose‐dependent inhibition in cell proliferation. This effect seems to be related to a cell cycle arrest in G0/G1 phase in both cell lines and to the induction of cellular senescence in TT cells. Everolimus in combination with octreotide may be active as anti‐tumour therapy in patients with progressive metastatic MTC, suggesting to further evaluate this agent in MTC patients in a large prospective study.
Myxoma of the ear lobe in a 23‐month‐old girl with Carney complex
Authors: Briassoulis George , Quezado Martha , Lee Chyi‐Chia Richard , Xekouki Paraskevi , Keil Meg , Stratakis Constantine A.
Published: September 2011

Myxomas of the ear are extremely uncommon, especially in young children. A 23‐month‐old girl born to a family with known Carney complex, a condition that predisposes to multiple myxomas, presented with a large, cauliflower‐like mass located on the back of her right ear. Histopathologically, the lesion was composed of scattered spindle‐shaped or stellate cells with abundant associated mucin and a very sparse inflammatory infiltrate containing lymphocytes and neutrophils. The patient was a carrier of a protein kinase A regulatory subunit 1A (PRKAR1A) mutation; PRKAR1A mutations cause Carney complex in most patients with this rare disorder. This is the earliest presentation of an ear lobe myxoma reported in the literature.

Briassoulis G, Quezado M, Lee C‐CR, Xekouki P, Keil M, Stratakis CA. Myxoma of the ear lobe in a 23‐month‐old girl with Carney complex.
The effects of small sample size and sample bias on threshold selection and accuracy assessment of species distribution models
Authors: Bean William T. , Stafford Robert , Brashares Justin S.
Published: September 2011

Species distribution models are used for a range of ecological and evolutionary questions, but often are constructed from few and/or biased species occurrence records. Recent work has shown that the presence‐only model Maxent performs well with small sample sizes. While the apparent accuracy of such models with small samples has been studied, less emphasis has been placed on the effect of small or biased species records on the secondary modeling steps, specifically accuracy assessment and threshold selection, particularly with profile (presence‐only) modeling techniques. When testing the effects of small sample sizes on distribution models, accuracy assessment has generally been conducted with complete species occurrence data, rather than similarly limited (e.g. few or biased) test data. Likewise, selection of a probability threshold – a selection of probability that classifies a model into discrete areas of presences and absences – has also generally been conducted with complete data. In this study we subsampled distribution data for an endangered rodent across multiple years to assess the effects of different sample sizes and types of bias on threshold selection, and examine the differences between apparent and actual accuracy of the models. Although some previously recommended threshold selection techniques showed little difference in threshold selection, the most commonly used methods performed poorly. Apparent model accuracy calculated from limited data was much higher than true model accuracy, but the true model accuracy was lower than it could have been with a more optimal threshold. That is, models with thresholds and accuracy calculated from biased and limited data had inflated reported accuracy, but were less accurate than they could have been if better data on species distribution were available and an optimal threshold were used.
The local‐regional species richness relationship: new perspectives on the null‐hypothesis
Authors: Szava‐Kovats Robert C. , Zobel Martin , Pärtel Meelis
Published: September 2011

Despite considerable criticism in recent years, the use of local (SL) and regional species richness (SR) plots has a long tradition to test for community saturation. The traditional approach has been to compare linear and polynomial regression models of untransformed measures of SL and SR with a statistically significant linear or polynomial model indicating unsaturated and saturated communities, respectively. This approach has been the target of much controversy owing to statistical issues, the confounding effects of the arbitrary choice for the size of the local and regional area, and the difficulty in attributing ecological processes to the underlying SL SR pattern. The statistical issues and effects of scale stem from the lack of statistical independence and induced correlation between SL SR arising from the mathematical constraint, SL<SR. However, by removing this mathematical constraint by means of a logratio transformation, SL SR relationships can be calculated using ordinary linear regression and with a logical and definitive null‐hypothesis based solely on the presence of a statistically significant slope, which provides a quantitative measure of curvature. Simulations of SL SR relationships with varying curvature and SL:SR ratio demonstrate that the logratio model can accurately measure curvature independent of the SL:SR ratio. Therefore, the tendency for studies with high local:regional area ratio to result in linear SL SR trends when analysed by traditional regression methods may be mitigated by reanalysis by the logratio model. By alleviating the effects of scale, the logratio model offers a more statistically sound assessment of the SL SR relationship, which in turn can serve as an effective tool to complement emerging process‐based models.
A novel gene required for natural competence in Aggregatibacter actinomycetemcomitans
Authors: Tanaka A. , Fujise O. , Chen C. , Miura M. , Hamachi T. , Maeda K.
Published: September 2011

Tanaka A, Fujise O, Chen C, Miura M, Hamachi T, Maeda K. A novel gene required for natural competence inAggregatibacter actinomycetemcomitans. J Periodont Res 2012; 47: 129–134. © 2011 John Wiley & Sons A/S

Background and Objective:  Natural competence is the ability of bacteria to take up extracellular DNA and incorporate it into their genomes. Some strains of Aggregatibacter actinomycetemcomitans, a critical periodontal pathogen, are naturally competent for transformation. However, information on natural competence genes is limited for this species. The aim of this study was to confirm the involvement of a novel gene identified near the fimbriae gene cluster in natural competence.

Material and Methods:  The functions of putative open reading frames (ORFs), designated AA00863–AA00865, in the Oralgen project database for A. actinomycetemcomitans strain HK1651, have not been determined. Using naturally transformable A. actinomycetemcomitans strains D7S‐1 and ATCC29523, we created deletion mutants of homologous genes of these ORFs. Natural competence in the study strains was determined using an agar‐based transformation frequency assay.

Results:  Mutation of the AA00865 homolog, which we named urpA in A. actinomycetemcomitans strain D7S‐1, resulted in the loss of natural competence, whereas mutations of the AA00864 and AA00863 homologs, located downstream of urpA gene, did not. Similar results were also observed in the mutants of A. actinomycetemcomitans ATCC29523. Complementation of the deleted sequence in the urpA mutant restored natural competence.

Conclusion:  The urpA gene is a novel gene required for natural competence in A. actinomycetemcomitans and does not exhibit significant homology with any natural competence genes previously identified in other bacterial species.
Melatonin and its analogs in insomnia and depression
Authors: Cardinali Daniel P. , Srinivasan Venkataramanujan , Brzezinski Amnon , Brown Gregory M.
Published: September 2011

Abstract:  Benzodiazepine sedative‐hypnotic drugs are widely used for the treatment of insomnia. Nevertheless, their adverse effects, such as next‐day hangover, dependence and impairment of memory, make them unsuitable for long‐term treatment. Melatonin has been used for improving sleep in patients with insomnia mainly because it does not cause hangover or show any addictive potential. However, there is a lack of consistency on its therapeutic value (partly because of its short half‐life and the small quantities of melatonin employed). Thus, attention has been focused either on the development of more potent melatonin analogs with prolonged effects or on the design of slow release melatonin preparations. The MT1 and MT2 melatonergic receptor ramelteon was effective in increasing total sleep time and sleep efficiency, as well as in reducing sleep latency, in insomnia patients. The melatonergic antidepressant agomelatine, displaying potent MT1 and MT2 melatonergic agonism and relatively weak serotonin 5HT2C receptor antagonism, was found effective in the treatment of depressed patients. However, long‐term safety studies are lacking for both melatonin agonists, particularly considering the pharmacological activity of their metabolites. In view of the higher binding affinities, longest half‐life and relative higher potencies of the different melatonin agonists, studies using 2 or 3 mg/day of melatonin are probably unsuitable to give appropriate comparison of the effects of the natural compound. Hence, clinical trials employing melatonin doses in the range of 50–100 mg/day are warranted before the relative merits of the melatonin analogs versus melatonin can be settled.
Ectoplacental Cone Induces Resistance to Apoptosis in High Doses of Interferon (IFN)‐γ‐Treated Decidual Cells
Authors: Borbely Alexandre U. , Fontenele‐Neto José D. , Vidsiunas Alex K. , Gomes Sara Z. , Hoshida Mara S. , de Oliveira Sérgio F. , Bevilacqua Estela
Published: September 2011

Citation Borbely AU, Fontenele‐Neto JD, Vidsiunas AK, Gomes SZ, Hoshida MS, de Oliveira SF, Bevilacqua E. Ectoplacental cone induces resistance to apoptosis in high doses of interferon (IFN)‐γ‐treated decidual cells. Am J Reprod Immunol 2012; 67: 73–83

Problem  In this study, we explored the relationship between decidual cells (DC) and interferon (IFN)‐γ, in the presence or absence of ectoplacental cone (EC) using a coculture system.

Method of study  Decidual cells and EC were isolated from pregnant mice on gestation day 7.5. DCs were cultured for 48 hr and then treated with fresh EC. After characterization, they were treated with IFN‐γ, and cell death was evaluated.

Results  Interferon‐γ drastically increased decidual apoptosis, which was partially reverted by the addition of EC to the IFN‐γ‐treated decidual culture. Moreover, the addition of EC to non‐treated DC cultures was also capable of attenuating death rates.

Conclusion  Resistance to apoptosis may be induced in DC by the EC. This suggests that EC may participate in the inhibition of IFN‐γ‐dependent apoptosis and, therefore, play important role for DC survival in a cytokine‐enriched placental environment.
The influence of landscape‐level heterogeneity in fire frequency on canopy composition in the boreal forest of eastern Canada
Authors: Cyr Dominic , Gauthier Sylvie , Bergeron Yves
Published: September 2011

Question

Will a three‐fold variation in fire frequency among large patches (≈105–106 ha) of boreal forest generate differences in canopy composition and, more specifically, will it influence the relative abundance of species with regard to their typical position along the succession gradient.

Location

A landscape of 1.6 Mha in the boreal forest of eastern Canada (Quebec).

Methods

We sampled 160 circular plots in closed‐canopy forest in which we measured canopy vegetation composition, local fire history (time since last fire) and edaphic conditions. We conducted multivariate analyses (NMDS, multi‐response permutation procedure) and pair‐wise comparisons to probe differences in canopy composition between areas of contrasting fire frequency before and after controlling for the influence of local environmental factors.

Results

There are significant differences between areas of contrasting fire frequency in terms of relative species abundance, even after analytically removing the effect of important local environmental factors. In old stands,Picea marianais significantly more abundant in high fire frequency areas whileAbies balsameais significantly more abundant in low fire frequency areas, both before and after controlling for local environmental factors, including time since last fire. Young stands do not differ in terms of individual species relative abundance but show more variability among stands in low fire frequency areas.

Main conclusion

The low fire frequency areas allow late‐successional specialistA. balsameato dominate over ubiquitous successional generalistP. marianabecause of the typically longer time elapsed since the last fire. This suggests that succession fromP. marianatoA. balsameacan occur long after what is typically covered by dendroecologically reconstructed fire history in this type of boreal landscape (> 200–300 yr).
A Case Series: Herpes Simplex Virus as an Occupational Hazard
Authors: BROWNING WILLIAM D. , MCCARTHY JAMES P.
Published: September 2011

Statement of the Problem:  Herpes labialis infections are common and present a serious risk to the dental team.

Purpose of the Study:  The purpose is to make dentists aware of the risks involved with treatment of patients with active herpes labialis. In addition, evidence‐based risk‐management strategies are presented.

Methods and Materials:  The incidence and natural history of herpes simplex virus type 1 (HSV‐1) are reviewed. Four previously unreported case histories are presented to illustrate the impact common sequelae of HSV‐1 can have on the dental team. The differences between HSV‐1 and the blood‐borne diseases which are the focus of universal precautions are discussed. In particular, the highly contagious, highly transmissible nature of HSV‐1 and its transmission through aerosols are highlighted. Finally, the need to include protection against aerosols in the profession's understanding of universal precautions is noted.

Results:  The authors suggest limiting the treatment of patients with active lesions to urgent care only, and treating active HSV‐1 lesions to reduce time of healing. For four common clinical situations involving HSV‐1 infections, evidence‐based methods for protecting the dental team and the patient from cross‐contamination are also presented.

Conclusion:  While it is clear that the treatment of patients with active herpes labialis lesions increases risk of cross‐infection, there are good protocols for controlling this risk.

CLINICAL SIGNIFICANCE

By bringing common vectors of cross‐infection to light and providing evidence‐based protocols for preventing them, this article provides practitioners with positive steps that can be taken for controlling the risk of spreading herpes infections to the dental team.

(J Esthet Restor Dent 24:61–67, 2012)
Executives' Assessments of International Joint Ventures in China: A Multi-Theoretical Investigation
Authors: Reuer Jeffrey J. , Tyler Beverly B. , Tong Tony W. , Wu Cheng-Wei
Published: September 2011

Despite the rich set of theories that have developed on international joint ventures (IJVs), little is known about what theoretical criteria senior executives actually incorporate in their judgments of IJV opportunities and partners. Empirical studies have often applied individual theories in a particularistic fashion, rather than recognizing the different theoretical perspectives that boundedly-rational executives may incorporate into their decision models. In this article, we combine decision criteria associated with multiple theories rooted in organizational economics to investigate how top executives process information on IJV opportunities in China. Using an established experimental technique known as policy capturing, we examine how executives cognitively weigh criteria from four prominent theories when making initial assessments of IJVs (i.e., the resource-based view, transaction cost economics, information economics, and real options theory). Our arguments and findings on executives' IJV decision models contribute to decision-making research on alliances and IJVs in China.
The AMPK/SNF1/SnRK1 fuel gauge and energy regulator: structure, function and regulation
Authors: Ghillebert Ruben , Swinnen Erwin , Wen Jing , Vandesteene Lies , Ramon Matthew , Norga Koen , Rolland Filip , Winderickx Joris
Published: September 2011

All life forms on earth require a continuous input and monitoring of carbon and energy supplies. The AMP‐activated kinase (AMPK)/sucrose nonfermenting1 (SNF1)/Snf1‐related kinase1 (SnRK1) protein kinases are evolutionarily conserved metabolic sensors found in all eukaryotic organisms from simple unicellular fungi (yeast SNF1) to animals (AMPK) and plants (SnRK1). Activated by starvation and energy‐depleting stress conditions, they enable energy homeostasis and survival by up‐regulating energy‐conserving and energy‐producing catabolic processes, and by limiting energy‐consuming anabolic metabolism. In addition, they control normal growth and development as well as metabolic homeostasis at the organismal level. As such, the AMPK/SNF1/SnRK1 kinases act in concert with other central signaling components to control carbohydrate uptake and metabolism, fatty acid and lipid biosynthesis and the storage of carbon energy reserves. Moreover, they have a tremendous impact on developmental processes that are triggered by environmental changes such as nutrient depletion or stress. Although intensive research by many groups has partly unveiled the factors that regulate AMPK/SNF1/SnRK1 kinase activity as well as the pathways and substrates they control, several fundamental issues still await to be clarified. In this review, we will highlight these issues and focus on the structure, function and regulation of the AMPK/SNF1/SnRK1 kinases.
Biological characteristics of two lysines on human serum albumin in the high‐affinity binding of 4Z,15Z‐bilirubin‐IXα revealed by phage display
Authors: Minomo Ai , Ishima Yu , Kragh‐Hansen Ulrich , Chuang Victor T. G. , Uchida Makiyo , Taguchi Kazuaki , Watanabe Hiroshi , Maruyama Toru , Morioka Hiroshi , Otagiri Masaki
Published: September 2011

4Z,15Z‐bilirubin‐IXα (4Z,15Z‐BR), an endogenous compound that is sparingly soluble in water, binds human serum albumin (HSA) with high affinity in a flexible manner. A phage library displaying recombinant HSA domain II was constructed, after three rounds of panning against immobilized 4Z,15Z‐BR, and eight clones with high affinity for the pigment were found to contain conserved basic residues, such as lysine or arginine, at positions 195 and 199. The wild type and two mutants, K195A and K199A, of whole HSA as well as stand‐alone domain II were expressed inPichia pastorisfor ligand‐binding studies. The binding of 4Z,15Z‐BR to the K195A and K199A mutants was decreased in both whole HSA and the domain II proteins. The P‐helicity conformer (P‐form) of 4Z,15Z‐BR was found to preferentially bind to the wild types and the K195A mutants, whereas the M‐form bound to the K199A mutants. Photoconversion experiments showed that the P‐form of 4Z,15Z‐BR was transformed into highly water‐soluble isomers at a much faster rate than the M‐form. In addition, the M‐form of 4Z,15Z‐BR showed higher affinity for domain I than for domain II. The present findings suggest that, whereas both Lys195 and Lys199 in subdomain IIA are important for the high‐affinity binding of 4Z,15Z‐BR, Lys199 plays a more prominent role in the elimination of 4Z,15Z‐BR.

Database

Model data are available in the PMDB database under accession numbers2VUEand2BXA.
Outcomes with the “V” Implantation Technique vs. Standard Technique for Testosterone Pellet Therapy
Authors: Conners William , Flinn Kevin , Morgentaler Abraham
Published: September 2011

Introduction

Standard technique (ST) for implantation of testosterone pellets involves making a single linear track in the subcutaneous tissue of the buttock from the incision. After our initial experience with this modality, we modified this surgical technique to our current “V” technique (VT). This involves two tracks both caudally directed and emanating from the same skin incision but angulated approximately 10–15 degrees apart. While this allows additional pellets to be inserted more easily, and increased space to place those pellets further from the skin incision, it minimally increases the surgical procedure.

Aim

We sought to examine the impact of this technical modification on therapeutic efficacy and surgical complication rates.

Methods

Retrospective chart review of all patients treated with testosterone pellets at our institution.

Main Outcome Measure

Complication rates for infection, extrusion, hematoma, and pain.

Results

One hundred sixty-eight patients underwent 281 implantation procedures (40 via ST and 241 via VT). The mode number of pellets used with ST was 8 (range 6–8) and with VT was 10 (range 10–13). Incidence of pellet extrusion was 7.5% with ST and 0.8% with VT. Infection complicated ST in 5% of cases but only 1.2% with VT. No cases of hematoma were seen with ST but 1.2% of VT cases. Pain prompting discontinuation of therapy was seen in 7.5% with ST and 1.7% with VT. Significant pain without discontinuation was seen in 5% with ST and 1.2% with VT. Only in 1 of the 3 cases of hematoma was the individual on blood thinners. Fifty-eight other insertions were performed on blood thinners without significant hematoma. None of the individuals who developed infection or bleeding required additional surgical therapy.

Conclusion

VT allows successful placement of larger number of pellets, with low rates of complications, especially extrusion, even in men on anticoagulants.
On rapid migration and accretion within discs around supermassive black holes
Authors: McKernan B. , Ford K. E. S. , Lyra W. , Perets H. B. , Winter L. M. , Yaqoob T.
Published: September 2011

Galactic nuclei should contain a cluster of stars and compact objects in the vicinity of the central supermassive black hole due to stellar evolution, minor mergers and gravitational dynamical friction. By analogy with protoplanetary migration, nuclear cluster objects (NCOs) can migrate in the accretion discs that power active galactic nuclei (AGN) by exchanging angular momentum with disc gas. Here we show that an individual NCO undergoing runaway outward migration comparable to type III protoplanetary migration can generate an accretion rate corresponding to Seyfert AGN or quasar luminosities. Multiple migrating NCOs in an AGN disc can dominate traditional viscous disc accretion, and at large disc radii, ensemble NCO migration and accretion could provide sufficient heating to prevent the gravitational instability from consuming disc gas in star formation. The magnitude and energy of the X-ray soft excess observed at ∼0.1–1 keV in Seyfert AGN could be explained by a small population of ∼102–103 accreting stellar mass black holes or a few ULXs. NCO migration and accretion in AGN discs are therefore extremely important mechanisms to add to realistic models of AGN discs.
Regional Flow Simulation in Fractured Aquifers Using Stress‐Dependent Parameters
Authors: Preisig Giona , Joel Cornaton Fabien , Perrochet Pierre
Published: September 2011

A model function relating effective stress to fracture permeability is developed from Hooke's law, implemented in the tensorial form of Darcy's law, and used to evaluate discharge rates and pressure distributions at regional scales. The model takes into account elastic and statistical fracture parameters, and is able to simulate real stress‐dependent permeabilities from laboratory to field studies. This modeling approach gains in phenomenology in comparison to the classical ones because the permeability tensors may vary in both strength and principal directions according to effective stresses. Moreover this method allows evaluation of the fracture porosity changes, which are then translated into consolidation of the medium.