bluuebunny/crossref_metadata_2025 huggingface dataset:
Insulin resistance and metabolic syndrome in primary gout: relation to punched‐out erosions
Authors: Gheita Tamer A. , El‐Fishawy Hussein S. , Nasrallah Mohamed M. , Hussein Hani
Published: October 2012

Objectives

To verify the relation of gout to insulin resistance (IR) and metabolic syndrome (MetS) and find any association of metatarsophalangeal (MTP) joint erosions to the features of MetS and IR.

Methods

Forty‐six primary gout male patients with a mean age of 41.96 ± 5.77 years were grouped according to the presence of MetS. Twenty‐seven age and sex matched healthy volunteers served as controls. Insulin sensitivity was estimated using the homeostatic model assessment index (HOMA‐B) for beta cell function and HOMA‐IR for peripheral tissue IR.

Results

Gout patients had significantly higher HOMA‐IR and HOMA‐B compared to controls. Those with MetS (n = 27) had significantly higher serum uric acid (SUA) than those without (n = 19; 11.51 ± 3.72 mg/dL vs. 9.15 ± 2.34 mg/dL; P = 0.012). Gout patients with MTP erosions had notable higher insulin levels and more IR as shown by the higher levels of HOMA‐IR and HOMA‐B compared to those without. HOMA‐IR and HOMA‐B significantly correlated with the presence of erosions. Moreover, the presence of erosions significantly correlated with SUA (r = 0.64, P < 0.0001).

Conclusions

The level of SUA is closely related to IR in patients with and without MetS. There is an association of the severity of gout and presence of MTP erosions to IR. Metabolic syndrome forms an important marker for those who develop more punched‐out erosions.
Work instability and financial loss in early inflammatory arthritis
Authors: Looper Karl J. , Mustafa Sally S. , Zelkowitz Phyllis , Purden Margaret , Baron Murray
Published: October 2012

Objective

Inflammatory arthritis is associated with a high degree of work instability and financial burden. In this study, we examine the extent of work instability and financial loss as well as their association with disease characteristics during the first 18 months of inflammatory arthritis.

Method

One hundred and four patients in the early phase (more than 6 weeks, < 18 months) of inflammatory arthritis were recruited from a larger early inflammatory arthritis registry. Questionnaires recorded sociodemographic data and disease characteristics, including pain assessed using the Short Form McGill Pain Questionnaire (MPQ) and physical functioning measured with the Medical Outcomes Study Short Form 36 (SF‐36) physical functioning score. The Rheumatoid Arthritis Work Instability Scale (RA‐WIS) was used to measure patient‐perceived functioning in the workplace and the Financial Loss Questionnaire (FLQ) measured the impact on family finances.

Results

Participants' mean age was 56 years, 70.2% were female and 49.0% were working. Average yearly household income was < 60 000 Canadian dollars (CAD) for 38.5% of the sample. Of our working patients, 43% had a medium or high risk of work loss as measured by the RA‐WIS and 35% reported a financial loss. On multivariate analysis, MPQ and SF‐36 contributed to the dependent variable work instability, while age and SF‐36 contributed to financial loss.

Conclusion

This study identifies pain and physical dysfunction as potential modifiable risk factors for negative socioeconomic repercussions of illness in early inflammatory arthritis.
Enforcement of a lifespan‐sustaining distribution of Sir2 between telomeres, mating‐type loci, and rDNA repeats by Rif1
Authors: Salvi Jayesh S. , Chan Janet N.Y. , Pettigrew Christopher , Liu Tony T. , Wu Jane D. , Mekhail Karim
Published: October 2012

Telomere dysfunction is linked with genome instability and premature aging. Roles for sirtuin proteins at telomeres are thought to promote lifespan in yeast and mammals. However, replicative lifespan of the budding yeast Saccharomyces cerevisiae shortens upon deletion of Rif1, a protein that limits the recruitment of the sirtuin histone deacetylase Sir2 to telomeres. Here we show that Rif1 maintains replicative lifespan by ultimately stabilizing another age‐related chromosomal domain harboring the ribosomal DNA (rDNA) repeats. Deletion of Rif1 increases Sir2 localization to telomeres and the silent mating‐type loci, while releasing a pool of the histone deacetylase from the intergenic spacer 1 (IGS1) of rDNA. This is accompanied by a disruption of IGS1 silent chromatin assembly and increases in aberrant recombination within rDNA repeats. Lifespan defects linked with Rif1 deletion are abolished if rDNA repeats are forcibly stabilized via deletion of the replication fork‐blocking protein Fob1. In addition, Sir2 overexpression prevents Rif1 deletion from disrupting Sir2 at IGS1 and shortening lifespan. Moreover, subjecting cells lacking Rif1 to caloric restriction increases IGS1 histone deacetylation and lifespan, while uncovering novel genetic interactions between RIF1 and SIR2. Our data indicate that Rif1 maintains lifespan‐sustaining levels of Sir2 at rDNA by preventing excessive recruitment of the histone deacetylase to telomeric and silent mating‐type loci. As sirtuin histone deacetylases, such as Sir2 or mammalian SIRT6, each operate at multiple age‐related loci, we propose that factors limiting the localization of sirtuins to certain age‐related loci can promote lifespan‐sustaining roles of these sirtuins elsewhere in the genome.
Comparison of peri‐operative core temperature in obese and non‐obese patients*
Authors: Fernandes L. A. , Braz L. G. , Koga F. A. , Kakuda C. M. , Módolo N. S. P. , de Carvalho L. R. , Vianna P. T. G. , Braz J. R. C.
Published: October 2012

Our aim was to compare peri‐operative core temperatures and the incidence of hypothermia in obese and non‐obese women with active forced‐air warming. Twenty female patients scheduled for abdominal surgery were allocated to two groups according to body mass index. Ten obese (30.0–34.9 kg.m−2) and 10 non‐obese (18.5–24.9 kg.m−2) women received forced‐air warming on their lower limbs. At the end of surgery, the mean (SD) core temperatures were 36.7 (0.5) °C in the obese group and 36.0 (0.6) °C in the non‐obese group (p < 0.001). Only in the non‐obese group was there a significant decrease in the intra‐operative core temperature values (p < 0.001). The incidences of intra‐operative hypothermia were lower in the obese group (10%) compared with non‐obese group (60%; p = 0.019). In the postoperative recovery phase, the mean (SD) core temperature data were higher in the obese group than in the non‐obese group (36.2 (0.4) vs 35.6 (0.5) °C, respectively (p < 0.001)). In conclusion, obese female patients have higher peri‐operative core temperature and a lower incidence of hypothermia compared with non‐obese female patients during abdominal surgery with active forced‐air warming.
Short DNA sequences and bacterial DNA induce esophageal, gastric, and colorectal cancer cell invasion
Authors: Kauppila Joonas H. , Karttunen Tuomo J. , Saarnio Juha , Nyberg Pia , Salo Tuula , Graves David E. , Lehenkari Petri P. , Selander Katri S.
Published: October 2012

Toll‐like receptor 9 (TLR9) recognizes both bacterial and self‐DNA and it is abundantly expressed in the gastrointestinal tract. In this study, we investigated the influences of both bacterial DNA and specific short DNA sequences on TLR9‐mediated gastrointestinal cancer cell invasion. We assessed the effect of various DNA ligands on cellular invasion and on TLR9 and matrix metalloproteinase expression of three gastrointestinal cancer cell lines. DNA‐ligands described in this study include CpG‐ODN M362, 9‐mer (hairpin), human telomeric sequence h‐Tel22 G‐quadruplex, and bacterial DNAs from Escherichia coli and Helicobacter pylori. All of the DNAs studied were demonstrated to induce invasion in the studied cells. The DNA‐induced invasion was inhibited with a broad‐spectrum MMP inhibitor and partly also with chloroquine suggesting that it could be mediated via MMP activation, endosomal signaling, and TLR9. Interestingly, H. pylori DNA was shown to induce a more pronounced invasion in a gastric cancer cell line than in the other cell lines. Our results suggest that bacterial DNA as well as deoxynucleotides having stable secondary structures (i.e. hairpins or G‐quadruplex structures) may serve as endogenous, invasion‐inducing TLR9‐ligands and promote local progression and metastasis of cancers in the alimentary tract.
The contribution of shame to post‐psychotic trauma
Authors: Turner Michelle H. , Bernard Mark , Birchwood Max , Jackson Chris , Jones Chris
Published: October 2012

Objectives

The current study examined shame in a clinical sample recovering from a first episode of psychosis by focusing on the contribution of different types of shame to post‐psychotic trauma while controlling for current affective symptoms.

Design

The study used a cross‐sectional correlational design.

Method

Fifty individuals who met the criteria for a psychotic disorder whose acute psychotic symptoms were in remission completed measures of internal and external shame associated with psychosis, general shame, post‐psychotic trauma, and depression.

Results

Post‐psychotic trauma symptoms were correlated with internal and external shame associated with psychosis and general shame. However, the relation between post‐psychotic trauma and external shame associated with psychosis remained after controlling for general shame and current affective symptoms. In addition, internal shame had a stronger association with depression. Thus, internal and external shame due to psychosis had different associations with different types of post‐psychotic emotional dysfunction.

Conclusions

The results support the importance of assessing shame as a multi‐faceted construct and suggest that assessing shame directly associated with mental illness is a worthwhile endeavour.

Practitioner Points

Assessing different types of shame following psychosis can inform assessments, formulations, and interventions with post‐psychotic trauma.

Our results support the application of Compassionate Mind Therapy to psychosis.

However, we did not assess self‐criticism or self‐reassurance.

We also did not investigate the relation between specific psychotic symptoms and different types of shame.
Essentialism, historical construction, and social influence: Representations of Pomakness in majority talk in Western Thrace (Greece)
Authors: Figgou Lia
Published: October 2012

Social psychological research has been particularly interested to study essentialism in the construction of social categories and to manifest its potential consequences in intergroup attitudes. Drawing upon this literature, the present study focuses on the argumentative resources employed to construct ethnic categories in a specific rhetorical context: focus group discussions between majority Greek educators about the minority group of Pomaks, historically residing in Western Thrace (Greece). Discussions were framed as an attempt to capture the particularities of minority education and data were analysed by the use of tools and concepts of discursive and rhetorical psychology. Analysis indicates that participants have multiple and complex recourses available to construct Pomakness. Representations of Pomakness as an essential a‐historical entity coexist with conceptions of category membership and identification as a result of certain historical conditions and processes of social influence. Essential and de‐essential category constructions are approached as rhetorically situated, oriented towards specific rhetorical ends in specific argumentative contexts. They are also considered, however, to be nested within a complex and dynamic intergroup context which reflects the ideological contradictions of the Greek policy towards the minority and which constitutes (but it is also reconstituted by) shifting group definitions and boundaries.
Why and how are you attached to yourSocialGroup? Investigating different forms of social identification
Authors: Amiot Catherine E. , Aubin Roxanne M.
Published: October 2012

Social identity is a key social psychological variable to understand intergroup behaviours. Over and above the different dimensions of social identity (e.g., quality or degree of identification), recent research has looked at different forms of social identity, such as the clarity of one's collective identity, the self‐determined motivations underlying one's identification, and the contingencies attached to social identification. These forms of social identification reveal how and why group members are attached to their social group. The current research aims to directly test how these three forms of social identification regroup together and predict different individual and intergroup outcomes. Findings from three studies conducted in Québec (Ns = 119, 91) and Australia (N = 136) confirmed that the more comparative and competitive forms of social identification (i.e., non‐self‐determination to identify, collective self‐esteem contingency) tend to predict nationalism and ingroup bias. In contrast, the forms of social identity that capture the inherent satisfaction of being part of the group and the cognitive clarity of this group membership (i.e., self‐determined motivation to identity, clarity of collective identity) predict outcomes pertaining to patriotism, personal self‐esteem, and positive emotions. Results are interpreted in light of social identity theory and social psychological models of the self.
Explaining dehumanization among children: The interspecies model of prejudice
Authors: Costello Kimberly , Hodson Gordon
Published: October 2012

Although many theoretical approaches have emerged to explain prejudices expressed by children, none incorporate outgroup dehumanization, a key predictor of prejudice among adults. According to the Interspecies Model of Prejudice, beliefs in the human–animal divide facilitate outgroup prejudice through fostering animalistic dehumanization (Costello & Hodson, 2010). In the present investigation, White children attributed Black children fewer ‘uniquely human’ characteristics, representing the first systematic evidence of racial dehumanization among children (Studies 1 and 2). In Study 2, path analyses supported the Interspecies Model of Prejudice: children's human–animal divide beliefs predicted greater racial prejudice, an effect explained by heightened racial dehumanization. Similar patterns emerged among parents. Furthermore, parent Social Dominance Orientation predicted child prejudice indirectly through children's endorsement of a hierarchical human–animal divide and subsequent dehumanizing tendencies. Encouragingly, children's human–animal divide perceptions were malleable to an experimental prime highlighting animal–human similarity. Implications for prejudice interventions are considered.
High‐ versus low‐density multifocal pupillographic objective perimetry in glaucoma
Authors: Maddess Ted , Essex Rohan W , Kolic Maria , Carle Corinne F , James Andrew C
Published: October 2012

Background

Multifocal pupillographic objective perimetry was compared using 24 and 44 regions per visual field.

Design

Experimental design in a university setting.

Participants

Twenty‐seven normal control and 36 age‐matched glaucoma patients.

Methods

The four test variants differed in the mean interval between stimuli: 4, 1 or 0.25 s; and the number of visual field regions tested within the central 60 degrees: 24 or 44. All subjects had their diagnostic status confirmed by optical coherence tomography, two forms of perimetry and slit‐lamp biomicroscopy. Both eyes were measured concurrently in 2.73 ± 0.45 min/eye (mean ± standard deviation), and tests were repeated about 2 weeks apart.

Main Outcome Measures

The main outcome measures were: (i) mean change in light sensitivity due glaucoma; and (ii) areas under Receiver Operator Characteristic plots for detecting glaucoma.

Results

For all four variants, consensual responses, female gender and age produced small but significant sensitivity differences, and sensitivity declined with age by ≤−0.27 dB/decade (all P < 0.0003). The best diagnostic accuracy (area under curve 93.2 ± 3.89%) was produced by the one‐presentation/s 44‐region protocol. Across the four protocols, the effect of repeat testing was small (all methods ≤0.15 dB).

Conclusions

Presentation rate had little effect, but increasing the tested density from 24 to 44 regions/field improved diagnostic power. Given that multifocal pupillographic objective perimetry also provides information on response delay and afferent versus efferent defects at every visual field region, it may be a useful adjunct to perimetry.
Laparoscopic resection of colorectal cancer facilitates simultaneous surgery of synchronous liver metastases
Authors: Hatwell C. , Bretagnol F. , Farges O. , Belghiti J. , Panis Y.
Published: October 2012

Aim

Combined resection of colorectal cancer with surgery for synchronous liver metastases (LM) still remains controversial because of the possible higher morbidity rate, the necessity of an adequate abdominal approach for both resections and the impact on oncological results. However, laparoscopy may be beneficial in terms of operative results and could facilitate this combined procedure. The aim was to assess the benefit of the laparoscopic approach for colorectal cancer resection in patients undergoing simultaneous liver resection for synchronous LM.

Method

From 2006 to 2011, all patients with colorectal cancer and resectable synchronous LM, for which the total length of the procedure was suspected to be less than 8 h, underwent colorectal laparoscopic resection combined with open and/or laparoscopic liver surgery. In order to identify selection criteria, a comparative analysis was performed between patients with and without major postoperative morbidity.

Results

Fifty‐one patients underwent combined surgery with laparoscopic colectomy (n = 31) and proctectomy (n = 20). The conversion rate was 8%. Liver resections included major surgery (n = 10) and minor surgery (n = 41). Extraction of the colorectal specimen was performed through an incision used for open liver resection, except in seven patients who underwent a total laparoscopic procedure. Overall and major morbidity rates were 55% and 25%, respectively. Median (range) hospital stay was 16 (6–40) days. Regarding patient and tumour characteristics, no independent criteria of major morbidity risk were identified.

Conclusion

This study showed that laparoscopic colorectal resection combined with liver resection for synchronous LM was feasible and safe. Moreover, laparoscopy facilitates the surgical abdominal approach for combined colorectal and liver resection.
Does anti‐hepatitis B virus vaccine make any difference in long‐term number of liver transplantation?
Authors: Chaib E. , Coimbra B. G. M. M. , Galvão F. H. F. , Tatebe E. R. , Shinzato M. S. , D'Albuquerque L. A. C , Massad E.
Published: October 2012

Background

Hepatitis B virus (HBV) infection is a major cause of morbidity and mortality worldwide. Chronic hepatitis B infection is associated with an increased risk of cirrhosis, hepatic decompensation, and hepatocellular carcinoma. Our aim is to analyze, through a mathematical model, the potential impact of anti‐HBV vaccine in the long‐term (that is, decades after vaccination) number of LT.

Methods

The model simulated that the prevalence of HBV infection was 0.5% and that approximately 20% of all the liver transplantation carried out in the state of São Paulo are due to HBV infection.

Results

The theoretical model suggests that a vaccination program that would cover 80% of the target population would reach a maximum of about 14% reduction in the LT program.

Conclusion

Increasing the vaccination coverage against HBV in the state of São Paulo would have a relatively low impact on the number of liver transplantation. In addition, this impact would take several decades to materialize due to the long incubation period of liver failure due to HBV.
Determinants of vitamin D status in long‐term renal transplant patients
Authors: Penny Hugo , Frame Sharon , Dickinson Francis , Garrett Giorgia , Young Antony R. , Sarkany Robert , Chitalia Nihil , Hampson Geeta , Goldsmith David
Published: October 2012

In this study, we explored the determinants of vitamin D status in a large cohort of stable, Long‐term renal transplant (RTx) patients. Serum 25(OH)D concentrations, and bone biochemistry parameters, were retrospectively analyzed from 266 RTx patients (>10 yr post‐engraftment) presenting to clinic over the course of a year. Forty‐five percent of the cohort were vitamin D deficient (<37.5 nM), 38% insufficient (37.5 75–nM), and 17% sufficient (>75 nM). Serum 25(OH)D concentrations were higher in patients presenting in summer (p < 0.001) and in more active patients (p < 0.05). RTx patients with non‐melanoma skin cancer (NMSC) (n = 45) had higher 25(OH)D concentrations than patients without NMSC (n = 221; p < 0.05) despite these patients being older, having worse eGFR, transplanted for longer, and less active physically (p < 0.05). Lower 25(OH)D concentrations were associated with higher PTH concentrations (p < 0.05) which, in the setting of widespread hypovitaminosis, suggests that secondary hyperparathyroidism was common in this cohort. In conclusion, season and activity status are important determinants of vitamin D status. We report, for the first time, that NMSC is associated with higher 25(OH)D, probably through increased UV radiation exposure. Long‐term RTx patients may benefit from oral vitamin D supplementation, but this requires a randomized controlled trial to confirm.
Multinational study of oestrogen and progesterone receptor immunocytochemistry on breast carcinoma fine needle aspirates
Authors: Marinšek Ž. P. , Nolde N. , Kardum‐Skelin I. , Nizzoli R. , Önal B. , Rezanko T. , Tani E. , Ostović K. T. , Vielh P. , Schmitt F. , Kocjan G.
Published: October 2012

Ž. P. Marinšek, N. Nolde, I. Kardum‐Skelin, R. Nizzoli, B. Önal, T. Rezanko, E. Tani, K. T. Ostović, P. Vielh, F. Schmitt and G. Kocjan  Multinational study of oestrogen and progesterone receptor immunocytochemistry on breast carcinoma fine needle aspirates

Objectives:  To collect data on the variability of immunocytochemical (ICC) procedures used to detect oestrogen/progesterone receptors (ER/PR) on cytological material; to test the reproducibility of results; and to identify the crucial points in the ICC procedures that affect the result.

Methods:  Ten laboratories from eight countries participated in a two‐part study. In the first part, one of the participants (the coordinator) prepared and distributed cytospins from a fine needle aspirate of a primary breast carcinoma. Laboratories performed ICC staining for ER/PR according to their own methods on the test slides and in‐house positive controls. Slides were returned to the coordinator together with information on the preparation of positive control slides and the ICC methodology used. In the second part, obligatory methods of fixation and antigen retrieval were specified. Evaluation of results included grading the number of positive cells, staining intensity, background staining, cytoplasmic staining, sample condition and cellularity. Participants evaluated their own results, which were subsequently evaluated by the coordinator.

Results:  There was great variability in the preparation of slides for in‐house controls and ICC methodology. The outcome of ICC staining of in‐house control slides was excellent in two laboratories, adequate in three, sub‐optimal in four and inadequate in one. Only six obtained a positive reaction on the test slides and not all were of a high quality. Results of the second run were greatly improved in terms of cellularity of in‐house positive control slides, and scores for the percentage of stained cells and staining intensity of control and test slides. Cytospins and monolayer (ThinPrep®) preparations were superior to direct smears; methods of fixation and antigen retrieval were the key points in the staining process.

Conclusions:  Our experience points to the need for guidelines for hormonal receptor determination and external quality control on cytological material, in order for cytological methods to be used in routine clinical practice with a suitable degree of confidence.
Unravelling the Phellinus pini s.l. complex in North America: a multilocus phylogeny and differentiation analysis of Porodaedalea
Authors: Brazee N. J. , Lindner D. L.
Published: October 2012

Phellinus sensu lato (s.l.) is a complex of segregate genera that act as aggressive pathogens of woody plants. Nearly all of the genera in this complex have unresolved taxonomies, including Porodaedalea, which is one of the most important trunk rot pathogens of coniferous trees throughout the northern hemisphere. In an attempt to elucidate the species within Porodaedalea, a multilocus phylogenetic analysis was performed with partial sequences from four loci (internal transcribed spacer, nuclear large subunit, tef1 and rpb2) using 41 isolates that originated from North America and Europe. For reference, we analysed the neotype isolates of Porodaedalea pini and P. chrysoloma. Our results confirmed that Porodaedalea pini s.s. and P. chrysoloma s.s. are unique phylogenetic species that do not occur in North America. We detected two discrete clades of Porodaedalea originating from the southwestern and southeastern United States. Isolates from these regions grouped with significant statistical support and represent undescribed taxa. With the exception of P. cancriformans, our analyses revealed monophyly among 28 isolates originating from the northern United States, Canada and Fennoscandia, a group we have labelled the ‘Holarctic group’. Holarctic group isolates were collected from Larix, Picea, Pinus, Pseudotsuga and Tsuga and were presumed to represent at least four morphological species (P. gilbertsonii, P. laricis, P. pini s.l. and P. piceina). Tests of gene flow and genetic differentiation detected significant differences among Holarctic group isolates by region of origin, and three subgroups were designated: (i) Atlantic‐Boreal; (ii) Interior; and (iii) Pacific. Neutrality tests using the Holarctic group demonstrated significant departures from the standard neutral model of evolution and could indicate that a diversifying selection has maintained rare phenotypes in the population, which has fostered taxonomic confusion in Porodaedalea.
Pregnancy outcome following use of levodopa, pramipexole, ropinirole, and rotigotine for restless legs syndrome during pregnancy: a case series
Authors: Dostal M. , Weber‐Schoendorfer C. , Sobesky J. , Schaefer C.
Published: October 2012

Background

Restless legs syndrome (RLS) is related to parity, and its symptoms may worsen during pregnancy. Treatment with levodopa or dopamine agonists is the first‐line therapy for RLS; however, there are limited data on treatment in pregnancy. We therefore assessed the safety of levodopa, pramipexole, rotigotine, and ropinirole in pregnancy.

Methods

Prospective documentation of pregnancies exposed to levodopa, pramipexole, rotigotine, and ropinirole between 1998 and 2011 was evaluated as to their outcome (teratogenicity or fetotoxicity) by the Berlin Institute for Clinical Teratology and Drug Risk Assessment in Pregnancy.

Results

We were able to complete 59 pregnancy outcomes exposed to RLS pharmacotherapy. For specific treatments, the numbers of exposed pregnancies/live born children/spontaneous abortions/induced abortions/malformations were as follows: levodopa only: 38/29 (one pair of twins)/3/7/3; pramipexole only: 12/9/3/0/0; rotigotine only: 2/2/0/0/0; ropinirole only: 3/2/0/1/0; levodopa combined with pramipexole: 3/3/0/0/0; levodopa combined with ropinirole: 1/1/0/0/0. No major birth defects were found with any RLS treatment, and three infants exposed to levodopa had minor anomalies.

Conclusions

In our small prospective case series, there was no increased risk above baseline for major malformations or other adverse outcomes for levodopa and pramipexole. If necessary, levodopa treatment may be considered as an alternative to cabergoline, for which safety has been well documented in pregnancy.
Pain–autonomic interaction after work‐induced sleep restriction
Authors: Schestatsky P. , Dall‐Agnol L. , Gheller L. , Stefani L. C. , Sanches P. R. S. , de Souza I. C. , Torres I. L. , Caumo W.
Published: October 2012

Background and purpose

Poor sleep is commonly associated with alterations in pain perception. However, there is a lack of studies that address work‐associated sleep restriction (SR) and changes in non‐nociceptive perception and autonomic responses after work‐induced SR.

Methods

This study was performed with 19 medical students after a normal‐sleep night (NS phase) and after a night shift at the local emergency room (SR phase). We performed clinical assessment, quantitative sensory testing for electrical and temperature sensation, RR interval analysis, and recorded sudomotor skin responses (SSRs).

Results

The total mean duration of sleep was 436 ± 18 min in the NS group and 120 ± 28 min in the SR group (P < 0.001). The anxiety scores were higher following the SR phase compared with those after the NS phase (P < 0.01). After SR, there was a decrease in heat‐pain threshold, but neither warm nor electrical thresholds were affected. Following SR, subjects showed higher SSR amplitudes and an increased number of double responses at an interstimulus interval of 2 s. We also observed a moderate inverse correlation between heat‐pain thresholds and SSR amplitude (r = −0.46; P < 0.01). However, there was no correlation between anxiety scores and SSR parameters.

Conclusions

The effects of SR in the context of work stress on pain are specific and appear unrelated to general changes in sensory perception. Hyperalgesia was associated with abnormal autonomic responses, but not with increased anxiety, which suggests an association between the nociceptive and autonomic nervous systems that is independent of the emotional state.
The immediate and long‐term effects of water drawdown on macrophyte assemblages in a large subtropical reservoir
Authors: BOSCHILIA SOLANA MENEGHEL , DE OLIVEIRA EDSON FONTES , SCHWARZBOLD ALBANO
Published: October 2012

1. Disturbances play a central role in determining the spatial and temporal dynamics of many plant communities. In our study of macrophyte assemblages at 150 sites in five arms of a large subtropical reservoir (Itaipu Reservoir, Brazil–Paraguay border), we used co‐occurrence null models and spatiotemporal analyses to describe the patterns in the assemblages during a historically large water drawdown in 2000, in comparison with the previous year (1999) and subsequent years (2001–07). AC‐Score co‐occurrence index tested the null hypothesis of random structure during the drawdown period. A detrended correspondence analysis and multiresponse permutation procedure were used to verify whether species composition differed before, during and after the disturbance.

2. In contrast to our expectations, the null models showed that the macrophyte assemblages were spatially structured during the drawdown (2000), although species composition was significantly different from the previous year (1999) and also changed in the following years (2001–07). Significant species co‐occurrence patterns were generated by the drawdown disturbance, with species extinctions and colonisation by new species from propagules and seed bank germination.

3. The randomness we expected in 2000 actually occurred in 2001, probably because the reestablishment of normal water level enabled both submersed and free‐floating species to recolonise the shore that emergent species had inhabited since the drawdown. Biotic interactions appeared to increase during the years after the disturbance and the habitat preferences of the aquatic macrophytes were re‐established, resulting in higher similarities in aquatic macrophyte species composition in the years after the drawdown.
Polar auxin transport is essential for gall formation by Pantoea agglomerans on gypsophila
Authors: Chalupowicz Laura , Weinthal Dan , Gaba Victor , Sessa Guido , Barash Isaac , Manulis‐Sasson Shulamit
Published: October 2012

The virulence of the bacterium Pantoea agglomerans pv. gypsophilae (Pag) on Gypsophila paniculata depends on a type III secretion system (T3SS) and its effectors. The hypothesis that plant‐derived indole‐3‐acetic acid (IAA) plays a major role in gall formation was examined by disrupting basipetal polar auxin transport with the specific inhibitors 2,3,5‐triiodobenzoic acid (TIBA) and N‐1‐naphthylphthalamic acid (NPA). On inoculation with Pag, galls developed in gypsophila stems above but not below lanolin rings containing TIBA or NPA, whereas, in controls, galls developed above and below the rings. In contrast, TIBA and NPA could not inhibit tumour formation in tomato caused by Agrobacterium tumefaciens. The colonization of gypsophila stems by Pag was reduced below, but not above, the lanolin–TIBA ring. Following Pag inoculation and TIBA treatment, the expression of hrpL (a T3SS regulator) and pagR (a quorum‐sensing transcriptional regulator) decreased four‐fold and that of pthG (a T3SS effector) two‐fold after 24 h. Expression of PIN2 (a putative auxin efflux carrier) increased 35‐fold, 24 h after Pag inoculation. However, inoculation with a mutant in the T3SS effector pthG reduced the expression of PIN2 by two‐fold compared with wild‐type infection. The results suggest that pthG might govern the elevation of PIN2 expression during infection, and that polar auxin transport‐derived IAA is essential for gall initiation.
Does an anti‐oxidant ascorbic acid improve the condition of hippocampal formation slice preparations? – a micro‐EEG approach
Authors: Kazmierska Paulina , Grebowski Jacek , Konopacki Jan
Published: October 2012

The objective of this study was to assess whether ascorbic acid (AA), an intracellular anti‐oxidant critical for neuronal protection, when added to artificial cerebrospinal fluid (ACSF), is able to protect hippocampal (HPC) formation slice preparations from ageing. In this research, the micro‐electroencephalographic (EEG) technique was applied. Experiments were performed on 72 HPC formation slices obtained from 12 male Wistar rats. Two series of experiments were conducted: the control experiment, in which ACSF was used as an incubation medium, and the research one, in which ACSF was supplemented with 200 μM AA. The experimental model of carbachol‐induced EEG theta rhythm was applied. The following parameters of theta rhythm after 15, 30 and 45 min of recording were analysed: frequency, power, time duration of theta epochs and time duration of intervals between theta epochs. The results show that AA causes a statistically significant decrease in the power of theta rhythm after 15, 30 and 45 min of recording. The time duration of intervals between theta epochs was almost twice as long in slices incubated in ACSF + AA than in ACSF after 45 min of recording. The data obtained indicate that AA does not improve the condition of HPC slices. On the contrary, it worsens the ability of slice preparations to generate theta oscillations. We hypothesize that our data may result from the Fenton reaction or changes in the conformation of connexins.
Caring to achieve the maximum independence possible: a synthesis of qualitative evidence on older adults’ adaptation to dependency
Authors: Abad‐Corpa Eva , Gonzalez‐Gil Teresa , Martínez‐Hernández Antonio , Barderas‐Manchado Ana M , De la Cuesta‐Benjumea Carmen , Monistrol‐Ruano Olga , Mahtani‐Chugani Vinita ,   RETICEF‐evidencia Group
Published: October 2012

Aims and objectives.  To understand the process of adaptation to dependency in older adults and their families.

Background.  Dependency and family care giving are attracting the attention of policymakers, service providers and researchers.

Design.  An interpretative synthesis of qualitative studies has been conducted.

Methods.  An extensive search without time and idiom limitations was conducted using the main databases (MEDLINE, CINAHL, EMBASE, PsycINFO, SSCI, LILACS, CUIDEN, Cochrane Library and JBI): personal communication from expert panel was used to detect filters strategies to find qualitative studies; these strategies were combined with search terms for dependence in older adults. The studies (2164 potentially relevant papers) were judged by two reviewers based on reading title, abstract, keywords and/or full text (English, Spanish, French and Portuguese) to determine their inclusion. After, 203 papers were critically appraised by two reviewers (disagreements were resolved by discussions). Finally, the synthesis of the 20 studies with best interpretative character was carried out based on the principles and procedures of Grounded Theory.

Results.  The findings were related to the process of adaptation to dependency, the factors and the strategies used, the emotions, perceptions and feelings of care givers and older adults. The central category that emerged was ‘Caring to achieve the maximum independence possible’, and this could be seen as a transition period in which older adults and their families progressed in a mutually determined adaptation process. This category is made up of several redefinitions of concepts, phases, adaptation strategies and final responses to the process.

Conclusions.  The findings show the interconnected nature of physical, material, social and emotional aspects of care; and the profound social impact of providing and receiving care.

Relevance to clinical practice.  The nurses can assist families and older adults to enhance adaptation to dependency, anticipating and helping to redefine the concepts of care.
Demonstration of the usefulness of a theoretical framework for humanising care with reference to a residential aged care service in Australia
Authors: Borbasi Sally , Galvin Kathleen T , Adams Trevor , Todres Les , Farrelly Brona
Published: October 2012

Aims and objectives.  To demonstrate the usefulness of a theoretical framework for humanising care of dementia patients.

Background.  The term humanisation of care has been increasingly used to describe an approach to health care that is informed by core dimensions of what it means to be human. Recent developments in dementia care highlight the importance of maintaining personhood in people with dementia.

Design.  A conceptual framework is proposed by which the humanisation of care can be understood and applied. Eight dimensions that articulate core features of what needs to be attended to in order for a person to feel more deeply ‘met’ as a human being are discussed. Evidence from an evaluative study of a dementia outreach service is used to illustrate the usefulness of the humanising framework.

Methods.  Case study examples demonstrate the value of this framework by describing how a dementia outreach service enables care staff in residential aged care facilities to change their focus in the provision of care to residents with dementia. Each of the eight dimensions of humanisation/dehumanisation is used to illustrate how the dementia outreach service team have led to the improvements in resident care.

Results.  Positive outcomes can be achieved by providing humanised care to residents with dementia.

Conclusion.  The paper highlights the potential for the humanising framework to be used in dementia care and shows how the framework can be helpfully translated into practice so that carers are supported to adopt an inclusive view of care delivery.

Relevance to clinical practice.  A comprehensive framework, grounded in a strong philosophical foundation, can name a breadth of criteria for humanly sensitive care and can be translated into practice in such a way as to potentially transform the provision of care to residents in residential aged care facilities.
Supporting bereaved parents: a phenomenological study of a telephone intervention programme in a paediatric oncology unit
Authors: Darbyshire Philip , Cleghorn Alexandra , Downes Maeve , Elford Joanna , Gannoni Anne , McCullagh Cheryl , Shute Rosalyn
Published: October 2012

Aims and objectives.  This study sought to discover bereaved parents’ perspectives and experiences of a nurse‐led, ward‐based, telephone support programme in a children’s oncology unit.

Background.  Parental grief is especially intense and long‐lasting, and many parents can experience serious psychological problems. The oncology team learned that some parents felt ‘forgotten’ or ‘abandoned’ following their child’s death and addressed this concern by initiating and subsequently evaluating a telephone bereavement support programme.

Design.  An interpretive phenomenological investigation of the experiences of six parents who participated in the programme.

Methods.  Parents shared their experiences and perceptions of the programme in individual interviews. Interpretive phenomenology and thematic analysis guided the interviews’ interpretation to ascertain both the parents’ experiences of the programme and their understandings of everyday clinical terms such as ‘support’ or ‘reassurance’.

Results.  Parents found the programme supportive, especially valuing ongoing contact with a nurse who ‘knew them’. Telephone contact was preferred to visiting the hospital, which brought back painful memories. Calls were important elements in helping parents create meaning and memory around their deceased child.

Conclusions.  Regular telephone contact over an agreed period from a familiar member of the child’s treating team can create a more positive and supportive bereavement experience for parents in the year following their child’s death. The specific findings are discussed in the context of the death of a child as a crisis of meaning.

Relevance to clinical practice.  Clinical nurses are ideally placed to use existing close relationships to extend care and support to bereaved parents. This study shows how nurses can identify service gaps, work with interdisciplinary team colleagues to initiate appropriate actions and participate in the essential evaluation subsequently required.
Health outcomes and quality of life of residents of shared‐housing arrangements compared to residents of special care units – results of the Berlin DeWeGE‐study
Authors: Wolf‐Ostermann Karin , Worch Andreas , Fischer Thomas , Wulff Ines , Gräske Johannes
Published: October 2012

Aims and objectives

To compare different health outcomes as well as quality of life (QoL) between people with dementia living in shared‐housing arrangements (SHA) and special care units (SCU) in nursing homes.

Background

Often situated in large apartments in mostly urban settings, SHA are a specific German kind of small‐scale living facilities for older care‐dependent persons, predominantly suffering from dementia. SHA are completely disconnected from traditional nursing homes.

Design

In a longitudinal design, all new residents of SHA and SCU suffering with dementia in Berlin were surveyed for one year. They were assessed when they moved into the SHA or SCU and again 6 and 12 months later.

Methods

We surveyed physical and psychological health outcomes including ADL‐functioning (Barthel), neuropsychiatric symptoms of dementia (NPI) and challenging behaviour (Cohen‐Mansfield agitation inventory) as well as QoL (Qualidem).

Results

Fifty‐six persons (43 women, 13 men) were recruited into the longitudinal study. The average age was 82·5 years at admission, participants mostly had a moderate level of cognitive impairment (mean Mini Mental State Examination = 13·3), prevalence of neuropsychiatric symptoms was high. During the one‐year follow‐up, analyses show a significant decrease in cognitive abilities but also of neuropsychiatric symptoms in both groups. In SHA, QoL increases on average during the one‐year study period.

Conclusions

Both types of facilities attract slightly different populations according to our data. Comparison of SHA residents to SCU residents documented no significant beneficial effects of settings in terms of health outcomes.

Relevance to clinical practice

As no clear advantage of either SHA or SCU in nursing homes can be demonstrated for residents with dementia who move in newly, it is impossible to give a clear evidence‐based recommendation and the decision for one setting or the other can be made according solely to personal preference of the resident.
Microstratigraphy of a Miocene layered phosphatic pebble from the western margin of South Africa
Authors: Wigley Rochelle A. , Compton John S.
Published: October 2012

Detailed microstratigraphy and geochemistry of a single‐layered phosphatic pebble from the Southern Rocky Plateau at the Head of the Cape Canyon on the western margin of South Africa are utilized to reveal a complex interplay between deposition, erosion and authigenesis in the Miocene. The phosphatic pebble has three micrite and carbonate fluorapatite cemented layers separated by Fe‐rich hardground surfaces. The layers contain a diverse grain assemblage of reworked glauconite, phosphorite, detrital quartz and biogenic carbonate. Overlapping Sr‐isotope derived ages of point‐drilled samples from the three layers range from 19·1 to 17·6 Ma, although a single point near the outer edge of the uppermost layer has a Sr age of 12·8 to 10·4 Ma, and a reworked bivalve shell fragment from the middle layer has a Sr age of 26·3 to 24·6 Ma. The microstratigraphy of the phosphatic pebble provides evidence of multiple Baturin cycles, where periods of deposition and carbonate fluorapatite authigenesis are followed by reworking, erosion and precipitation of iron oxide hardground surfaces. The condensed microstratigraphy of the pebble is consistent with the regional depositional history of the area and indicates significant fluctuations in the depositional environment related to changes in sea‐level, sediment supply and upwelling along the western margin of southern Africa during the early to middle Miocene.
Quantitative analysis of the geometry of submarine external levées
Authors: Nakajima Takeshi , Kneller Benjamin C.
Published: October 2012

The shape of submarine external channel levées has been assessed in a variety of systems, over a range of slope gradients, measuring both their thickness decay away from the parent channel and also the maximum gradient on the back‐slope of the levée. The mathematical description of the shapes of the levées has been based on normalized data, using as characteristic length scales the distance from channel axis to the levée crest and the thickness of the entire levée (or levée package) at the levée crest. The variation in levée thickness perpendicular to the channel shows a clear pattern of power‐law decay on steeper slopes (generally > 0·6°) and either exponential or logarithmic decay on gentler slopes. The levée shape is sensitive to local variations in slope and may change over only a few hundreds of metres in the flow direction. The threshold gradient between these two styles shows some variation and may be dependent on grain size. The maximum gradient on the back‐slope of the levée shows a weak correlation with slope gradient, which varies from one system to another; this may also be a function of grain size. The variations in behaviour can be explained, in part, by differing rates of entrainment of ambient sea water into the currents as they flow over the levées, these rates being dependent upon the slope. Negligible entrainment on low gradients helps to explain the tendency to wider levées on low‐gradient basin floors, as well as the persistence of channelized flows on low gradients, with little dissipation over extreme distances.