bluuebunny/crossref_metadata_2025 huggingface dataset:
Embracing autism in Canadian rural communities
Authors: Hoogsteen Lindsey , Woodgate Roberta L.
Published: June 2013

Objective

The purpose of this study was to explore the lived experience of Canadian parents living in rural areas who were parenting a child with autism.

Design

A phenomenological design described by van Manen was applied to guide this study.

Setting

This study took place in rural communities of Western Canada.

Participants

Purposive sampling was used to recruit 26 families parenting a child with autism in rural communities. Participants ranged in age from 26 to 50 years old and lived an average of 197 kilometres away from an urban city.

Interventions

Parents of children with autism took part in audio‐taped, in‐depth interviews. A total of 26 open‐ended interviews were completed over four months with an average of 83 minutes per interview.

Main Outcome Measures

All interviews and field notes were transcribed verbatim and analyzed using van Manen's selective highlighting approach.

Results

When describing the characteristics of living rurally while parenting a child with autism, parents reported that the rural community had (i) less of everything, (ii) safety and familiarity, and (iii) a family of support. Parents believed that although there were disadvantages to living in a rural community, parents felt isolated in terms of services but not in terms of the support received by the community.

Conclusion

The results of this study add to our knowledge of parenting experiences with attention to the rural experience and furthermore, recommendations for nurses and health care professionals were provided.
Barriers and motivators to exercise for older adults: A focus on those living in rural and remote areas of Australia
Authors: Boehm Jackie , Franklin Richard C. , Newitt Rose , McFarlane Kathryn , Grant Tonya , Kurkowski Barbra
Published: June 2013

To identify the barriers and facilitators for exercise in older adults (50 years or over) specific to those living in rural and remote areas in Australia and to identify how this relates to falls prevention exercise programs in these areas. Literature review. Search of the databases of Medline, Scopus and Social Sciences Citation Index. Rural and remote areas. Searching identified 56 articles relating to barriers or facilitators to exercise in older adults in general, of which 25 are discussed in the article. Five of these articles specifically related to rural and remote areas, of which all were from studies in the United States. No literature specifically relating to rural and remote Australia was identified. Therefore, articles included in the final review were from three different domains – world literature (excluding those specific to rural and remote areas of Australia), rural and remote literature (note not Australian), and Australian literature to enable a comparison between the different populations to occur. There are similarities and differences between the barriers and facilitators in various populations, and no one factor alone will enable exercise in older adults. Research needs to be conducted on the barriers and facilitators to exercise in older adults living in rural and remote areas in Australia. Falls prevention exercise programs need to be tailored to suit the unique needs of the rural and remote older population.
Overactive bladder and its effects on sexual dysfunction among women
Authors: Ergenoglu Ahmet M. , Yeniel Ahmet Özgür , Itil Ismail Mete , Askar Niyazi , Meseri Reci , Petri Eckhard
Published: June 2013

Objective

To evaluate the relation between overactive bladder (OAB) and sexual dysfunction in sexually active nurses without stress urinary incontinence and pelvic organ prolapse.

Design

Prospective, observational study.

Setting

Tertiary care center

Population

200 nurses, under 49 years of age.

Method

Data were obtained with Turkish language‐validated questionnaires between January 2011 and June 2011. OAB was diagnosed using the Overactive Bladder Awareness Tool (OAB AT).

Main outcome measures

Scores on the Overactive Bladder Symptom and Health‐related Quality of Life Questionnaire Short Form (OABq‐SF), the Health‐related Quality of Life Questionnaire Short Form (HRQOL), and the Pelvic Organ Prolapse/Urinary Incontinence Sexual Questionnaire Short Form (PISQ‐12).

Results

Of the 127 enrolled volunteers, 51 were diagnosed with OAB. The mean age of the participants was 37.8 ± 7.3 years. After controlling for age, body mass index, and parity, OAB did not significantly affect PISQ‐12 scores, but significantly worsened OABq‐SF scores. No strong correlation was noted between the parts of the OABq‐SF and the domains of the PISQ‐12.

Conclusion

OAB is a common problem among sexually active young women and significantly affects their quality of life. However, OAB‐related sexual dysfunction plays a limited role among sexually active nurses.
Maternal chocolate and sucrose soft drink intake induces hepatic steatosis in rat offspring associated with altered lipid gene expression profile
Authors: Kjaergaard M. , Nilsson C. , Rosendal A. , Nielsen M. O. , Raun K.
Published: June 2013

Aim

According to the World Diabetes Foundation, there is an urgent need to investigate the impact of maternal health and nutrition during pregnancy to understand the background for the accelerating incidence of obesity and type 2 diabetes. In this study, we specifically concentrated on the role of overfeeding during different developmental periods.

Methods

Sprague–Dawley rats were offered chow or high‐fat/high‐sucrose diet (chow plus chocolate and soft drink) during gestation and lactation. At birth, offspring were randomly cross‐fostered within each dietary group into small and normal litter sizes until weaning, giving four dietary groups.

Results

At postnatal day 1, offspring from high‐fat/high‐sucrose‐fed dams were heavier and had increased hepatic triglycerides (TG), hepatic glycogen, blood glucose and plasma insulin compared with offspring from chow‐fed dams. Hepatic genes involved in lipid oxidation, VLDL transport and insulin receptor were down‐regulated, whereas FGF21 expression was up‐regulated. Independent of postnatal litter size, offspring from high‐fat/high‐sucrose‐fed dams aged 21 days had still increased hepatic TG and up‐regulated FGF21 expression, while plasma insulin started to decrease. Litter size reduction in offspring from high‐fat/high‐sucrose‐fed dams further increased body weight and adiposity, and up‐regulated genes involved in hepatic mitochondrial lipid oxidation and VLDL transport compared with all other groups. Litter size reduction did not have any impact on body weight gain and adiposity in offspring born to chow‐fed dams.

Conclusion

Our results suggest that supplementation of chocolate and soft drink during gestation and lactation contributes to early onset of hepatic steatosis associated with changes in hepatic gene expression and lipid handling.
Human Merkel cell polyomavirus: virological background and clinical implications
Authors: Coursaget Pierre , Samimi Mahtab , Nicol Jérome T.J. , Gardair Charlotte , Touzé Antoine
Published: June 2013

The Merkel cell polyomavirus (MCPyV), identified in humans in 2008, is associated with a relatively rare but aggressive neuroendocrine skin cancer, the Merkel cell carcinoma (MCC). MCC incidence is increasing due to the advancing age of the population, the increase in damaging sun exposure and in the number of immunocompromised individuals. MCPyV must be considered as the etiological agent of MCC and thus is the first example of a human oncogenic polyomavirus. MCPyV infection is common, and seroprevalence studies indicate that widespread exposure begins early in life. The majority of adults have anti‐MCPyV antibodies and there is a growing body of evidence that healthy human skin harbors resident or transient MCPyV suggesting that MCPyV infection persists throughout life. However, the mode of transmission, the host cells, and the latency characteristics of this virus remain to be elucidated. In addition, it is still not clear whether MCPyV is associated with diseases or lesions other than Merkel cell carcinoma. The etiologic role of MCPyV in MCC opens up opportunities to improve the understanding of this cancer and to potentially improve its treatment.
The human JC polyomavirus (JCPyV): virological background and clinical implications
Authors: Hirsch Hans H. , Kardas Piotr , Kranz Denise , Leboeuf Celine
Published: June 2013

JC polyomavirus (JCPyV) was the first of now 12 PyVs detected in humans, when in 1964, PyV particles were revealed by electron microscopy in progressive multifocal leukoencephalopathy (PML) tissues. JCPyV infection is common in 35–70% of the general population, and the virus thereafter persists in the renourinary tract. One third of healthy adults asymptomatically shed JCPyV at approximately 50 000 copies/mL urine. PML is rare having an incidence of <0.3 per 100 000 person years in the general population. This increased to 2.4 per 1000 person years in HIV‐AIDS patients without combination antiretroviral therapy (cART). Recently, PML emerged in multiple sclerosis patients treated with natalizumab to 2.13 cases per 1000 patients. Natalizumab blocks α4‐integrin‐dependent lymphocyte homing to the brain suggesting that not the overall cellular immunodeficiency but local failure of brain immune surveillance is a pivotal factor for PML. Recovering JCPyV‐specific immune control, e.g., by starting cART or discontinuing natalizumab, significantly improves PML survival, but is challenged by the immune reconstitution inflammatory syndrome. Important steps of PML pathogenesis are undefined, and antiviral therapies are lacking. New clues might come from molecular and functional profiling of JCPyV and PML pathology and comparison with other replicative pathologies such as granule cell neuronopathy and (meningo‐)encephalitis, and non‐replicative JCPyV pathology possibly contributing to some malignancies. Given the increasing number of immunologically vulnerable patients, a critical reappraisal of JCPyV infection, replication and disease seems warranted.
Immunobullous dermatosis associated with Waldenström macroglobulinaemia treated with rituximab
Authors: Chattopadhyay M. , Rytina E. , Dada M. , Bhogal B. S. , Groves R. , Handfield-Jones S.
Published: June 2013

Waldenström macroglobulinaemia (WM) is a chronic lymphoproliferative disorder characterized by the presence of a monoclonal IgM paraprotein. Specific cutaneous features of WM include neoplastic cell infiltrates, IgM storage papules and IgM bullous dermatosis. We report a patient with subepidermal bullous disease associated with WM. Immunofluorescence identified IgM deposition along the basement membrane zone (BMZ) with circulating anti-BMZ IgM antibodies reacting with the dermal side of salt-split skin. The autoantibodies did not react with type VII collagen or laminin 332. Following failed treatment with doxycycline, prednisolone, intravenous immunoglobulin and dapsone, the patient was successfully treated with a modified RCVP regimen (rituximab, cyclophosphamide and prednisolone). To our knowledge, this is the first reported case of IgM bullous disease of WM treated with rituximab.
Impact of implant–abutment connection and positioning of the machined collar/microgap on crestal bone level changes: a systematic review
Authors: Schwarz Frank , Hegewald Andrea , Becker Jürgen
Published: June 2013

Objectives

To address the following focused question: What is the impact of implant–abutment configuration and the positioning of the machined collar/microgap on crestal bone level changes?

Material and methods

Electronic databases of the PubMed and the Web of Knowledge were searched for animal and human studies reporting on histological/radiological crestal bone level changes (CBL) at nonsubmerged one‐/two‐piece implants (placed in healed ridges) exhibiting different abutment configurations, positioning of the machined collar/microgap (between 1992 and November 2012: n = 318 titles). Quality assessment of selected full‐text articles was performed according to the ARRIVE and CONSORT statement guidelines.

Results

A total of 13 publications (risk of bias: high) were eligible for the review. The weighted mean difference (WMD) (95% CI) between machined collars placed either above or below the bone crest amounted to 0.835 mm favoring an epicrestal positioning of the rough/smooth border (P < 0.001) (P‐value for heterogeneity: 0.885, I2: 0.000% = no heterogeneity). WMD (95% CI) between microgaps placed either at or below the bone crest amounted to −0.479 mm favoring a subcrestal position of the implant neck (P < 0.001) (P‐value for heterogeneity: 0.333, I2: 12.404% = low heterogeneity). Only two studies compared different implant–abutment configurations. Due to a high heterogeneity, a meta‐analysis was not feasible.

Conclusions

While the positioning of the machined neck and microgap may limit crestal bone level changes at nonsubmerged implants, the impact of the implant–abutment connection lacks documentation.
Testosterone therapy in hypogonadal men results in sustained and clinically meaningful weight loss
Authors: Yassin A. A. , Doros G.
Published: June 2013

What is already known about this subject

Hypogonadism is associated with increased fat mass and reduced muscle mass, which contributes to obesity and health risks, such as cardiovascular disease.

Testosterone treatment of hypogonadal men improves muscle mass and reduces fat mass; however, many of these studies are of short duration.

Thus, the long‐term effects of testosterone on body anthropometry are not known.

What this study adds

Long‐term testosterone treatment of hypogonadal men, up to 5 years duration, produced marked and significant decrease in body weight, waist circumference and body mass index.

Hypogonadism contributes to reduced muscle mass and increased adiposity. Testosterone treatment ameliorates loss of muscle mass and reduces fat accumulation associated with hypogonadism. In this study, we evaluated the long‐term effects of normalizing testosterone (T) levels in hypogonadal men on anthropometric parameters. Open‐label, single‐center, cumulative, prospective registry study of 261 men (32–84 years, mean 59.5 ± 8.4 years, with T levels ≤12 nmol L−1 [mean: 7.7 ± 2.1]). Among the 261 men on T treatment, we followed up on 260 men for at least 2 years, 237 for 3 years, 195 for 4 years and 163 for at least 5 years. Subjects received parenteral T undecanoate 1000 mg every 12 weeks after an initial interval of 6 weeks. Body weight (BW), waist circumference (WC) and body mass index (BMI) were measured at baseline and yearly after treatment with T. BW decreased from 100.1 ± 14.0 kg to 92.5 ± 11.2 kg and WC was reduced from 107.7 ± 10.0 cm to 99.0 ± 9.1 cm. BMI declined from 31.7 ± 4.4 m kg−2 to 29.4 ± 3.4 m kg−2. All parameters examined were statistically significant vs. baseline and vs. the previous year over 5 years, indicating a continuous weight loss (WL) over the full observation period. The mean per cent WL was 3.2 ± 0.3% after 1 year, 5.6 ± 0.3%, after 2 years, 7.5 ± 0.3% after 3 years, 9.1 ± 0.3% after 4 years and 10.5 ± 0.4% after 5 years. The data obtained from this uncontrolled, observational, registry study suggest that raising serum T to normal physiological levels in hypogonadal men produces consistent loss in BW, WC and BMI. These marked improvements were progressive over the 5 years of the study.
Side‐effects of henna and semi‐permanent ‘black henna’ tattoos: a full review
Authors: de Groot Anton C.
Published: June 2013

Henna, the dried and powdered leaf of Lawsonia inermis, is widely used as a dye for the skin, hair, and nails, and as an expression of body art, especially in Islamic and Hindu cultures. As it stains the skin reddish‐brown, it is also called red henna. Black henna is the combination of red henna with p‐phenylenediamine (PPD), and is used for temporary ‘black henna tattoos’. This article provides a full review of the side‐effects of topical application of red and black henna, both cutaneous (allergic and non‐allergic) and systemic. Red henna appears to be generally safe, with rare instances of contact allergy and type I hypersensitivity reactions. In children with glucose‐6‐phosphate dehydrogenase deficiency, topical application of henna may cause life‐threatening haemolysis. Black henna tattoos will induce contact allergy to its ingredient PPD at an estimated frequency of 2.5%. Once sensitized, the patients may experience allergic contact dermatitis from the use of hair dyes containing PPD. There are often cross‐reactions to other hair dyes, dyes used in textiles, local anaesthetics, and rubber chemicals. The sensitization of children to PPD may have important consequences for health and later career prospects. Systemic toxicity of black henna has been reported in certain African countries.
Sensitizing capacity of Disperse Orange 1 and its potential metabolites from azo reduction and their cross‐reactivity pattern
Authors: Malinauskiene Laura , Zimerson Erik , Bruze Magnus , Ryberg Kristina , Isaksson Marlene
Published: June 2013

Background

Simultaneous contact allergies to Disperse Orange 1, 4‐nitroaniline and p‐aminodiphenylamine (PADPA), as well as to other disperse azo dyes and to p‐phenylenediamine (PPD), have been reported. Cross‐reactivity is one of the possible explanations for simultaneous reactions between PPD and disperse azo dyes. Some metabolites from the azo reduction of these disperse azo dyes could be sensitizers, as human skin bacteria produce azo reductases.

Objectives

To investigate the sensitizing capacity of Disperse Orange 1, PADPA and 4‐nitroaniline, and the cross‐reactivity between these substances and Disperse Yellow 3, its potential metabolites from azo reduction (4‐aminoacetanilide and 2‐amino‐p‐cresol), and PPD.

Method

The guinea‐pig maximization test was used.

Results

It was found that both Disperse Orange 1 and PADPA are strong sensitizers and cross‐react with each other. We were unable to sensitize guinea‐pigs with 4‐nitroaniline tested in equimolar concentrations to Disperse Orange 1.

Conclusions

The results indicate that patients sensitized primarily to Disperse Orange 1 will also react to PADPA, which can be found mainly in hair dyes. PPD, 4‐nitroaniline, 4‐aminoacetanilide, 2‐amino‐p‐cresol and Disperse Yellow 3 did not show any cross‐reactivity with Disperse Orange 1 or PADPA.
The use of habitat suitability models and species–area relationships to predict extinction debts in coastal forests, South Africa
Authors: Olivier Pieter I. , van Aarde Rudi J. , Lombard Amanda T.
Published: June 2013

Aim

Predicting extinctions before they are realized has proven difficult, yet is increasingly important for biodiversity conservation as habitat destruction continues unabated around the world. We evaluated whether habitat suitability models can be used in conjunction with species–area relationships (SAR) to detect apparent extinction debts as implicated by the conservation status assigned to bird species.

Location

KwaZulu‐Natal province, South Africa.

Methods

We modelled historic distributions of coastal forests using MaxEnt, a presence‐only technique for modelling species distributions. The model provided an estimate of forest loss. We then conducted 293 point counts to survey birds within remaining forest fragments and employed an information‐theoretic framework to test for the best fit SAR model. Extinction debts were calculated using the estimate of forest loss and the empirical SAR data.

Results

Our model suggests extensive forest loss (82%) within a naturally fragmented landscape. The power function provided the best fit for bird SAR. Fourteen bird species are predicted to go extinct from coastal forests. Predicted extinctions closely matched the number of threatened species locally but not globally. Predicted extinctions also only matched globally threatened species that reach their northernmost distribution limit within coastal forests, but not species that reach their southernmost distribution limit here.

Main conclusions

We found that habitat suitability models could be used in conjunction with SAR to estimate extinction debt implied by conservation statuses of extant species. Our approach assumed that forest loss drives extinction debts but also provided the opportunity to link forest loss and the likelihood of extinction. Models of historical forest distribution may provide guidelines of where to implement restoration actions. Maintaining matrix habitats that link forest fragments and targeted landscape level restoration that increases fragment area and link isolated fragments will be important to prevent predicted extinctions.
Using Electronic Medical Records in Admission Decisions: A Cost Effectiveness Analysis
Authors: Ben‐Assuli Ofir , Leshno Moshe
Published: June 2013

In recent years, the healthcare sector has invested heavily in medical information systems to improve decision making while reducing medical costs and integrating medical data from multiple sources. However, the overall contribution of this technology to the medical field remains controversial, especially in high‐stress environments such as the emergency department. This article evaluates the differential effects of accessing an electronic medical record (EMR) system on the decision to admit, based on diagnosis of acute myocardial infarction (AMI), which is one of the main reasons people go to the emergency department. The admission decision with or without accessing the EMR system is modeled as a decision tree and a Markovian process. A cost‐effectiveness analysis compares the added value of information (retrieved from the EMR system) against the cost of providing this information. This model is then tested on a simulation of patients presenting symptoms of AMI. The results show that use of the EMR led to greater cost‐effectiveness in cases of suspected AMI. The findings of this study may assist physicians by demonstrating a probable contribution of EMR to improved medical outcomes and may inform policy makers in the healthcare sector regarding the advisability of investing in such systems in an emergency department.
IT Governance Characteristics, Electronic Medical Records Sophistication, and Financial Performance in U.S. Hospitals: An Empirical Investigation
Authors: Smith Antoinette L. , Bradley Randy V. , Bichescu Bogdan C. , Tremblay Monica Chiarini
Published: June 2013

As a result of a recent federal government mandate, an increasing number of hospitals have decided to adopt electronic medical record (EMR) systems. This initiative is expected to lead toward more efficient and higher quality health care; however, little is known about governance characteristics and organizational performance for EMR adopters. Our goal is to inform theory and practice by examining hospitals with a sophisticated EMR and comparing those hospitals to similar hospitals (with a less sophisticated EMR) to understand the association between information technology (IT) governance characteristics and the implications on financial performance. Leveraging elements of the upper echelon theory, we posit that hospitals in which the chief information officer (CIO) reports to the chief executive officer, CIO turnover is low, and an IT steering committee is present are more likely to have a sophisticated EMR. We argue that EMR sophistication leads to improved financial performance. Our results underscore the importance of continuity in the CIO position on successful EMR implementations. Results also show that hospital size and financial performance are strongly associated with EMR sophistication. In addition, we find that a sophisticated EMR appears to be a fundamental element in improving hospitals’ revenue cycle management. Moreover, we find that hospitals with a sophisticated EMR appear to be more profitable. Finally, we observe that total payroll expense adjusted by total discharges drops among the sophisticated hospitals, potentially due to an increase in employee productivity. These insights can serve as a basis for tempering expectations relative to the financial impact of EMR adoption.
Demand Functions in Decision Modeling: A Comprehensive Survey and Research Directions
Authors: Huang Jian
Published: June 2013

A variety of mathematical forms have been developed to characterize demand functions which depend on a firm's operational and marketing activities. Such demand functions are being increasingly used by researchers in economics and different functional areas of business. We provide a comprehensive survey of commonly used demand models which depend on (i) price, (ii) rebate, (iii) lead time, (iv) space, (v) quality, and (vi) advertising. Our survey includes single firm–demand models in each category, as well as game theoretic multifirm models involving strategic interaction among the firms. We observe that certain types of functional forms, such as linear, power/iso‐elastic, multinomial logit, and multiplicative competitive interaction, have been widely used to construct various demand models in all six categories, but that a large majority of publications deal with categories (i) and (v) of demand models. For each of the six categories, we survey relevant functional forms in the representative papers, and discuss the main properties, the advantages, the disadvantages, and comment on possible future research directions. We also present discussions of the applications of these analytical demand models in empirical studies. The article ends with a summary of our major findings.
The Interdisciplinary Future of Supply Chain Management Research
Authors: Sanders Nada R. , Zacharia Zach G. , Fugate Brian S.
Published: June 2013

Since the term supply chain management (SCM) was first introduced over 30 years ago, the field of SCM has undergone numerous transformations. Today, it is a prevailing theme in scholarly and popular research, and numerous disciplines claim its ownership. However, current and emerging SCM research challenges are becoming increasingly more complex. Fragmented and "siloed" research efforts across a range of disciplines may not be adequate to address the full complexities associated with these phenomena. We interviewed 50 SCM academic thought leaders, across a range of disciplines, and 20 SCM executives with the goal of helping researchers develop a consistent stream of work that builds on existing research, identifies relevant research directions, and provides guidance for the future. Although there were some differences in opinions, there was consensus on the boundary characteristics of SCM, as well as the identification of interdisciplinary research (IDR) as necessary for the enablement of SCM to address the numerous current and emerging intractable SCM challenges. In this article, we present these findings and provide a path forward based on the collective wisdom of these academics and executives.
Market Impact on IT Security Spending
Authors: Kolfal Bora , Patterson Raymond A. , Yeo M. Lisa
Published: June 2013

Traditionally, IT security investment decisions are made in isolation. However, as firms that compete for customers in an industry are closely interlinked, a macro perspective is needed in analyzing these decisions. We utilize the notions of direct‐ and cross‐risk elasticity to describe the customer response to adverse IT security events in the firm and competitor, respectively, thus allowing us to analyze optimal security investment decisions. Examining both symmetric and asymmetric duopoly cases using a continuous‐time Markov chain (CTMC) model, we demonstrate that optimal IT security spending, expected firm profits and willingness of firms to cooperate on security improvements are highly dependent on the nature of customer response to adverse events. We also examine the investment problem when security attacks on different firms are correlated.
Olanzapine increases hepatic glucose production through the activation of hypothalamic adenosine 5′‐monophosphate‐activated protein kinase
Authors: Ikegami M. , Ikeda H. , Ohashi T. , Ohsawa M. , Ishikawa Y. , Kai M. , Kamei A. , Kamei J.
Published: June 2013

Aims

To investigate the mechanism of the metabolic disturbance induced by the atypical antipsychotic olanzapine, we examined whether adenosine 5′‐monophosphate‐activated protein kinase (AMPK) in the hypothalamus and hepatic glucose production are involved in the effect of olanzapine.

Methods

Male 6‐week‐old ICR mice were used. Blood glucose levels were determined by the glucose oxidase method. The mRNA levels of gluconeogenic or glycolytic enzymes were measured by reverse transcription polymerase chain reaction (RT‐PCR). AMPK expression was measured by Western blotting.

Results

Systemic injection of olanzapine increased blood glucose levels in both unfasted and fasted mice. However, the increase in fasted mice was less than that in unfasted mice. Central administration of olanzapine also increased the blood glucose levels in unfasted mice, but not in fasted mice. In a pyruvate tolerance test, olanzapine significantly increased blood glucose levels. In addition, olanzapine increased the mRNA levels of glucose‐6‐phosphatase (G6Pase), a gluconeogenic enzyme, in the liver. Furthermore, olanzapine increased phosphorylated AMPK in the hypothalamus of unfasted mice, and olanzapine‐induced hyperglycaemia was inhibited by the AMPK inhibitor compound C. Central administration of the AMPK activator AICAR significantly increased G6Pase mRNA levels in the liver and blood glucose levels. Moreover, both olanzapine‐ and AICAR‐induced hyperglycaemia were attenuated by the β‐adrenergic receptor antagonist propranolol, suggesting that olanzapine and AICAR induce hepatic glucose production through the sympathetic nervous system.

Conclusions

Our results indicate that olanzapine activates AMPK in the hypothalamus, which increases hepatic glucose production via the sympathetic nervous system.
Efficacy and safety of canagliflozin in Japanese patients with type 2 diabetes: a randomized, double‐blind, placebo‐controlled, 12‐week study
Authors: Inagaki N. , Kondo K. , Yoshinari T. , Maruyama N. , Susuta Y. , Kuki H.
Published: June 2013

Aims

We examined the efficacy, safety and tolerability of canagliflozin, a sodium glucose co‐transporter 2 inhibitor, in Japanese patients with type 2 diabetes (T2DM) undergoing diet and exercise therapy.

Methods

Patients aged 20–80 years with T2DM diagnosed ≥3 months previously, and HbA1c of 6.9–9.9% were randomized to 50, 100, 200 or 300 mg canagliflozin or placebo once daily for 12 weeks. The primary and secondary endpoints were changes in HbA1c, fasting plasma glucose (FPG), urinary glucose/creatinine and postprandial glycaemic parameters following a meal test. The safety assessments included adverse events (AEs) and clinical laboratory tests.

Results

Overall, 383 patients were randomized to receive either placebo (n = 75), or 50 mg (n = 82), 100 mg (n = 74), 200 mg (n = 77) or 300 mg canagliflozin (n = 75). At week 12, significant reductions in HbA1c were observed in all canagliflozin groups relative to placebo (−0.61, –0.80, –0.79 and −0.88% for 50, 100, 200 and 300 mg, respectively, versus +0.11% for placebo; all, p < 0.01). FPG and postprandial glycaemic parameters improved significantly in the canagliflozin groups. Body weight was significantly decreased by canagliflozin. No deaths or drug‐related serious AEs were reported. There was no dose‐dependent increase in the incidence of AEs in the canagliflozin groups. The incidence of hypoglycaemia was low; episodes were not severe or dose dependent. Canagliflozin did not affect serum creatinine levels or the urinary albumin/creatinine ratio.

Conclusions

Treatment with canagliflozin for 12 weeks significantly improved glycaemic control and reduced body weight in Japanese patients with T2DM. Canagliflozin was well tolerated.
Detection of leachables and cytotoxicity after exposure to methacrylate‐ and epoxy‐based root canal sealers in vitro
Authors: Lodienė Greta , Kopperud Hilde M. , Ørstavik Dag , Bruzell Ellen M.
Published: June 2013

Root canal sealing materials may have toxic potential in vitro depending on the cell line, cytotoxicity assay, material chemistry, and degree of polymer curing. The aims of the present study were to detect leaching components from epoxy‐ or methacrylate‐based root canal sealers and to investigate the degree of cytotoxicity after exposure to extracts from these materials. Qualitative determination of substances released from the materials was performed by gas‐ and liquid chromatography/mass spectrometry. Submandibular salivary gland acinar cell death (apoptosis/necrosis) was determined using a fluorescence staining/microscopy technique. The major leachable monomer from the epoxy‐based material was bisphenol‐A diglycidyl ether (BADGE), whereas leachables from the methacrylate‐based materials were mainly triethylene glycol dimethacrylate (TEGDMA), urethane dimethacrylate (UDMA), hydroxyethyl methacrylate (HEMA), and polyethyleneglycol dimethacrylate (PEGDMA). Exposure to diluted extracts of cured methacrylate‐based materials caused a postexposure time‐dependent increase in cell death. This effect was not demonstrated as a result of exposure to undiluted extract of cured epoxy‐based material. Extracts of all fresh materials induced apoptosis significantly, but at lower dilutions of the epoxy‐ than the methacrylate‐based materials. The degree of leaching, determined from the relative chromatogram peak heights of eluates from the methacrylate‐based sealer materials, corresponded with the degree of cell death induced by extracts of these materials.
A Discussion‐Based Online Approach to Fostering Deep Cultural Inquiry in an Introductory Language Course
Authors: Garrett‐Rucks Paula
Published: June 2013

Fostering and assessing language learners' cultural understanding is a daunting task, particularly at the early stages of language learning with target language instruction. The purpose of this study was to explore the development of beginning French language learners' intercultural understanding in a computer‐mediated environment where students discussed online cultural instruction among peers, in English, outside of formal instructional time. Discourse analyses of the discussion transcripts revealed sizeable growth in learners' development of intercultural sensitivity in response to different types of online instructional materials. Volunteer participants provided additional insight into the influences of the instructional materials on changes in their worldviews in post‐discussion interviews. In addition to providing evidence of effective uses of technology to resolve conflicts between target language use and deep cultural learning in the beginning world language curriculum, findings from this study document the application of an assessment model used to measure learners' development of intercultural understanding.
A climate of control: flooding, displacement and planned resettlement in the Lower Zambezi River valley, Mozambique
Authors: Arnall Alex
Published: June 2013

In recent years, the potential role of planned, internal resettlement as a climate change adaptation measure has been highlighted by national governments and the international policy community. However, in many developing countries, resettlement is a deeply political process that often results in an unequal distribution of costs and benefits among relocated persons. This paper examines these tensions in Mozambique, drawing on a case study of flood‐affected communities in the Lower Zambezi River valley. It takes a political ecology approach – focusing on discourses of human–environment interaction, as well as the power relationships that are supported by such discourses – to show how a dominant narrative of climate change‐induced hazards for small‐scale farmers is contributing to their involuntary resettlement to higher‐altitude, less fertile areas of land. These forced relocations are buttressed by a series of wider economic and political interests in the Lower Zambezi River region, such as dam construction for hydroelectric power generation and the extension of control over rural populations, from which resettled people derive little direct benefit. Rather than engaging with these challenging issues, most international donors present in the country accept the ‘inevitability’ of extreme weather impacts and view resettlement as an unfortunate and, in some cases, necessary step to increase people's ‘resilience’, thus rationalising the top‐down imposition of unpopular social policies. The findings add weight to the argument that a depoliticised interpretation of climate change can deflect attention away from underlying drivers of vulnerability and poverty, as well as obscure the interests of governments that are intent on reordering poor and vulnerable populations.
Effect of low planting density on the spikelet number in ‘Tachisuzuka’, a rice (Oryza sativa L.) cultivar with a short panicle for whole crop silage use
Authors: Matsushita Kei , Iida Shuichi , Ideta Osamu , Ishii Takuro , Fujimoto Hiroshi , Watanabe Hajime , Takahashi Yoshihiko
Published: June 2013

A promising new cultivar of rice (Oryza sativa L.) ‘Tachisuzuka’ has been developed for silage use with improved feeding value due to a radical decrease in spikelets. However, ‘Tachisuzuka’ has the problem of inefficient seed production. We investigated the effect of planting density on the spikelet number in ‘Tachisuzuka’ to find out how seed yields of this cultivar can be increased by means of cultivation methods. ‘Tachisuzuka’ was cultivated at six different planting densities, in the range of 7.4–22.2 hills m−2. Unlike in ordinary cultivars, there was a negative correlation between the spikelet number per unit area and hills per unit area. Moreover, the spikelet number increased by 67% under the low planting density. This result implies that the efficiency of seed production of ‘Tachisuzuka’ could be improved by low planting density through an increase in spikelet number per unit area.
Multiple metastatic infections in a hemodialysis patient with untunneled internal jugular catheter
Authors: Peddi Sandeep , Ram Rapur , Boreddy Varalakshmi Devi , Avssn Sridhar , Chennu Krishna Kishore , Vishnubotla Siva Kumar
Published: June 2013

We present an end‐stage renal disease patient on dialysis with fever. The primary source was right internal jugular vein catheter which had metastatic infections in the body probably via an arteriovenous communication in a cavity in left lung. Patient had right psoas muscle abscess and a left kidney abscess. An 18F‐fluorodeoxyglucose‐positron emission spectroscopy scan was done to find out left kidney abscess. A search of literature did not reveal many patients of psoas abscess secondary to infection of hemodialysis access.
Developing evidence‐based practice champions in the Maldives
Authors: Shifaza Fathimath , Evans David , Bradley Helen , Ullrich Sandra
Published: June 2013

Evidence‐based practice (EBP) is an approach that has gained recognition for facilitating the transfer of evidence into clinical practice. EBP champions is a strategy that can be adopted to encourage the uptake of EBP. This paper describes an action research project that was undertaken in Maldives. EBP champion model has been introduced in the Maldives early 2012 and aims to produce clinical leaders from variety of backgrounds who could implement EBP. This paper provides an extended discussion of the process that was undertaken to prepare EBP champions and their roles in implementing EBP.
Hand hygiene compliance among the nursing staff in freestanding nursing homes in Taiwan: A preliminary study
Authors: Liu Wen‐I , Liang Shu‐Yuan , Wu Shu‐Fang Vivienne , Chuang Yeu‐Hui
Published: June 2013

This study aimed to explore the hand hygiene compliance among the nursing staff in Taiwanese freestanding nursing homes. A descriptive observational research design was used. A total of 782 opportunities for hand hygiene were observed by one trained research assistant in two freestanding nursing homes. The hand‐hygiene observation tool was used to assess hand hygiene practice. The overall hand hygiene compliance among nursing staff in nursing homes was only 11.3%. Results further showed that the compliance was greater after contact with body fluids (odds ratio = 6.9, confidence interval (CI) = 3.75–9.88, P = 0.000) and lower before the performance of aseptic procedures (odds ratio = 0.15, CI = 0.04–0.63, P = 0.003) when compared with other activities. Hand hygiene compliance was relatively low among the nursing staff in freestanding nursing homes in Taiwan. To comprehensively analyze this issue, further research involving a larger number of nursing homes and strategies to improve compliance with hand hygiene among the nursing staff at these institutions is needed.
Reporting and methodological quality of systematic reviews or meta‐analyses in nursing field in China
Authors: Jin Ying‐hui , Ma En‐ting , Gao Wei‐jie , Hua Wei , Dou Hao‐ying
Published: June 2013

The aim of this paper was to evaluate reporting and methodological quality of systematic reviews or meta‐analyses in the nursing field in China. Over the last decade, evidence‐based nursing has been gradually known and accepted by nurses in China, and the number of systematic reviews or meta‐analyses of nursing flied has steadily increased, but the quality of these reviews is unsatisfactory. The Chinese Journal Full‐Text Database, the Chinese Biomedicine Literature Database and the Wanfang Database were searched for systematic reviews or meta‐analyses in the nursing field, from inception through December 2011. The Preferred Reporting Items of Systematic Reviews and Meta‐analyses and the Assessment of Multiple Systematic Reviews checklists were used to assess reporting characteristics and methodological quality, respectively. A total of 63 systematic reviews or meta‐analyses were identified. The deficiencies of methodological quality were mainly in literature searches, heterogeneity handling, recognition and assessment of publication bias. In addition, the deficiencies of reporting characteristics were reflected in incomplete reporting of literature search, quality assessment, risk of bias and results. Focusing on improving the quality of reporting and methodological quality of systematic reviews or meta‐analyses in the nursing field in China is urgently needed.
Predicting nurses' turnover intentions by demographic characteristics, perception of health, quality of work attitudes
Authors: Al‐Hussami Mahmoud , Darawad Muhammad , Saleh Ali , Hayajneh Ferial Ahmed
Published: June 2013

The purpose of this paper is to examine the impact of demographic variables, organizational commitment levels, perception of health and quality of work on turnover intentions. A self‐reported cross‐sectional survey design was used to collect data from Jordanian registered nurses who were working betweenJune 2011 andNovember 2011. The findings showed strong effects of the quality of work, perception of health and normative organizational commitments on turnover intentions. This study sheds the light on the important work outcomes in health‐care organizations. Increasing nursing quality of work and normative organizational commitment are good strategies for reducing turnover intentions.
In vitro effect of calcium nanophosphate and high‐concentrated fluoride agents on enamel erosion: an AFM study
Authors: Medeiros Isabella Cavalcante , Brasil Veruska Lima Moura , Carlo Hugo Lemes , Santos Rogerio Lacerda Dos , De Lima Bruno Alessandro Silva Guedes , De Carvalho Fabíola Galbiatti
Published: June 2013

Background

Calcium nanophosphate paste can provide ions to remineralize enamel. There are, however, no data available about the remineralizing effect of this paste on the prevention of enamel erosion, when compared with highly concentrated fluoride agents.

Aim

To analyze the effect of calcium nanophosphate paste, fluoride gel, and varnish to protect against enamel erosion using surface Knoop hardness (KNH) and atomic force microscopy (AFM).

Design

Forty enamel blocks (4 × 4 mm) of third molars were used for 4 groups (n = 10): 1.23% fluoride gel (Fluorgel–DFL®); calcium nanophosphate paste (Desensibilize NanoP‐FGM®); fluoride varnish (Duraphat‐Colgate®) and control (without agent). The specimens were immersed in cola drink for 5 min and 2 h in artificial saliva, 4× per day for 5 days. The agents were applied before the first erosive cycle. KNH values were obtained before and after the erosive challenge. The surface morphology was evaluated by AFM. anova, Tukey's, and T‐Student tests were applied.

Results

After erosion, no significant difference was found for KNH among gel, nanophosphate, and varnish groups; however, they showed higher KNH than control group. Gel and nanophosphate paste showed a protective layer formation on enamel surface by AFM.

Conclusions

The calcium nanophosphate paste showed similar protection against enamel erosion compared with high‐concentrated fluoride agents, even containing lower fluoride concentration.
Union Wage Gap in the U.S. Construction Sector: 1983–2007
Authors: Bilginsoy Cihan
Published: June 2013

Wage gap decomposition shows that declining union power was the principal force behind the shrinking union wage premium in the U.S. construction industry between the 1980s and the 2000s. This decline was largely offset by changes in returns to workforce attributes and workforce compositions. Without these moderating effects, the decline in the wage gap would have been twice as large (in log points). The patterns were similar in the basic and mechanical trades, but magnitudes of change were larger in the latter.
Microarray analysis of unbalanced translocation in Wolf‐Hirschhorn syndrome
Authors: Dai Ying , Yang Jing , Chen Yuanyuan , Bao Liming , Cheng Qian
Published: June 2013

Wolf–Hirschhorn syndrome (WHS) is caused by deletions involving chromosome region 4p16.3, which is characterized by growth delay, mild‐to‐severe mental retardation, hypotonia, facial dysmorphisms and shows extensive phenotypic variability include feeding difficulties, epilepsy and congenital anomalies. Variation in the size of the deletion involving chromosome region 4p16.3 may explain the clinical variation. However, previous studies indicate that duplication for another chromosome region due to an unbalanced translocation elucidate approximately 40–45% WHS patients. Therefore, we used whole genomic cytogenetics array to analyze the entire genome at a significantly higher resolution over conventional cytogenetics to characterize the exact subtelomeric aberration region of one patient with developmental delay and several facial characteristics reminiscent Wolf–Hirschhorn syndrome. Here we report that our patient had 3.7 Mb deletion at the 4p16.2 and 6.8 Mb duplication at 8p23.1 resulted from the unbalanced translocations der(4)t(4;8)(p16.2;p23.1). We confirmed that our patient with monosomy 4p16.2 which is consistent with Wolf–Hirschhorn syndrome and trisomy 8p23.1. The combination of the 4p deletion with 8p partial trisomy explains the complex phenotype presented by our patient.
Expanding the spectrum of genetic mutations in antenatal Bartter syndrome type II
Authors: Fretzayas Andreas , Gole Evangelia , Attilakos Achilleas , Daskalaki Anna , Nicolaidou Polyxeni , Papadopoulou Anna
Published: June 2013

Bartter syndrome (BS) is a group of genetic disorders characterized by hypokalemic metabolic alkalosis, hyponatremia and elevated renin and aldosterone plasma concentrations. BS type II is caused by mutations in the KCNJ1 gene and usually presents with transient hyperkalemia. We report here a novel KCNJ1 mutation in a male neonate, prematurely born after a pregnancy complicated by polyhydramnios. The infant presented with typical clinical and laboratory findings of BS type II, such as hyponatremia, hypochloremic metabolic alkalosis, severe weight loss, elevated renin and aldosterone levels and transient hyperkalemia in the early postnatal period, which were later normalized. Molecular analysis revealed a compound heterozygous mutation in the KCNJ1 gene, consisting of a novel K76E and an already described V315G mutation, both affecting functional domains of the channel protein. Typical manifestations of antenatal BS in combination with hyperkalemia should prompt the clinician to search for mutations in the KCNJ1 gene first.