bluuebunny/crossref_metadata_2025 huggingface dataset:
Effectiveness of advanced practice nursing interventions in older people: protocol for a systematic review and qualitative study
Authors: Morilla‐Herrera Juan Carlos , Morales‐Asencio José Miguel , Martín‐Santos Francisco Javier , Garcia‐Mayor Silvia , Rodríguez‐Bouza Mónica , González‐Posadas Fernando
Published: October 2012

Aims

This protocol outlines a review and qualitative study to determine the models and effectiveness of Advanced Practice Nursing developed for the health care of people over 65 years in different settings (hospital care, home care, outpatients' care, and nursing homes) and to identify the ingredients of the interventions developed by Advanced Practice Nursing in the field of geriatric care.

Background

Numbers of nurses in advanced roles have increased internationally in conjunction with research to determine their effectiveness. Nevertheless, in older people, evidence of advanced practice roles remains scattered, and there is little synthesis of evidence, and therefore it is not easy to visualize the different practice models, their components, and their impact.

Design

Study protocol with two phases: a systematic review and a qualitative study.

Methods

First phase: Depending on comparability of studies, meta‐analysis will be undertaken. If so, results will be summarized in relative and absolute measures or mean difference, depending on the type of outcome. Sensitivity and heterogeneity analyses will be performed. Second phase: a content analysis will be carried out of the interventions identified in the systematic review, and they will be contrasted with the contents of the Nursing Interventions Classification. Finally, this matching will be submitted to expert consensus using a Delphi technique. Approval from the Ethics Committee was obtained in July 2010 and funding was obtained in March 2011.

Conclusion

The identification of components of Advanced Practice Nursing models and evidence of their effectiveness will contribute to designing more grounded nursing services for older people. Additionally, the categorization of Advanced Practice Nursing interventions through Nursing Interventions Classification would permit comparisons to be made between settings or between healthcare systems.
A comparative concept analysis of centring vs. opening meditation processes in health care
Authors: Birx Ellen
Published: October 2012

Aim

To report an analysis and comparison of the concepts centring and opening meditation processes in health care.

Background

Centring and opening meditation processes are included in nursing theories and frequently recommended in health care for stress management. These meditation processes are integrated into emerging psychotherapy approaches and there is a rapidly expanding body of neuroscience research distinguishing brain activity associated with different types of meditation. Currently, there is a lack of theoretical and conceptual clarity needed to guide meditation research in health care.

Data sources

A search of healthcare literature between 2006–2011 was conducted using Alt HealthWatch, CINAHL, PsychNET and PubMed databases using the keywords ‘centring’ and ‘opening’ alone and in combination with the term ‘meditation.’ For the concept centring, 10 articles and 11 books and for the concept opening 13 articles and 10 books were included as data sources.

Method

Rodgers' evolutionary method of concept analysis was used.

Results

Centring and opening are similar in that they both involve awareness in the present moment; both use a gentle, effortless approach; and both have a calming effect. Key differences include centring's focus on the individual's inner experience compared with the non‐dual, spacious awareness of opening.

Conclusion

Centring and opening are overlapping, yet distinct meditation processes. The term meditation cannot be used in a generic way in health care. The differences between centring and opening have important implications for the further development of unitary‐transformative nursing theories.
Effect of whitening and desensitizing dentifrices on composite surfaces treated with surface sealants
Authors: dos Santos Paulo Henrique , Brogin Fabiana Ferres , Catelan Anderson , Suzuki Thaís Yumi Umeda , Guedes Ana Paula Albuquerque , Pavan Sabrina , Assunção Wirley Gonçalves , Briso André Luiz Fraga
Published: October 2012

Objective

This study evaluated the effect of different dentifrices on the microhardness and surface roughness of composite surfaces covered by surface sealants.

Methods

Samples of Filtek P60 were made and divided into groups, in accordance with surface treatments: G1 – Fortify; G2 – Fortify Plus; G3 – control (none). For Knoop microhardness evaluation, the specimens were placed in a microdurometer, under a load of 50 g for 15 sec. The analyses of surface roughness were carried out individually in a profilometer. The specimens were submitted to toothbrushing using dentifrices: Colgate Maximum Protection Anti‐caries, Colgate Whitening or Sensodyne, diluted in distilled water (1:3) for 30 000 cycles.

Results

The results showed that the control group (G3) presented the highest microhardness values. The control group presented, before toothbrushing, the lowest surface roughness values, and after toothbrushing there were no differences among the experimental groups.

Conclusion

The maintenance of the lowest values of microhardness demonstrated the effectiveness of these sealant materials to support the abrasive wear.
A Preliminary Investigation of a Telephone Administration of the Quality of Marriage Index
Authors: Woods Sarah B. , Priest Jacob B. , Denton Wayne H.
Published: October 2012

Follow‐up data collection presents many challenges for longitudinal research. Validating paper‐and‐pencil assessments for use via telephone may alleviate these issues. This study evaluates psychometric properties of the Quality of Marriage Index (QMI; Norton, 1983, Journal of Marriage and the Family, 45, 141) when administered by telephone and compares scores with the paper‐and‐pencil version. Participants included women with major depressive disorder and dyadic discord and their male spouses (n = 24 couples). Results suggest excellent scale reliability for the verbal QMI. However, a significant mean difference was found: participants scored on average 3 points higher on the telephone‐administered QMI than on the written QMI. Recommendations for future research and clinical implications are discussed.
Internal and External Threat in Relationship With Right‐Wing Attitudes
Authors: Onraet Emma , Van Hiel Alain , Dhont Kristof , Pattyn Sven
Published: October 2012

Objective

Previous studies on the relationship between threat and right‐wing attitudes have tended to focus on either internal threat, emanating from one's private life, or external threat, originating from society. However, these studies failed to examine whether these types of threats constitute two distinctive dimensions and which of these threats is most closely related to right‐wing attitudes.

Method

In order to explore the dimensions underlying threat, a factor analysis on a variety of threat scales was conducted (Study 1;N = 300). Furthermore, in a meta‐analysis (Study 2; totalN = 22,086) and a questionnaire study in a large representative sample (Study 3,N = 800) the strength of the relationships of internal and external threat with right‐wing attitudes were investigated.

Results

The present studies revealed that internal and external threat can be considered as two distinct dimensions underlying threat. Moreover, whereas external threat yielded strong relationships with right‐wing attitudes, internal threat only explained a minor part of the variance in these attitudes.

Conclusions

External rather than internal threat underlies the relationship between threat and right‐wing attitudes.
Personalized Psychotherapy: A Treatment Approach Based on Theodore Millon's Integrated Model of Clinical Science
Authors: Strack Stephen , Millon Theodore
Published: October 2012

In this article we present personalized psychotherapy, a treatment approach for people with a wide range of personality problems and clinical syndromes that is a central part of Theodore Millon's unified clinical science model of personality and psychopathology. Because the intervention strategy is fully integrated with an evolutionary perspective on human development, we offer it in this context. We begin with a historical overview of Millon's model and its relationship to the Diagnostic and Statistical Manual of Mental Disorders (DSM). We then present his basic theoretical principles and personality taxonomy, and discuss variations in personality functioning across the normal–abnormal continuum. We move on to describe assessment measures that were developed to operationalize his concepts and ideas, and which are used as the basis for creating treatment plans. The premises and principles of personalized psychotherapy are described to show how the intervention model is squarely focused on the integrated unity of the person. We look at presenting problems of all kinds from the point of view of how they emanate from, and are related to, the individual's unique combination of temperament, traits, preferences, behavioral patterns, and coping strategies. We then specify multimodal interventions (e.g., a combination of pharmacologic, cognitive, behavioral, phenomenological, interpersonal, and/or intrapsychic treatments) and apply them in a particular sequence to maximize their impact, not only on the target symptoms, but on the underlying personality elements believed to be their primary cause.
Cure for immune‐tolerant hepatitis B in children: is it an achievable target with sequential combo therapy with lamivudine and interferon?
Authors: Poddar U. , Yachha S. K. , Agarwal J. , Krishnani N.
Published: October 2012

We prospectively studied the HBsAg seroconversion with sequential combination therapy of lamivudine (LAM) and interferon (IFN) in hitherto untreatable ‘immune‐tolerant’ chronic hepatitis B in children. In this case–control study, 28 children with immune‐tolerant hepatitis B [HBsAg positive for >6 months with near normal aminotransferase level, minimal/no inflammation in liver histology and high viral load (HBV DNA>107 copies/mL)] were treated with LAM alone at 3 mg/kg/day for 8 weeks followed by LAM plus IFN alpha (5 MU/m2 three times a week) for another 44 weeks. They were compared with 34 untreated children. HBV markers (HBsAg, HBeAg, anti‐HBe, quantitative HBV DNA) were carried out at baseline, at the end of therapy and 6 monthly thereafter. The mean age was 5.9 ± 3.2 years and 24 were boys. End therapy response: HBe seroconversion was achieved in 11, and of these, five had complete response (HBsAg clearance), 11 did not respond and six had virologic response (DNA undetectable but no HBe seroconversion). Six months after therapy, 10 of the 11 (91%) originally seroconverted children remained seroconverted while one seroreverted. Six of the 28 (21.4%) children lost HBsAg and they remained HBsAg negative and anti‐HBs positive on follow‐up. After a mean follow‐up of 21.1 ± 11.9 months, the status remained same in the responders but one of the nonresponders HBe seroconverted (39.3%). There were no serious side effects of therapy. It is possible to achieve a cure in more than one‐fifth of immune‐tolerant children with hepatitis B with the sequential combination of LAM and IFN.
Pulmonary pharmacokinetics of tulathromycin in swine. Part I: Lung homogenate in healthy pigs and pigs challenged intratracheally with lipopolysaccharide ofEscherichia coli
Authors: Villarino N. , Lesman S. , Fielder A. , García‐Tapia D. , Cox S. , Lucas M. , Robinson J. , Brown S. A. , Martín‐Jiménez T.
Published: October 2012

The objective of the study was to assess the pharmacokinetics of tulathromycin in lung tissue homogenate (LT) and plasma from healthy and lipopolysaccharide (LPS)‐challenged pigs. Clinically healthy pigs were allocated to two dosing groups of 36 animals each (group 1 and 2). All animals were treated with tulathromycin (2.5 mg/kg). Animals in group 2 were also challenged intratracheally withLPSfromEscherichia coli(LPS‐Ec) 3 h prior to tulathromycin administration. Blood andLTsamples were collected from all animals during 17‐day post‐tulathromycin administration. ForLT, one sample from the middle (ML) and caudal lobes (CL) was taken. The concentration of tulathromycin was significantly lower in theMLafter the intratracheal administration ofLPS‐E. coli(P < 0.02). In healthy pigs andLPS‐challenged animals, the distribution of the drug into the lungs was rapid and persisted at high levels for 17‐day postadministration. The distribution of the drug within the lung seems to be homogenous, at least between the middle and caudal lobes within dosing groups. The concentration versus time profile of the drug and pharmacokinetic parameters in two different lung areas (middle and caudal lobe) were consistent within the groups. The clinical significance of these findings is unknown.
Oncogenic potential of Cyclin Kinase Subunit‐2 in cholangiocarcinoma
Authors: Shen Dong‐Yan , Zhan Yi‐Hong , Wang Qian‐Ming , Rui Gang , Zhang Zhi‐Ming
Published: October 2012

Background

Cyclin kinase subunit‐2 (Cks2), a member of the human Cks family, plays an important role in the regulation of meiosis and mitosis; and its abnormal expression is usually associated with carcinogenesis. However, its exact functions and molecular mechanisms remain unclear.

Aims

To observe Cks2 expression in cholangiocarcinoma and explore its role in the carcinogenesis of cholangiocarcinoma and possible mechanism.

Methods

Cks2 expression in cholangiocarcinoma was detected with immunostaining and RT‐PCR. MTT, colony formation, immunofluorescence, flow cytometry and Western blotting were performed to explore the role of Cks2 in cholangiocarcinoma and possible mechanism.

Results

Cks2 was significantly elevated in cholangiocarcinoma tissues and its over‐expression was associated with poor differentiation, CA19‐9 and poor prognosis. Furthermore, Cks2 down‐regulation inhibited cholangiocarcinoma cell proliferation and colony formation in vitro, and the growth of cholangiocarcinoma xenografts in animals; especially, enhanced the sensitivity of cholangiocarcinoma cells to chemotherapy. We further found that Cks2 knockdown induced cholangiocarcinoma cell cycle arrest in G2/M phase through down‐regulation of Cyclin A and Cyclin B1 and Bax up‐regulation and activation, mitochondrial membrane permeabilization and caspase‐3 activation, which resulted in facilitating cholangiocarcinoma apoptosis.

Conclusions

These findings suggest that Cks2 may serve as an independent prognostic factor in patients with cholangiocarcinoma, and play an important role in the carcinogenesis of cholangiocarcinoma by facilitating cell cycle progression and Bax‐mediated mitochondrial caspase‐dependent apoptosis.
Antibodies to soluble liver antigen in patients with various liver diseases: A multicentre study
Authors: Efe Cumali , Ozaslan Ersan , Wahlin Staffan , Purnak Tugrul , Muratori Luigi , Quarneti Chiara , Yüksel Osman , Muratori Paolo
Published: October 2012

Background

Antibodies to soluble liver antigen (anti‐SLA) are specific serological markers of autoimmune hepatitis (AIH). The clinical significance and frequency of anti‐SLA have never been reported among AIH patients from Italy and Turkey.

To retrospectively assess the estimated prevalence, sensitivity, specificity and clinical significance of anti‐SLA in AIH and various liver diseases.

Methods

A total of 986 patients who had been tested for serum anti‐SLA were included in study. The presence of anti‐SLA was detected using recombinant enzyme linked immunosorbent assay and immuno‐blot. The general characteristics and outcome of patients were obtained from their medical records.

Results

Antibodies to SLA were found in 30 (3%) of 986 patients. Of these, 27 (90%) had AIH and its variants, whereas the remaining three (10%) had primary biliary cirrhosis. The prevalence of anti‐SLA was 9% in AIH patients from Italy and 15% in patients from Turkey. The specificity of these antibodies was 99.5%, whereas sensitivity was 11%. The positive predictive and negative predictive values were 90% and 77.5% respectively (95% confidence interval). Biochemical remission was achieved in 90% of anti‐SLA positive AIH patients, but relapse after immunosuppressive withdrawal or during maintenance therapy was observed in 53% of the patients.

Conclusions

Seropositivity for anti‐SLA occurs at similar frequencies in AIH patients from different geographical regions and ethnic groups. The sensitivity of anti‐SLA is low, but it has high specificity for AIH. Additional studies are necessary to prove clinical significance of anti‐SLA in AIH.
Risk factors and a predictive model for acute hepatic failure after transcatheter arterial chemoembolization in patients with hepatocellular carcinoma
Authors: Min Yang Won , Kim Jeong , Kim Seonwoo , Sung Young Kyung , Lee Jin Hee , Gwak Geum‐Youn , Paik Yong Han , Choi Moon Seok , Koh Kwang Cheol , Paik Seung Woon , Yoo Byung Chul , Lee Joon Hyeok
Published: October 2012

Background/Aims

Acute hepatic failure (AHF) is one of the most serious complications of transcatheter arterial chemoembolization (TACE). The aims of this study were to investigate risk factors of AHF after TACE and to establish a predictive model for AHF.

Methods

In the evaluation set, a total of 820 patients who underwent TACE as a first treatment for hepatocellular carcinoma were included. The demographic, laboratory, radiological and treatment‐related factors were analysed to identify risk factors for AHF after TACE and a predictive model was established using the identified risk factors. In the validation set, a different cohort of 438 patients was included to validate the predictive model.

Results

The incidence of post‐TACE AHF was 15.1% (124/820). Multivariate analysis revealed that presence of portal vein thrombosis, high aspartate aminotransferase, bilirubin, and log alpha‐foetoprotein levels, and low albumin and sodium levels were independent risk factors. A mathematical model was established using these independent risk factors, and the area under the receiver operating characteristic curve of the model was 0.773 (95% confidence interval, 0.726–0.820). The cut‐off value of 9 had a sensitivity of 78.2%, a specificity of 72.3%, a positive likelihood ratio of 2.82, a negative likelihood ratio of 0.30, a positive predictive value of 28.9% and a negative predictive value of 95.8%.

Conclusions

The risk factors of post‐TACE AHF were presence of portal vein thrombosis, high aspartate aminotransferase, bilirubin, and alpha‐foetoprotein levels, and low serum albumin and sodium levels. A mathematical model to predict post‐TACE AHF was established.
Monkeying around with ploidy
Authors: Buggs Richard J. A.
Published: October 2012

Inferences of whole genome duplication (WGD) events accompany the annotation of every newly sequenced plant genome, but much remains unknown about the evolutionary processes and pathways relating to WGD (Soltis et al. 2010). What ecological, biogeographical and genetic factors cause WGD to occur in nature? How does WGD affect gene expression? How do genomes evolve after WGD? New species that have arisen recently through WGD are good places to seek answers to such questions. These could be relatively common in nature, but reliably demonstrating their recent origin requires documentary evidence, which can be very hard to come by. Thus far, records of species introductions and meticulous botanizing have demonstrated six new natural allopolyploids in just four genera: Tragopogon miscellus and T. mirus, Senecio cambrensis and S. eboracensis, Spartina anglica and Cardamine schultzii (Abbott & Rieseberg 2012; Ainouche et al. 2009; Soltis & Soltis 2009). It is risky to generalize about a universal feature of plant evolution from such a small sample; more examples are needed, in different genera. It is therefore of considerable interest that Mario Vallejo‐Marin of University of Stirling has this year named a new allopolyploid species of monkey flower, Mimulus peregrinus, and presented evidence that it is <140 years old (Vallejo‐Marin 2012). This discovery is particularly timely as the monkey flower genus is developing rapidly as a model system for ecological genetics (Wu et al. 2008), and in the current issue of Molecular Ecology, Jennifer Modliszewski and John Willis of Duke University present new data showing high genetic diversity in another recently discovered monkey flower allopolyploid, M. sookensis (Modliszewski & Willis 2012).
Mapping the genomic architecture of ecological speciation in the wild: does linkage disequilibrium hold the key?
Authors: Rogers Sean M.
Published: October 2012

The hunt for the genes underlying ecological speciation has now closed in on a number of candidates, but making the link from genotype to phenotype continues to pose a significant challenge. This is partly because genetic studies in many systems remain impeded by long generation times or an inability to perform controlled crosses. Now, in this issue of Molecular Ecology, Malek et al. (2012) demonstrate the utility of a novel admixture mapping approach that can be used to identify genomic regions contributing to adaptive trait divergence between natural populations. Remarkably, they validate their approach by mapping traits associated with mate choice in a wild limnetic and benthic threespine stickleback (Gasterosteus aculeatus) species pair, finding several loci associated with male nuptial coloration and shape. While this study benefited from tried‐and‐true microsatellites in a well‐characterized species with a detailed genetic map (and genome sequence), the field is quickly moving towards the use of next‐generation sequencing, especially for nonmodel systems. The ability to characterize molecular polymorphisms for any system suggests that molecular ecologists working on virtually any species may benefit from applying Malek et al.'s approach, if naturally admixed populations are available.
NGF is involved in oral ovalbumin‐induced altered colonic contractility in rats: evidence from the blockade of TrkA receptors with K252a
Authors: Jardí F. , Martínez V. , Vergara P.
Published: October 2012

Background  Nerve growth factor (NGF)‐mucosal mast cell (MMC) interaction has been implicated in the remodeling of enteric circuitries and associated functional changes. We investigated the involvement of NGF and its receptor TrkA in the altered colonic contractile activity observed in the model of oral ovalbumin (OVA)‐induced MMC hyperactivity in rats. We also studied the role of colonic MMCs as a source of NGF.

Methods  Rats received oral OVA, alone or with the TrkA antagonist K252a. Colonic co‐expression of NGF/TrkA and rat mast cell protease II (RMCPII) (double immunofluorescence), RMCPII content (ELISA) and expression of NGF, Brain‐derived neurotrophic factor (BDNF) and TrkA/B (QT‐PCR) were assessed. Colonic contractile activity was determined in vivo and in vitro.

Key Results  TrkA, but not NGF, was localized in colonic MMCs (RMCPII‐positive). Oral ovalbumin exposure increased colonic RMCPII levels but did not change the percentage of TrkA‐positive MMCs. Neither OVA nor K252a, alone or combined, altered NGF, BDNF or TrkA/B expression. Spontaneous colonic activity in vivo and in vitro was altered by OVA, an effect prevented by K252a. Electrical stimulation‐induced contractile responses in vivo and carbachol responses in vitro were increased by OVA in a K252a‐independent manner. In OVA‐treated animals, inhibition of NO synthesis with l‐NNA significantly enhanced spontaneous colonic activity in vitro, a response completely prevented by K252a.

Conclusions & Inferences  These results suggest that NGF‐TrkA‐dependent pathways are implicated in colonic contractile alterations observed during OVA exposure in rats. NGF‐TrkA system might represent a potential target for treatment of gastrointestinal disorders characterized by colonic motor alterations.
Evaluation of anal sphincter resistance and distensibility in healthy controls using EndoFLIP ©
Authors: Alqudah M. M. , Gregersen H. , Drewes A. M. , McMahon B. P.
Published: October 2012

Background  Ano‐rectal disorders are common in the general population. Although they are not life threatening conditions, they do represent a social stigma and a reduced quality of life for the sufferer. The underlying physiology of muscle function contributing to ano‐rectal competence is complex and there is room for a much better understanding so that treatments can improve.

Methods  A cylindrically shaped, liquid filled bag (12 cm long), mounted on a catheter was inserted into the anus and positioned straddling the ano‐rectal region in 20 healthy volunteers (10 females). Series of volume‐controlled distensions (40 mL min−1 to 40 mL) were carried out and data on 16 CSA at 5 mm apart and bag pressure were recorded. Provocative tests using squeeze and cough at bag volumes of 20, 30, and 40 mL were carried out.

Key Results  Ramp distension of the anal canal showed that the opening pressure for females (mean, 11 mmHg) was higher than for males (mean, 5 mmHg) (P < 0.001). Geometric profile of the anal canal at low distension volumes showed narrow bands at proximal and distal ends of the anal profile and shortening of a middle narrow zone at higher volumes. Inter‐individual differences were observed in the behavior of the proximal end and the distal end of the anal profile during squeeze.

Conclusions & Inferences  This distensibility technique provides an important new way of studying the anal canal and hence may have a role in testing sphincter competence in patients with disorders.
Na+/Ca2+ exchanger 2‐heterozygote knockout mice display decreased acetylcholine release and altered colonic motility in vivo
Authors: Azuma Y. T. , Nishiyama K. , Kita S. , Komuro I. , Nakajima H. , Iwamoto T. , Takeuchi T.
Published: October 2012

Background  The Na+/Ca2+ exchanger (NCX) is a plasma membrane transporter involved in regulating intracellular Ca2+ concentrations. NCX is critical for Ca2+ regulation in cardiac muscle, vascular smooth muscle, and nerve fibers. However, little is known about the physiological role of NCX in the myenteric neurons and smooth muscles of the gastrointestinal tract.

Methods  To determine the role of NCX1 and NCX2 in gastrointestinal tissues, we examined electric field stimulation (EFS)‐induced responses in the longitudinal smooth muscle of the distal colon in NCX1‐ and NCX2‐heterozygote knockout mice.

Key Results  We found that the amplitudes of EFS‐induced relaxation that persisted during EFS were greater in NCX2 heterozygous mice (HET) than in wild‐type mice (WT). Under the nonadrenergic, noncholinergic (NANC) condition, EFS‐induced relaxation in NCX2 HET was similar in amplitude to that of WT. In addition, an NCX inhibitor, YM‐244769 enhanced EFS‐induced relaxation but did not affect EFS‐induced relaxation under the NANC condition, as in NCX2 HET. Unlike NCX2 HET, NCX1 HET displayed no marked changes in colonic motility. These results indicate that cholinergic function in the colon is altered in NCX2 HET. The magnitude of acetylcholine (ACh)‐induced contraction in NCX2 HET was similar to that in WT. In contrast, EFS‐induced ACh release was reduced in NCX2 HET compared with that in WT.

Conclusions & Inferences  In this study, we demonstrate that NCX2 regulates colonic motility by altering ACh release onto the myenteric neurons of the distal colon.
The characteristics of the staircase phenomenon during the period of twitch stabilization in infants in TOF mode
Authors: Zhou Zhi‐Jian , Wang Xuan , Zheng Shan , Zhang Xue‐Feng
Published: October 2012

Background

Acceleromyography used to monitor the neuromuscular transmission function is available in infants and children. However, information on the so‐called staircase phenomenon during the baseline stabilization period in this population is limited. Our objective was to assess the characteristics of such phenomenon in infants in acceleromyography.

Methods

Thirty infants were divided into three groups: group A (aged 1–5 months, n = 10), group B (aged 6–11 months, n = 10), and group C (aged 12–24 months, n = 10). Anesthesia was induced and maintained without neuromuscular blocking agents. Patients received a supramaximal stimulus followed by TOF measurements every 15 s over the course of 30 min with a TOF‐Watch® SX. All data were collected in a notebook computer using the TOF‐Watch® SX Monitor software through optical fibers.

Results

The evoked T1 responses in younger infants (group A) were significantly lower than those in older infants (groups B and C) from 0–20 min. In group A, the signals increased to the maximum value of 121 ± 15% that of the control at 7.25 min and decreased toward a plateau of 113 ± 18% at 30 min. In group B, the signal heights increased to the maximum value of 143 ± 14% at 9.5 min, then decreased slowly to 136 ± 10% at 19.5 min, finally reaching 116 ± 12% at 30 min. In group C, the mean values of T1 reached the maximum of 139 ± 19% that of control at 9.5 min and finally reached 126 ± 22% of control at 30 min.

Conclusions

The staircase effect presents in a shorter time course and at lower degrees in smaller infants. However, in older infants, staircase effect still presents in a long period and may influence the onset time and duration of twitch depression after muscle relaxants administration.
Development of a SCAR marker linked with a MYMV resistance gene in mungbean (Vigna radiata L. Wilczek)
Authors: Dhole Vinod J. , Reddy Kandali S.
Published: October 2012

Yellow mosaic disease (YMD) caused by mungbean yellow mosaic virus (MYMV) is the most important disease of mungbean, causing great yield loss. The present investigation was carried out to study the inheritance and identify molecular markers linked with MYMV resistance gene by using F1, F2 and 167 F2 : 8 recombinant inbred lines (RILs) developed from the cross ‘TM‐99‐37’ (resistant) × Mulmarada (susceptible). The F1 was susceptible, F2 segregated in 3S:1R phenotypic ratio and RILs segregated in 1S:1R ratio in the field screening indicating that the MYMV resistance gene is governed by a single recessive gene. Of the 140 RAPD primers, 45 primers showing polymorphism in parents were screened using bulked segregant analysis. Three primers amplified specific polymorphic fragments viz. OPB‐07600, OPC‐061750 and OPB‐12820. The marker OPB‐07600 was more closely linked (6.8 cM) with a MYMV resistance gene as compared to OPC‐061750 (22.8 cM) and OPB‐12820 (25.2 cM). The resistance‐specific fragment OPB‐07600 was cloned, sequenced and converted into a sequence‐characterized amplified region (SCAR) marker and validated in twenty genotypes with different genetic backgrounds.
e‐photosynthesis: a comprehensive dynamic mechanistic model of C3 photosynthesis: from light capture to sucrose synthesis
Authors: ZHU XIN‐GUANG , WANG YU , ORT DONALD R. , LONG STEPHEN P.
Published: October 2012

Photosynthesis is arguably the most researched of all plant processes. A dynamic model of leaf photosynthesis that includes each discrete process from light capture to carbohydrate synthesis, e‐photosynthesis, is described. It was developed by linking and extending our previous models of photosystem II (PSII) energy transfer and photosynthetic C3 carbon metabolism to include electron transfer processes around photosystem I (PSI), ion transfer between the lumen and stroma, ATP synthesis and NADP reduction to provide a complete representation. Different regulatory processes linking the light and dark reactions are also included: Rubisco activation via Rubisco activase, pH and xanthophyll cycle‐dependent non‐photochemical quenching mechanisms, as well as the regulation of enzyme activities via the ferredoxin‐theoredoxin system. Although many further feedback and feedforward controls undoubtedly exist, it is shown that e‐photosynthesis effectively mimics the typical kinetics of leaf CO2 uptake, O2 evolution, chlorophyll fluorescence emission, lumen and stromal pH, and membrane potential following perturbations in light, [CO2] and [O2] observed in intact C3 leaves. The model provides a framework for guiding engineering of improved photosynthetic efficiency, for evaluating multiple non‐invasive measures used in emerging phenomics facilities, and for quantitative assessment of strengths and weaknesses within the understanding of photosynthesis as an integrated process.
Toxic Epidermal Necrolysis in a Child Successfully Treated with Infliximab
Authors: Scott‐Lang Victoria , Tidman Michael , McKay David
Published: October 2012

A 7‐year‐old boy developed severe toxic epidermal necrolysis (TEN) secondary to carbamazepine and was transferred to our center after further deterioration despite receiving one dose of intravenous immunoglobulin. After administration of one dose of infliximab, there was a clear halting of progression of blistering and an apparent dramatic improvement. We consider it likely that the administration of infliximab led to the improvement in this child and that anti‐tumor necrosis factor‐alpha therapy may be a logical treatment for TEN, given the possible underlying pathologic process. Well‐conducted studies on the safety and efficacy of any such treatment are urgently required.
High‐resolution seismic reflection profiling of neotectonic faults in Lake Timiskaming, Timiskaming Graben, Ontario‐Quebec, Canada
Authors: Doughty Michael , Eyles Nick , Eyles Carolyn
Published: October 2012

The Timiskaming Graben is a 400 km long, 50 km wide north‐west trending morphotectonic depression within the Canadian Shield of eastern North America and experiences frequent intraplate earthquakes. The graben extends along the border of Ontario and Quebec, connecting southward with the Nipissing and Ottawa‐Bonnechere grabens and the St. Lawrence Rift System which includes a similar structure underlying the Hudson Valley of the eastern USA. Together they form a complex failed rift system related to regional extension of North American crust during the breakup of Rodinia and, later, Pangea. The Timiskaming Graben lies within a belt of heightened seismic activity (Western Quebec Seismic Zone) with frequent moderate magnitude (greater than magnitude 5) earthquakes including a magnitude 6.2 in 1935. These events threaten aging urban infrastructure built on soft glacial sediments; post‐glacial landslides along the Ottawa Valley suggest earthquakes as large as magnitude 7. The inner part of the Timiskaming Graben is filled by Lake Timiskaming, a large 110 km long post‐glacial successor to glacial Lake Barlow that was ponded by the Laurentide Ice Sheet 9500 years ago. The effects of frequent ground shaking on lake floor sediments was assessed by collecting more than 1000 line kilometres of high‐resolution ‘chirp’ seismic profiles. Late glacial Lake Barlow glaciolacustrine and overlying post‐glacial sediments are extensively deformed by extensional faults that define prominent horsts and grabens; multibeam bathymetry data suggest that faults influence the morphology of the modern lake floor, despite high sedimentation rates, and indicate recent neotectonic deformation. The Lake Timiskaming area provides evidence of post‐glacial intracratonic faulting related to recurring earthquake activity along a weak spot within the North American plate.
Short‐term proteomic dynamics reveal metabolic factory for active extrafloral nectar secretion by Acacia cornigera ant‐plants
Authors: Orona‐Tamayo Domancar , Wielsch Natalie , Escalante‐Pérez María , Svatos Ales , Molina‐Torres Jorge , Muck Alexander , Ramirez‐Chávez Enrique , Ádame‐Alvarez Rosa‐María , Heil Martin
Published: October 2012

Despite the ecological and evolutionary importance of nectar, mechanisms controlling its synthesis and secretion remain largely unknown. It is widely believed that nectar is ‘secreted phloem sap’, but current research reveals a biochemical complexity that is unlikely to stem directly from the phloem. We used the short daily peak in production of extrafloral nectar by Acacia cornigera to investigate metabolic and proteomic dynamics before, during and after 2 h of diurnal secretion. Neither hexoses nor dominating nectar proteins (nectarins) were detected in the phloem before or during nectar secretion, excluding the phloem as the direct source of major nectar components. Enzymes involved in the anabolism of sugars, amino acids, proteins, and nectarins, such as invertase, β–1,3–glucanase and thaumatin‐like protein, accumulated in the nectary directly before secretion and diminished quantitatively after the daily secretion process. The corresponding genes were expressed almost exclusively in nectaries. By contrast, protein catabolic enzymes were mainly present and active after the secretion peak, and may function in termination of the secretion process. Thus the metabolic machinery for extrafloral nectar production is synthesized and active during secretion and degraded thereafter. Knowing the key enzymes involved and the spatio‐temporal patterns in their expression will allow elucidation of mechanisms by which plants control nectar quality and quantity.
A Two-Step Mechanism for the Activation of Actinorhodin Export and Resistance in Streptomyces coelicolor
Authors: Xu Ye , Willems Andrew , Au-yeung Catherine , Tahlan Kapil , Nodwell Justin R.
Published: October 2012

Many microorganisms produce secondary metabolites that have antibiotic activity. To avoid self-inhibition, the producing cells often encode cognate export and/or resistance mechanisms in the biosynthetic gene clusters for these molecules. Actinorhodin is a blue-pigmented antibiotic produced by
Streptomyces coelicolor
. The
actAB
operon, carried in the actinorhodin biosynthetic gene cluster, encodes two putative export pumps and is regulated by the transcriptional repressor protein ActR. In this work, we show that normal actinorhodin yields require
actAB
expression. Consistent with previous
in vitro
work, we show that both actinorhodin and its 3-ring biosynthetic intermediates [e.g., (
S
)-DNPA] can relieve repression of
actAB
by ActR
in vivo
. Importantly, an ActR mutant that interacts productively with (
S
)-DNPA but not with actinorhodin responds to the actinorhodin biosynthetic pathway with the induction of
actAB
and normal yields of actinorhodin. This suggests that the intermediates are sufficient to trigger the export genes in actinorhodin-producing cells. We further show that actinorhodin-producing cells can induce
actAB
expression in nonproducing cells; however, in this case actinorhodin is the most important signal. Finally, while the “intermediate-only” ActR mutant permits sufficient
actAB
expression for normal actinorhodin yields, this expression is short-lived. Sustained culture-wide expression requires a subsequent actinorhodin-mediated signaling step, and the defect in this response causes widespread cell death. These results are consistent with a two-step model for actinorhodin export and resistance where intermediates trigger initial expression for export from producing cells and actinorhodin then triggers sustained export gene expression that confers culture-wide resistance.

IMPORTANCE
Understanding the links between antibiotic resistance and biosynthesis is important for our efforts to manipulate secondary metabolism. For example, many secondary metabolites are produced at low levels; our work suggests that manipulating export might be one way to enhance yields of these molecules. It also suggests that understanding resistance will be relevant to the generation of novel secondary metabolites through the creation of synthetic secondary metabolic gene clusters. Finally, these cognate resistance mechanisms are related to mechanisms that arise in pathogenic bacteria, and understanding them is relevant to our ability to control microbial infections clinically.
Predicting the Outcome of Infectious Diseases: Variability among Inbred Mice as a New and Powerful Tool for Biomarker Discovery
Authors: Martin Miriam E. , Dieter Jacquelyn A. , Luo Zheng , Baumgarth Nicole , Solnick Jay V.
Published: October 2012

Individuals respond differently to infectious diseases. Even among inbred mice that are presumed to be genetically identical, the response to a microbial pathogen is variable, which is generally thought to reflect experimental inconsistencies, technical errors, and stochastic processes. Here we describe the remarkable observation that the variability of
Helicobacter pylori
colonization density in the stomachs of experimentally infected C57BL/6J mice is tightly correlated with weight loss and viral load after a challenge with influenza virus, though
H. pylori
infection
per se
does not affect influenza and vice versa. Since these two infectious agents are found in different tissue compartments and are detected using unrelated methods, the correlation in microbial burden must represent a biological measure of disease susceptibility among genetically nearly identical individuals and not technical or stochastic factors. We hypothesize that inbred mice represent a powerful new tool for the identification of biomarkers to predict the outcome of infectious diseases.
Unexpected Diversity and Expression of Avian Endogenous Retroviruses
Authors: Bolisetty Mohan , Blomberg Jonas , Benachenhou Farid , Sperber Göran , Beemon Karen
Published: October 2012

Endogenous retroviruses (ERVs) were identified and characterized in three avian genomes to gain insight into early retroviral evolution. Using the computer program RetroTector to detect relatively intact ERVs, we identified 500 ERVs in the chicken genome, 150 in the turkey genome, and 1,200 in the zebra finch genome. Previous studies suggested that endogenous alpharetroviruses were present in chicken genomes. In this analysis, a small number of alpharetroviruses were seen in the chicken and turkey genomes; however, these were greatly outnumbered by beta-like, gamma-like, and alphabeta proviruses. While the avian ERVs belonged to the same major groups as mammalian ERVs, they were more heterogeneous. In particular, the beta-like viruses revealed an evolutionary continuum with the gradual acquisition and loss of betaretroviral markers and a transition from beta to alphabeta and then to alpharetroviruses. Thus, it appears that birds may resemble a melting pot for early ERV evolution. Many of the ERVs were integrated in clusters on chromosomes, often near centromeres. About 25% of the chicken ERVs were in or near cellular transcription units; this is nearly random. The majority of these integrations were in the sense orientation in introns. A higher-than-random number of integrations were >100 kb from the nearest gene. Deep-sequencing studies of chicken embryo fibroblasts revealed that about 20% of the 500 ERVs were transcribed and translated. A subset of these were also transcribed
in vivo
in chickens, showing tissue-specific patterns of expression.

IMPORTANCE
Studies of avian endogenous retroviruses (ERVs) have given us a glimpse of an earlier retroviral world. Three different classes of ERVs were observed with many features of mammalian retroviruses, as well as some important differences. Many avian ERVs were transcribed and translated.
Pathological yawning as an ictal seizure manifestation in the elderly
Authors: Nicotra Alessia , Khalil Nofal M , Owbridge P , Hakda Mina , Beitverda Younatan
Published: October 2012

Excessive yawning has been reported in the peri-ictal period preceding or following seizures. We describe an exceptional case of an elderly man with impairment of consciousness and paroxysmal excessive yawning. We hypothesise that this can be regarded as an autonomic seizure originating from diencephalic/brainstem structures, manifesting with yawning as an ictal phenomenon.
Aneurysmal dilation of the ascending thoracic aorta and the aortic arch following surgical repair of type A dissection
Authors: Cormack Suzanne M , Owens W Andrew
Published: October 2012

This report describes the case of a 71-year-old lady who was diagnosed with a Stanford type A dissecting aortic aneurysm which resulted in paraplegia secondary to spinal artery injury at T12 level. She had surgical repair with a tube graft. At a routine review CT scan 2 years postdissection, she presents with asymptomatic but significant dilation, of maximum diameter 78 mm, of the superior part of the ascending thoracic aorta, extending into the arch, suggestive of false aneurysm formation at the surgical anastomoses. There was also thrombosis of the false lumen in the distal arch and descending thoracic aorta. She is a candidate for urgent resection of the aortic arch and reimplantation of the brachiocephalic vessels.
Pitfalls in the management of herpes simplex virus encephalitis
Authors: Ibitoye Richard Tolulope , Sarkar Pamela , Rajbhandari Satyan
Published: October 2012

We report a case of Herpes Simplex Virus Encephalitis (HSVE) with a fatal outcome of a patient in his 70s presenting to a local teaching hospital with fever and confusion. We highlight pertinent issues regarding diagnosis, investigation and management, and consider ways of improving clinical outcomes. Finally, we discuss the differential diagnoses of acute encephalitis and review the management of HSVE.
Treatment of Stargardt disease with dobesilate
Authors: Cuevas Pedro , Outeiriño Luis A , Angulo Javier , Giménez-Gallego Guillermo
Published: October 2012

Stargardt disease is a common inherited macular degeneration characterised by a significant loss in the central vision during the first or second decade of the life. Bilateral atrophic changes in the central retina are associated with degeneration of photoreceptors and underlying retinal pigment epithelium, and yellow flecks are extending from the macula. We present a patient with Stargardt disease treated with an intravitreal injection of dobesilate, showing an improvement of visual acuity 4 weeks after treatment
Isolated extra pontine myelinolysis presenting as acute onset parkinsonism
Authors: Rizvi Imran , Ahmad Mehtab , Gupta Ankush , Zaidi Noorin
Published: October 2012

A 50-year-old woman was brought to the emergency department with complaints of altered mental status, her serum sodium at that time was 103mmol/l. Slow correction of hyponatraemia was started but despite every effort serum sodium rise was rapid. Although the patient improved initially, after 4 days she presented with features of parkinsonism. MRI brain was done and it was suggestive of features of EPM. She responded well to levodopa plus carbidopa therapy.
Unexpected remission of hepatocellular carcinoma (HCC) with lung metastasis to the combination therapy of thalidomide and cyproheptadine: report of two cases and a preliminary HCC cell line study
Authors: Feng Yu-Min , Feng Chin-Wen , Chen Solomon Chih-Cheng , Hsu Cheng-Da
Published: October 2012

We reported two cases of hepatocellular carcinoma (HCC) with lung metastases who were treated with a combination of thalidomide and cyproheptadine. The use of cyproheptadine in these two cases was originally for skin itching. Follow-up CT images revealed a complete remission of HCC in both of them after treatment for 6 months and 6 weeks, respectively. A following experimental cell line study demonstrated that cyproheptadine effectively reduced the viability of two HCC cell lines.
Comparative genomic analysis of Escherichia coli O104:H4 stx2 prophage reveals a potential new method to identify virulence factors
Authors: Du Pengcheng , Zhang Wen , Wang Haiyin , Chen Chen
Published: October 2012

This study investigated the process of virulence acquisition in a Shiga toxin-producing Escherichia coli O104:H4 strain, TY-2482, by comparing the sequence of stx2 (Shiga toxin 2) prophage with the sequences of 1421 complete bacterial genomes and analyzing the evolutionary relationships of the stx2 prophage-like regions identified. The results showed a strong positive correlation between the evolutionary distance and the distance to switch sites of GC skew, suggesting that the loci near these sites are “hotspots” for insertions. These findings represent a potential new method to identify virulence factors in bacterial genomes.