bluuebunny/crossref_metadata_2025 huggingface dataset:
Predictors of self‐injurious behaviour exhibited by individuals with autism spectrum disorder
Authors: Richman D. M. , Barnard‐Brak L. , Bosch A. , Thompson S. , Grubb L. , Abby L.
Published: September 2012

Background

Presence of an autism spectrum disorder is a risk factor for development of self‐injurious behaviour (SIB) exhibited by individuals with developmental disorders. The most salient SIB risk factors historically studied within developmental disorders are level of intellectual disability, communication deficits and presence of specific genetic disorders. Recent SIB research has expanded the search for risk factors to include less commonly studied variables for people with developmental disorders: negative affect, hyperactivity and impulsivity.

Method

A heterogeneous sample of 617 individuals with autism spectrum disorder diagnoses was derived from the National Database of Autism Research. Latent constructs were estimated from items of the community version of the Aberrant Behaviour Checklist. Structural equation modelling was used to assess whether impulsivity, hyperactivity, negative affect, severity of stereotypy, intellectual functioning or severity of autism symptoms predicted severity of SIB.

Results

Impulsivity (β = 0.46), followed by intellectual functioning (β = −0.39), and stereotypy (β = 0.23) were the variables most highly predictive of increased SIB; impulsivity and stereotypy remained significant predictors of SIB after severity of autism symptoms and intelligence quotient (IQ) were controlled for.

Conclusions

High levels of impulsivity and stereotypy were significant predictors of SIB in a large and diverse sample of people with confirmed autism diagnoses. Future research is needed on the effects of reducing impulsivity and stereotypy on the outcomes of treatment, early intervention and attempts to prevent the development of SIB.
Functional diversity of Teleost arylalkylamine N‐acetyltransferase‐2: is the timezyme evolution driven by habitat temperature?
Authors: Cazaméa‐Catalan D. , Magnanou E. , Helland R. , Vanegas G. , Besseau L. , Boeuf G. , Paulin C. H. , Jørgensen E. H. , Falcón J.
Published: September 2012

Arylalkylamine N‐acetyltransferase‐2 (AANAT2) is the enzyme responsible for the rhythmic production of the time‐keeping hormone melatonin. It plays a crucial role in the synchronization of biological functions with changes in the environment. Annual and daily fluctuations in light are known to be key environmental factors involved in such synchronization. Previous studies have demonstrated that AANAT2 activity is also markedly influenced by temperature but the mechanisms through which it impacts the enzyme activity need to be further deciphered. We investigated AANAT2 primary to tertiary structures (3D models) and kinetics in relation to temperature for a variety of Teleost species from tropical to Arctic environments. The results extend our knowledge on the catalytic mechanisms of AANAT enzymes and bring strong support to the idea that AANAT2 diversification was limited by stabilizing selection conferring to the enzyme well conserved secondary and tertiary structures. Only a few changes in amino acids appeared sufficient to induce different enzyme activity patterns. It is concluded that AANAT2 evolution is mainly driven by phylogenetic relationships although catalytic properties (enzyme turnover and substrate affinity) are also under the influence of the respective species normal habitat temperature.
Association between obesity measured by different parameters and severity of psoriasis
Authors: Duarte Gleison Vieira , Oliveira Maria de Fatima S. P. , Cardoso Thiago M. , Follador Ivonise , Silva Thadeu S. , Cavalheiro Carolina M. A. , Nonato Walker , Carvalho Edgar M.
Published: September 2012

Background  Obesity has been associated with the severity of psoriasis, but this relationship is not completely understood.

Objectives  This study aimed to evaluate associations between the severity of psoriasis and weight excess as determined using a variety of parameters.

Methods  A cross‐sectional study was performed in 296 psoriasis patients. Their body mass index (BMI), waist circumference (WC), and waist : hip ratio (WHR) values were compared with results on a psoriasis area severity index (PASI).

Results  The frequency of severe psoriasis was higher in men (P < 0.05). Direct correlations were established between PASI scores and each of BMI (R = 0.0154, P = 0.01), WC (R = 0.207, P = 0.001), and WHR (R = 0.164, P = 0.007).

Conclusions  This study extends previous reports of an association between psoriasis and obesity and shows a direct correlation between obesity as measured according to different parameters and psoriasis severity.
Improvement in onychomycosis after initiation of combined antiretroviral therapy
Authors: Moreno‐Coutiño Gabriela , Arenas Roberto , Reyes‐Terán Gustavo
Published: September 2012

Background  Onychomycosis is frequent in patients with late and advanced HIV disease; immunocompromised patients may develop atypical clinical presentations that can be difficult to control. Current treatment for onychomycosis is based on the prolonged administration of antifungal therapies that may have significant interactions with combined antiretroviral therapy (cART). An improvement in certain HIV‐associated opportunistic infections has been associated with initiation of cART.

Objectives  The aim of this study was to analyze the influence of cART on the outcome of onychomycosis in HIV‐infected patients.

Methods  HIV‐infected patients with dermatologic lesions attending the National Institute of Respiratory Diseases were asked to undergo physical examination. Detailed clinical histories were recorded. Routine laboratory tests, CD4 T cell count, and HIV viral load were performed. Onychomycosis was diagnosed on the basis of clinical appearance. Nail scrapings were collected from toenails and fingernails. Specimens were analyzed using direct microscopy. Nail changes after cART initiation were assessed by clinical examination.

Results  Improvement in onychomycosis was observed in six patients with late and advanced HIV disease after initiation of cART. Complete resolution of onychomycosis was observed in one patient without the use of antifungal therapy; one patient required topical antifungal treatment, and two patients required systemic antifungal treatment to achieve complete resolution.

Conclusions  Onychomycosis should be included in the group of pathologies that improve with cART‐induced immune reconstitution. The pathogenesis of onychomycosis in HIV disease warrants investigation in the context of cell‐mediated immunity restoration.
Severe infliximab‐induced psoriasis treated with adalimumab switching
Authors: Faillace César , Duarte Gleison Vieira , Cunha Rosângela Santos , de Carvalho Jozélio Freire
Published: September 2012

Background  Antitumor necrosis factor (anti‐TNF) agents are a well‐established treatment for various medical conditions, including psoriasis and psoriatic arthritis. However, anti‐TNF agents may themselves induce psoriasis in some patients.

Methods  The authors report two cases of patients with severe and refractory infliximab‐induced psoriasis.

Results  The patients had good clinical responses after switching to another TNF blocker.

Conclusion  For severe cases, infliximab withdrawal combined with conventional immunosuppressive psoriasis drugs or with adalimumab may be a therapeutic option.
A review of applications of tea tree oil in dermatology
Authors: Pazyar Nader , Yaghoobi Reza , Bagherani Nooshin , Kazerouni Afshin
Published: September 2012

Tea tree oil (TTO) is an essential oil, steam‐distilled from the Australian native plant, Melaleuca alternifolia. It has a minimum content of terpinen‐4‐ol and a maximum content of 1, 8‐cineole. Terpinen‐4‐ol is a major TTO component which exhibits strong antimicrobial and anti‐inflammatory properties. Tea tree oil exerts antioxidant activity and has been reported to have broad‐spectrum antimicrobial activity against bacterial, viral, fungal, and protozoal infections affecting skin and mucosa. Several studies have suggested the uses of TTO for the treatment of acne vulgaris, seborrheic dermatitis, and chronic gingivitis. It also accelerates the wound healing process and exhibits anti‐skin cancer activity. This review opens up new horizons for dermatologists in the use of this herbal agent.
Isotretinoin treatment in nodulocystic acne with and without polycystic ovary syndrome: efficacy and determinants of relapse
Authors: Cakir Gul Aslihan , Erdogan Fatma Gulru , Gurler Aysel
Published: September 2012

Background  Isotretinoin is the most efficacious long‐lasting treatment for acne; however, some factors, including polycystic ovary syndrome (PCOS), patient age, family history, and type and number of acne lesions, may lead to treatment resistance or relapse following treatment. The aim of this study was to compare the efficacy and permanence of systemic isotretinoin (SI) in nodulocystic acne patients with and without PCOS and to evaluate the factors associated with relapse during the first and second post‐treatment years.

Methods and Materials  The study included 96 female patients with nodulocystic acne. SI 0.5‐1 mg/kg/dl was given, with a total cumulative dose of 120–150 mg/kg. Response to treatment and relapse during the first and second post‐treatment years were evaluated.

Results  In all, the 50 non‐PCOS and 46 PCOS acne patients were similar. SI was similarly efficacious in both groups. In total, eight patients relapsed during the first post‐treatment year, versus 16 during the second. Relapse during the first year was associated with the number of nodules at the start of treatment and the number of papulopustular lesions at the end of treatment, whereas PCOS, patient age, and the number of nodules at the start of treatment were associated relapse during the second year.

Conclusion  Regardless of its association with PCOS, SI was effective in the treatment of nodulocystic acne. The factors associated with relapse during the 1st and 2nd post‐treatment years differed, except for the number of nodules at the start of treatment.
Acute kidney injury in intensive care units according to RIFLE classification: a population‐based study
Authors: SIGURDSSON M. I. , VESTEINSDOTTIR I. O. , SIGVALDASON K. , HELGADOTTIR S. , INDRIDASON O. S. , SIGURDSSON G. H.
Published: September 2012

Introduction

Recent studies of the incidence of acute kidney injury (AKI) are largely based on estimated baseline serum creatinine values. The aim of this study was to more accurately determine the incidence of AKI using the RIFLE criteria for intensive care unit (ICU) patients of a whole population.

Materials and methods

All adult patients admitted to the ICUs of Landspitali – The National University Hospital of Iceland in 2007 (n = 1026) were studied with meticulous search for baseline creatinine. The underlying risk factors and contributing causes for AKI were defined, and survival and ratio of end‐stage renal failure evaluated.

Results

A measured baseline creatinine value was found for all but two patients with AKI. The incidence of AKI according to RIFLE criteria was 21.7% [95% confidence interval (CI): 19.0–24.1%], with 7.1% (95 CI: 5.6–8.9%), 6.8% (95 CI: 5.3–8.5%) and 7.8% (95 CI: 6.2–9.6%) in the risk, injury and failure subgroups. Using estimated baseline creatinine overestimated the incidence of AKI by 3.5%. The sensitivity and specificity of the RIFLE criteria using estimated baseline creatinine were 76% and 95%. Renal replacement therapy was required for 17% of the AKI patients. One year survival of AKI patients was 51%, but only 2.5% of patients surviving 90 days required chronic renal replacement therapy.

Conclusions

The incidence of AKI in the ICU was lower than previously published, perhaps due to overestimation of AKI using estimated baseline creatinine or bias from tertiary referrals. AKI patients have high mortality, but the survivors have a low incidence of end‐stage renal failure.
Gender differences in risk factors for airway symptoms following tracheal intubation
Authors: JAENSSON M. , GUPTA A. , NILSSON U. G.
Published: September 2012

Background

A common complaint after endotracheal intubation is sore throat and hoarseness. The aim of this study was to describe gender differences and independent risk factors in the development of post‐operative sore throat and hoarseness after endotracheal intubation in adults.

Methods

This prospective cross‐sectional observational study was conducted at a university hospital in Sweden. A total of 495 patients were included (203 men and 292 women) and enrolled from a total of eight different surgical departments. Outcome variables were post‐operative sore throat and hoarseness evaluated post‐operatively in the post‐anaesthesia care unit. A total of 31 variables were recorded which described the intubation process, intraoperative factors as well as the extubation process. Bivariate and multivariate analyses were performed.

Results

The overall incidence of post‐operative sore throat was 35% and hoarseness 59%. The results show different predictors for men and women in the development of airway symptoms. The main risk factor for developing sore throat in men was intubation by personnel with < 3 months' work experience. In women, it was endotracheal tube size 7.0 and multiple laryngoscopies during intubation. The main risk factors for hoarseness were cuff pressure for both men and women, and oesophageal temperature probe in women.

Conclusion

Post‐operative sore throat and hoarseness result from several factors, and the cause of these symptoms are multifactorial and differs by gender. Identification of these factors pre‐operatively may increase awareness among anaesthesia personnel and possibly reduce the incidence of these minor but distressing symptoms.
An International Reference Reagent for the detection of anti‐human neutrophil antigen‐1a
Authors: Metcalfe P. , Rigsby P. , Pearson H. , Lucas G.
Published: September 2012

Background and Objectives  Testing for neutrophil antibodies has become more common as awareness of transfusion‐related acute lung injury (TRALI) has increased. However, unlike other areas of blood cell antibody testing, there are no certified reference reagents available with which laboratories can determine the sensitivity of detection of their assays. This report describes the production and evaluation of a freeze‐dried preparation of human plasma, code 09/284, containing anti‐human neutrophil antigen‐1a (anti‐HNA‐1a) for use as a minimum sensitivity reagent.

Materials and Methods  One‐millilitre of aliquots of plasma containing anti‐HNA‐1a were freeze‐dried in glass ampoules. To characterize the material, 24 laboratories took part in an international collaborative study. The participants evaluated doubling dilutions of the material using their in‐house routine assays and recorded the highest dilution in which the antibody could be detected.

Results  When diluted 1 in 4, most laboratories were able to detect the anti‐HNA‐1a in the material, and the participants agreed that this was an appropriate level to set as the minimum sensitivity required.

Conclusions  In October 2011, the WHO Expert Committee on Biological Standardization approved the material 09/284 as an International Reference Reagent for the detection of anti‐HNA‐1a.
Human neutrophil antibodies in a blood donor population: a lookback study
Authors: Gottschall J. , Triulzi D. , Kakaiya R. , Carrick D. , Roback J. D. , Carey P. , Kleinman S. ,   For the NHLBI Retrovirus Epidemiology Donor Study‐II
Published: September 2012

Background and Objectives  Human neutrophil antibodies (HNA) have been associated with severe transfusion‐related acute lung injury (TRALI). We identified HNA antibodies in a blood donor population and performed an observational lookback on patients who received products from these donors to determine whether TRALI was associated with these transfusions.

Materials and Methods  Human neutrophil antibodies were determined in 1171 blood donors (388 non‐transfused males, 390 human leucocyte antigen (HLA) antibody–negative females and 393 HLA antibody–positive females) for IgG and IgM antibodies using a flow cytometric assay. Selected positive samples had a monoclonal antibody immobilization of granulocyte antigen (MAIGA) and neutrophil genotyping performed to confirm specificity. Lookback was performed on patients receiving blood from donors with positive samples by extracting recipient data from hospital medical records. An expert panel of three pulmonary critical care physicians reviewed the summarized data and assigned a diagnosis of TRALI, possible TRALI, cannot distinguish between TRALI and TACO, TACO and other.

Results  Eight donors had HNA antibodies of which five contributed to this lookback (3‐HNA‐specific antibodies, 2‐HNA non‐specific antibodies). Seventy‐six blood products were transfused from these donors into individual patients. One patient developed TRALI that was associated with a donor with a non‐specific HNA antibody as well as class‐I and class‐II HLA antibodies.

Conclusion  The incidence of TRALI in this lookback was low and combined with low frequency of HNA antibodies in the donor population suggests not screening donors for HNA antibodies at this time is acceptable.
Chronic vulvovaginal candidiasis: What we know and what we have yet to learn
Authors: Fischer Gayle
Published: September 2012

Vulvovaginal candidiasis (VVC) is defined as vulvovaginitis, causally associated with Candida species in the vagina. It is seen commonly in vulval clinics as a cause of persistent vulvovaginitis and yet this chronic condition is yet to be formally defined and explained. The classic symptom complex of chronic itch, pain and dyspareunia exacerbating premenstrually and remitting during menstruation associated with an erythematous vulval eruption is well described but the exact aetiology remains elusive. Research in recent years has suggested that VVC is not an opportunistic infection or an immunodeficiency but a hypersensitivity response to a commensal organism that may be genetically determined. Further, it is apparent on clinical grounds that oestrogen plays an essential permissive role and that, in healthy non‐diabetic patients, VVC does not occur in the absence of oestrogen whether endogenous or exogenous. The nature of this relationship has not been established. In this article I discuss the diagnostic features of VVC, its management and what is currently understood of its aetiology.
Rural physical health care services for people with serious mental illness: A nursing perspective
Authors: Happell Brenda , Scott David , Platania‐Phung Chris , Nankivell Janette
Published: September 2012

Objective:  To understand nurse perspectives on the physical health needs of their mental health clients and how well rural services are meeting their overall care needs.

Design:  Focus groups with semistructured format.

Setting:  Community mental health care in a regional and rural district of Queensland.

Participants:  Thirty‐eight nurses in public mental health care.

Results:  The major themes were (i) stigma of mental illness, (ii) barriers to accessing physical health care services, (iii) nurse adaptations under demands, and (iv) community and integration towards better overall health. Nurses integrate overall care and foster its continuity for people with physical and mental co‐morbidity and can be supported much better in sustaining this.

Conclusion:  Access and continuity of physical health care experienced by all Australians is exacerbated for people in rural areas. Physical health of people with serious mental illness residing in remote Australia needs to be a national health priority.
Prospective observational study of dementia and delirium in the acute hospital setting
Authors: Travers C. , Byrne G. , Pachana N. , Klein K. , Gray L.
Published: September 2012

Background

Dementia and delirium appear to be common among older patients admitted to acute hospitals, although there are few Australian data regarding these important conditions.

Aim

The aim of this study was to determine the prevalence and incidence of dementia and delirium among older patients admitted to acute hospitals in Queensland and to profile these patients.

Method

Prospective observational cohort study (n = 493) of patients aged 70 years and older admitted to general medical, general surgical and orthopaedic wards of four acute hospitals in Queensland between 2008 and 2010. Trained research nurses completed comprehensive geriatric assessments and obtained detailed information about each patient's physical, cognitive and psychosocial functioning using the interRAI Acute Care and other standardised instruments. Nurses also visited patients daily to identify incident delirium. Two physicians independently reviewed patients' medical records and assessments to establish the diagnosis of dementia and/or delirium.

Results

Overall, 29.4% of patients (n = 145) were considered to have cognitive impairment, including 102 (20.7% of the total) who were considered to have dementia. This rate increased to 47.4% in the oldest patients (aged ≥90 years). The overall prevalence of delirium at admission was 9.7% (23.5% in patients with dementia), and the rate of incident delirium was 7.6% (14.7% in patients with dementia).

Conclusion

The prevalence of dementia and delirium among older patients admitted to acute hospitals is high and is likely to increase with population aging. It is suggested that hospital design, staffing and processes should be attuned better to meet these patients' needs.
Margarellinae: a new calliostomatid subfamily
Authors: Williams Suzanne T.
Published: September 2012

Williams, S. T. (2012). Margarellinae: a new calliostomatid subfamily. —Zoologica Scripta, 00, 000–000.
The Dynamic Linkages between Foreign Direct Investment and Domestic Investment in ECOWAS Countries: A Panel Cointegration Analysis
Authors: Eregha P.B.
Published: September 2012

Abstract:  This paper examines the crowding out or crowding in effect of foreign direct investment inflow on domestic investment in Africa. Data for the period 1970–2008 were extracted from the UN statistical online database and the World Development Indicator 2009 online database and the study employed a recent panel cointegration estimation technique. The study revealed that foreign direct investment inflow crowds out domestic investment in the ECOWAS region. The study therefore recommends that policy makers in the ECOWAS countries focus on promotional resources to attract some types of foreign direct investment and regulate others. Policies should also be directed at putting in place a better targeted approach to screen foreign direct investment applications to ascertain their productive base before allowing them.
Financial Liberalization and Foreign Bank Entry on the Domestic Banking Performance in MENA Countries
Authors: Hassan M. Kabir , Sanchez Benito , Ngene Geoffrey M. , Ashraf Ali
Published: September 2012

Abstract:  This study examines the impact of financial liberalization and foreign bank entry on the domestic banking sector from 1996 to 2007, and builds upon and expands the work of Lee (2002). We find that foreign bank entry, financial liberalization, ownership structure and degree of openness of foreign bank entry positively impact domestic banking system operating efficiency, capitalization, risk management, long‐term soundness, financial performance as well as economic and financial development. However, foreign bank entry is associated with reduced profit margins and increased operating costs of domestic banks in countries with less developed capital markets. Empirical evidence seems to support the argument that foreign bank presence leads to better allocation of capital and eliminates connected lending practices.
Serological survey of viral hepatitis markers among newly diagnosed patients with HIV/AIDS in China
Authors: Shen YZ , Wang ZY , Qi TK , Jiang XY , Song W , Tang Y , Wang JR , Liu L , Zhang RF , Zheng YF , Dai ZS , Lu HZ
Published: September 2012

Objectives

The aim of the study was to determine the seroprevalence and epidemiological features of hepatitis B virus (HBV) and hepatitis C virus (HCV) infection among patients newly diagnosed with HIV/AIDS in China.

Methods

Two thousand and forty patients newly diagnosed with HIV/AIDS from 10 provinces in China were selected during 2009 to 2010. Serum samples obtained from each individual were screened for HBV and HCV serum markers [HBV surface antigen (HBsAg), HBV surface antibody (HBsAb), HBV envelope antigen (HBeAg), HBV envelope antibody (HBeAb), HBV core antibody (HBcAb) and HCV antibody (HCVAb)]; liver function tests were also performed. Demographics and medical histories were collected.

Results

Of the 2040 patients, 741 (36.3%) were positive for at least one HBV and HCV serum marker; 300 (14.71%) were HCVAb positive, and 248 (12.16%) were isolated HCVAb positive; 222 (10.9%) were positive for HBsAg; 19 (0.93%) were positive for both HBsAg and HCVAb. The highest prevalence of HBsAg positivity was found in Guangxi (15.31%), followed by Guangdong (15.19%) and Shanghai (14.36%). The highest prevalence of HCVAb positivity was found in Xinjiang (43.18%), followed by Henan (39.06%) and Yunnan (27.36%). The proportion of patients with abnormal liver function in patients positive for HCVAb and/or HBsAg was significantly higher than that in those who were negative for both HCVAb and HBsAg (P < 0.001).

Conclusions

The seroprevalence of HBV and HCV among patients newly diagnosed with HIV/AIDS in China is high. HBsAg and HCVAb positivity prevalences were found to vary significantly in different provinces in China. Patients newly diagnosed with HIV/AIDS and coinfected with HBV and HCV are at higher risk of abnormal liver function. It is necessary to routinely screen for HBV and HCV infection among patients newly diagnosed with HIV/AIDS.
Relevance of multiple basin drainage and primary histologic regression in prognosis of trunk melanoma patients with negative sentinel lymph nodes
Authors: Ribero S , Quaglino P , Osella‐Abate S , Sanlorenzo M , Senetta R , Macrì L , Savoia P , Macripò G , Sapino A , Bernengo M.G
Published: September 2012

Background  Lymphatic drainage to multiple basins (MLBD) is frequently observed in patients with primary melanoma located in the trunk. Conflicting data regarding the prognostic impact of MLBD are reported.

Objective and methods  We reviewed our case series of 352 patients with trunk melanoma to evaluate the pattern of basin drainage and to analyse whether different basin drainages may have different significance in negative sentinel lymph node (SLN) patients. The presence of single/multiple basin drainage, the status of SLN, the presence of melanoma regression, Breslow thickness, ulceration and type of melanoma were recorded for each patients and correlated to Disease Free Survival (DFS) and Overall Survival (OS).

Results  MLBD occurred in 77 patients (21.9%) and single basin lymphatic drainage (SLBD) occurred in 275 patients (79.1%). The presence of metastases in SLN was not significantly different in patients with MLBD compared to those with SLBD (26% vs. 19.6%). No differences in OS and DFS were found in SLBD/MLBD independently from SLN status. However DFS was higher in patients with MLBD and negative SLN (P = 0.0001), in addition, in patients with negative SLN and SLBD disease recurrence was 19% while was only 7% in patients with negative SLN obtained from MLBD (P = 0.03). Multivariate analysis showed that Breslow thickness <2 mm, MLBD pattern and regression of melanoma were favourable variables for DFS of patients with negative SLN.

Conclusions  An accurate study of the drainage basin and of all the SLNs obtained from MLBD is recommended because of the impact in prognosis of melanoma of the trunk.
Carbon partitioning in soybean (Glycine max) leaves by combined 11C and 13C labeling
Authors: Dirks Rebecca C. , Singh Manmilan , Potter Gregory S. , Sobotka Lee G. , Schaefer Jacob
Published: September 2012

We labeled soybean (Glycine max) leaves with 200 and 600 ppm 13CO2 spiked with 11CO2 and examined the effects of light intensity and water stress on metabolism by using a combination of direct positron imaging and solid‐state 13C nuclear magnetic resonance (NMR) of the same leaf.

We first made 60‐min movies of the transport of photosynthetically assimilated 11C labels. The positron imaging identified zones or patches within which variations in metabolism could be probed later by NMR. At the end of each movie, the labeled leaf was frozen in liquid nitrogen to stop metabolism, the leaf was lyophilized, and solid‐state NMR was used either on the whole leaf or on various leaf fragments.

The NMR analysis determined total 13C incorporation into sugars, starch, proteins, and protein precursors.

The combination of 11C and 13C analytical techniques has led to three major conclusions regarding photosynthetically heterogeneous soybean leaves: transient starch deposition is not the temporary storage of sucrose excluded from a saturated sugar‐transport system; peptide synthesis is reduced under high‐light, high CO2 conditions; and all glycine from the photorespiratory pathway is routed to proteins within photosynthetically active zones when the leaf is water stressed and under high‐light and low CO2 conditions.
Women’s experiences of important others in a pregnancy dominated by intimate partner violence
Authors: Engnes Kristin , Lidén Eva , Lundgren Ingela
Published: September 2012

Background:  Being exposed to intimate partner violence (IPV) during pregnancy is a difficult and complex situation. Despite this, there are few studies describing women’s own needs for help and support.

Aim:  The aim of this study is to gain a deeper understanding of women’s experiences of important others in relation to changing their life situation in a pregnancy dominated by IPV.

Methods:  The study has a qualitative phenomenological design. The data were collected through in‐depth interviews with seven Norwegian women, who were exposed to IPV during pregnancy.

Findings:  Being pregnant and exposed to violence in relation to important others means confronting present life, life history and future life. The essence implies striving for control in an uncontrolled situation, where other people might be experienced as both a rescuer and a risk. This is further described in four constitutions: the child needs protection; my mother is always present for me; an exhausted run for help; and a reduced, but important social network.

Conclusions and implications for practice:  For women exposed to violence, pregnancy can offer an opportunity for change. Midwives play a unique role in relation to care and continuity in this phase of life, as they can support pregnant women, help to identify their needs, possibilities for action and advise them about appropriate services. Midwives can encourage and support women to find people whom they can trust and who can offer assistance. It is vital that midwives ask about the women’s relationship to the baby and their social networks, especially the relationship with their mothers.

Ethical considerations:  During the whole study process, guidelines for research on violence against women were followed, to respect the integrity, security and confidentiality of the participants. The study is ethically approved.
‘It Looks Like You Just Want Them When Things Get Rough’: Civil Society Perspectives on Negative Trial Results and Stakeholder Engagement inHIVPrevention Trials
Authors: Koen Jennifer , Essack Zaynab , Slack Catherine , Lindegger Graham , Newman Peter A.
Published: September 2012

Civil society organizations (CSOs) have significantly impacted on the politics of health research and the field of bioethics. In the globalHIVepidemic,CSOs have served a pivotal stakeholder role. The dire need for development of new prevention technologies has raised critical challenges for the ethical engagement of community stakeholders inHIVresearch. This study explored the perspectives ofCSOrepresentatives involved inHIVprevention trials (HPTs) on the impact of premature trial closures on stakeholder engagement. Fourteen respondents fromSouthAfrican and internationalCSOs representing activist and advocacy groups, community mobilisation initiatives, and human and legal rights groups were purposively sampled based on involvement inHPTs. Interviews were conducted fromFebruary‐May 2010. Descriptive analysis was undertaken across interviews and key themes were developed inductively.CSOrepresentatives largely described positive outcomes of recent microbicide andHIVvaccine trial terminations, particularly inSouthAfrica, which they attributed to improvements in stakeholder engagement. Ongoing challenges to community engagement included the need for principled justifications for selective stakeholder engagement at strategic time‐points, as well as the need for legitimate alternatives toCABs as mechanisms for engagement. Key issues forCSOs in relation to research were also raised.
Validation of the BCIS‐1 Myocardial Jeopardy score using cardiac magnetic resonance perfusion imaging
Authors: Morton Geraint D. J. , De Silva Kalpa , Ishida Masaki , Chiribiri Amedeo , Indermuehle Andreas , Schuster Andreas , Redwood Simon , Nagel Eike , Perera Divaka
Published: September 2012

The recently described angiographic BCIS‐1 Myocardial Jeopardy Score (BCIS‐JS) provides a semi‐quantitative estimate of the extent of coronary artery disease (CAD). It is simple to use and applicable to all patients including those with bypass grafts. Our objective was to validate the BCIS‐JS by evaluating its correlation with myocardial ischaemic burden and its accuracy at predicting a prognostic ischaemic threshold. Seventy‐five patients with angina and known or suspected CAD referred for coronary angiography prospectively underwent high‐resolution CMR perfusion imaging. There was good correlation between the BCIS‐JS and myocardial ischaemic burden: r = 0·75, P<0·0001. Area under the ROC curve for BCIS‐JS to detect ≥12% myocardial ischaemic burden was 0·87 (95% CI 0·78–0·96). BCIS‐JS ≥6 predicted ≥12% myocardial ischaemic burden with a sensitivity of 68% and a specificity of 91%. The BCIS‐JS correlates well with myocardial ischaemic burden. A BCIS‐JS ≥6 predicts the prognostically important ischaemic threshold of 12% with high specificity. These findings demonstrate that the BCIS‐JS has functional relevance and support its utility for classification of CAD burden in clinical trials and in clinical practice.
Scratching the surface of allergic transfusion reactions
Authors: Savage William J. , Tobian Aaron A.R. , Savage Jessica H. , Wood Robert A. , Schroeder John T. , Ness Paul M.
Published: September 2012

Allergic transfusion reactions (ATRs) are a spectrum of hypersensitivity reactions that are the most common adverse reaction to platelets and plasma, occurring in up to 2% of transfusions. Despite the ubiquity of these reactions, little is known about their mechanism. In a small subset of severe reactions, specific antibody has been implicated as causal, although this mechanism does not explain all ATRs. Evidence suggests that donor, product, and recipient factors are involved, and it is possible that many ATRs are multifactorial. Further understanding of the mechanisms of ATRs is necessary so that rationally designed and cost‐effective prevention measures can be developed.
Transfusion of banked red blood cells and the effects on hemorrheology and microvascular hemodynamics in anemic hematology outpatients
Authors: Yürük Koray , Milstein Dan M.J. , Bezemer Rick , Bartels Sebastiaan A. , Biemond Bart J. , Ince Can
Published: September 2012

BACKGROUND: The aim of this study was to investigate the effects of red blood cell (RBC) transfusion on the hemorrheologic properties and microcirculatory hemodynamics in anemic hematology outpatients receiving 2 to 4 RBC units of either “fresh” (leukoreduced storage for less than 1 week) or “aged” (leukoreduced storage for 3‐4 weeks) RBCs.

STUDY DESIGN AND METHODS: Measurements were performed before and 30 minutes after RBC transfusion in hematology outpatients. Leukoreduced RBC suspensions were stored in saline‐adenine‐glucose‐mannitol (SAGM) additive solution. Whole blood viscosity was measured using Couette low‐shear viscometry, RBC deformability and aggregability were measured using laser‐assisted optical rotational cell analysis, and microcirculatory density and perfusion were assessed using sidestream dark field imaging.

RESULTS: One group of patients (n = 10) received a median (interquartile range) of 3 (2‐3) RBC bags that were stored for 7 (5‐7) days (fresh) and the other group of patients (n = 10) received 3 (3‐3) RBC bags that were stored for 23 (22‐28) days (aged). After transfusion of fresh versus aged RBCs, hematocrit increased to 32 ± 3% versus 31 ± 2% (p < 0.363), whole blood viscosity increased to 4.2 ± 0.4 Pa/sec versus 4.2 ± 0.6 Pa/sec (p < 0.912), RBC deformability index remained unaffected, RBC aggregability index increased to 55 ± 10 versus 55 ± 13 (p = 0.967), microcirculatory flow remained unaffected, and microcirculatory density increased to 19.3 ± 2.5 mm/mm2 versus 18.7 ± 1.9 mm/mm2 (p = 0.595), respectively.

CONCLUSION: Storing leukoreduced SAGM‐suspended RBCs for 3 to 4 weeks did not affect their ability to improve hemorrheologic properties and microcirculatory hemodynamics in our small group of anemic hematology outpatients. Larger studies are needed to confirm this finding.
Evidence for the transmission of parvovirus B19 in patients with bleeding disorders treated with plasma‐derived factor concentrates in the era of nucleic acid test screening
Authors: Soucie J. Michael , De Staercke Christine , Monahan Paul E. , Recht Michael , Chitlur Meera B. , Gruppo Ralph , Hooper W. Craig , Kessler Craig , Kulkarni Roshni , Manco‐Johnson Marilyn J. , Powell Jerry , Pyle Meredith , Riske Brenda , Sabio Hernan , Trimble Sean ,   the US Hemophilia Treatment Center Network
Published: September 2012

BACKGROUND: Parvovirus B19 (B19V) is a small, nonenveloped virus that typically causes a benign flu‐like illness that occurs most frequently in childhood. The virus is resistant to current viral inactivation steps used in the manufacture of antihemophilic factor concentrates and B19V transmission through these products has been documented. Since 2000, B19V nucleic acid test (NAT) screening of plasma pools has been implemented to further decrease the viral burden in these products, but no study has examined populations using these products to assess the impact of the screening on B19V transmission.

STUDY DESIGN AND METHODS: Blood specimens obtained from participants of a surveillance system established in federally supported specialized bleeding disorders clinics were used in a B19V seroprevalence study.

RESULTS: A total of 1643 specimens from 1043 participants age 2 to 7 years born after B19V NAT screening was implemented were tested. Age‐specific prevalence rates were generally higher for subjects exposed to either plasma‐derived products alone or in combination with other products compared to subjects with no exposure to antihemophilic products. Overall, compared to participants unexposed to blood or blood products, those exposed to plasma‐derived products alone were 1.7 times more likely to have antibodies to B19V (p = 0.002).

CONCLUSION: These results are consistent with continued B19V transmission through plasma‐derived factor concentrates. Effective viral inactivation and detection processes are needed to protect users of these products from infection with B19V or other new or emerging viruses.
Manufacturing regional disparity in the pursuit of economic equality: Alberta's First Nations Gaming Policy, 2006–2010
Authors: Belanger Yale D. , Williams Robert J. , Arthur Jennifer N.
Published: September 2012

The Province of Alberta in 2001 implemented the First Nations Gaming Policy (FNGP) to improve First Nations development potential by permitting the construction of reserve casinos. This article argues that during the policy development stages provincial and First Nations leaders failed to consider the geographic placement of reserve communities, both in terms of where casinos would be placed and how gaming revenues would ultimately be distributed. Therefore, a policy intended to assist with First Nations economic rejuvenation in Alberta has benefitted a small proportion of First Nations while exacerbating regional economic difficulties the policy was in part calculated to ameliorate. The authors recommend revisiting the FNGP to establish a more equitable revenue distribution formula, thus resulting in a greater distribution of gaming revenues to a larger number of First Nations.
Value chains, business conventions, and market adaptation: A comparative analysis of Norwegian and Icelandic fish exports
Authors: Trondsen Torbjørn
Published: September 2012

Business transactions’ value chains can constrain their capacity to maximize market value from limited resources. Seafood markets exhibit a strong demand for fresh, high‐quality seafood yet empirical studies show large variations in value chains’ adaptation and exploitation of market opportunities. This article presents a comprehensive model that identifies the main drivers and constraints in value chains for wild harvested seafood that generate differences in market adaptation. The model is built on theories of value chains, business conventions, competitive behaviour, governance conventions, legal regulation, and direct ecological and economic constraints. The model is applied in a comparative case analysis of market adaptation by value chains for North Atlantic cod products in Norway and Iceland, which explains why business conventions in Iceland are more consumer market adapted than those in Norway.
Visualizing the directional bias in property crime incidents for five Canadian municipalities
Authors: Frank Richard , Andresen Martin A. , Brantingham Patricia L.
Published: September 2012

There are three interconnected and fundamental elements that define the spatiality of crime: places, distances, and directions. Over the past 180 years, research has flourished for the first two fundamental elements with relatively little research on directionality. In this article, we develop a visualization technique allowing for the display of the directional bias for a large number of offenders that aids in subsequent analysis. We show that a directional bias in criminal activity is present overall, but is not monolithic. Consequently, urban form and understanding place play a strong role in criminal directional biases for moving through our environments.
A Positive Event Dependence Model for Self‐Controlled Case Series with Applications in Postmarketing Surveillance
Authors: Simpson Shawn E.
Published: September 2012

A primary objective in the application of postmarketing drug safety surveillance is to ascertain the relationship between time‐varying drug exposures and recurrent adverse events (AEs) related to health outcomes. The self‐controlled case series (SCCS) method is one approach to analysis in this context. It is based on a conditional Poisson regression model, which assumes that events at different time points are conditionally independent given the covariate process. This requirement is problematic when the occurrence of an event can alter the future event risk. In a clinical setting, for example, patients who have a first myocardial infarction (MI) may be at higher subsequent risk for a second. In this work, we propose the positive dependence self‐controlled case series (PD‐SCCS) method: a generalization of SCCS that allows the occurrence of an event to increase the future event risk, yet maintains the advantages of the original model by controlling for fixed baseline covariates and relying solely on data from cases. As in the SCCS model, individual‐level baseline parameters drop out of the PD‐SCCS likelihood. Data sources used for postmarketing surveillance can contain tens of millions of people, so in this situation it is particularly advantageous that PD‐SCCS avoids doing a costly estimation of individual parameters. We develop expressions for large sample inference and optimization for PD‐SCCS and compare the results of our generalized model with the more restrictive SCCS approach.
Clinical effects of buttonhole cannulation method on hemodialysis patients
Authors: Kim Mi‐Kyoung , Kim Hee‐Seung
Published: September 2012

Although the buttonhole cannulation method is now widely used as an alternative to the rope‐ladder method in most countries, only the latter method is used in Korea. This study was performed to investigate clinical benefit of the buttonhole technique for arteriovenous fistula (AVF) cannulation in maintenance hemodialysis (HD) patients. Thirty‐two patients receiving HD via mature AVF were included and AVF cannulation was performed by 20 experienced nurses. During the 8 weeks, AVFs were cannulated by the rope‐ladder method with 15‐gauge sharp needles. After creating of 2 pairs of tunnel tracks by sharp needles for 7 weeks, AVFs were cannulated by the buttonhole method using 15‐gauge blunt needles during the 16 weeks. Vascular access blood flow rate (BFR), dialysis venous pressure (DVP), and dialysis adequacy (Kt/V) were measured within the first week of the two cannulation methods. Cannulation pain, hemostasis time, and nurse's stress were evaluated at the end of the two methods. There were no statistical differences in vascular access BFR (P = 0.139), DVP (P = 0.152), and dialysis adequacy (P = 0.343) between the two methods. However, the buttonhole method shortened hemostasis time (P = 0.001) and decreased cannulation pain (P = 0.001) as well as nurse's stress (P = 0.001) compared with the rope‐ladder method. In conclusion, the buttonhole cannulation method improves hemostasis time, cannulation pain, and nurse's stress without a change in vascular access BFR and dialysis adequacy in HD patients.
Effects of flaxseed consumption on systemic inflammation and serum lipid profile in hemodialysis patients with lipid abnormalities
Authors: Khalatbari Soltani Saman , Jamaluddin Rosita , Tabibi Hadi , Mohd Yusof Barakatun Nisak , Atabak Shahnaz , Loh Su‐Peng , Rahmani Leila
Published: September 2012

Inflammation and lipid abnormalities are two important risk factors for cardiovascular disease in hemodialysis (HD) patients. The present study was designed to investigate the effects of flaxseed consumption on systemic inflammation and serum lipid profile in HD patients with lipid abnormalities. This was an unblinded, randomized clinical trial. Thirty HD patients with dyslipidemia (triglyceride >200 mg/dL and/or high‐density lipoprotein‐cholesterol (HDL‐C) <40 mg/dL) were randomly assigned to either a flaxseed or control group. Patients in the flaxseed group received 40 g/day ground flaxseed for 8 weeks, whereas patients in the control group received their usual diet, without any flaxseed. At baseline and at the end of week 8, 7 mL of blood was collected after a 12‐ to 14‐hour fast and serum concentrations of triglyceride, total cholesterol, low‐density lipoprotein‐cholesterol (LDL‐C), HDL‐C, and C‐reactive protein (CRP) were measured. Serum concentrations of triglyceride (P < 0.01), total cholesterol (P < 0.01), LDL‐C (P < 0.01), and CRP (P < 0.05) decreased significantly in the flaxseed group at the end of week 8 compared with baseline, whereas serum HDL‐C showed a significant increase (P < 0.01). These changes in the flaxseed group were significant in comparison with the control group. The study indicates that flaxseed consumption improves lipid abnormalities and reduces systemic inflammation in HD patients with lipid abnormalities.