bluuebunny/crossref_metadata_2025 huggingface dataset:
Enhancement of biomixing by swimming algal cells in two-dimensional films
Authors: Kurtuldu Hüseyin , Guasto Jeffrey S. , Johnson Karl A. , Gollub J. P.
Published: June 2011

Fluid mixing in active suspensions of microorganisms is important to ecological phenomena and presents a fascinating stochastic process. We investigate the mixing produced by swimming unicellular algal cells (
Chlamydomonas
) in quasi-two-dimensional liquid films by simultaneously tracking the motion of the cells and that of microscopic passive tracer particles advected by the fluid. The reduced spatial dimension of the system leads to long-range flows and a surprisingly strong dependence of tracer transport on the concentration of swimmers, which is explored over a wide range. The mean square displacements are well described by a stochastic Langevin model, which is used to parameterize the mixing. The effective diffusion coefficient
D
grows rapidly with the swimmer concentration Φ as
D
 ∼ Φ
3/2
, as a result of the increasing frequency of tracer-swimmer interactions and the long-range hydrodynamic disturbances created by the swimmers. Conditional sampling of the tracer data based on the instantaneous swimmer position shows that the rapid growth of the diffusivity enhancement with concentration must be due to particle interactions with multiple swimmers simultaneously. Finally, the anomalous probability distributions of tracer displacements become Gaussian at high concentration, but manifest strong power-law tails at low concentration, while the tracer displacements always grow diffusively in time.
An Alternate Approach to Improving Healthcare Worker Influenza Vaccination Rates
Authors: Esolen Lisa M. , Kilheeney Kimberly L. , Merkle Richard E. , Bothe Albert
Published: June 2011

Optimizing employee influenza vaccination rates has become a healthcare focus. We detail an approach involving a strong requirement for unvaccinated workers to wear a face mask and a super-convenient vaccination process. Our major teaching hospital achieved 95% compliance in 2009, and our health system reached 90% and 92% compliance for 2 years.
Clostridium difficileInfection in a Long-Term Care Facility: Hospital-Associated Illness Compared with Long-Term Care-Associated Illness
Authors: Kim Jong Hun , Toy Diana , Muder Robert R.
Published: June 2011

Background.

Controversy exists over whetherClostridium difficileinfection (CDI) commonly occurs in long-term care facility residents who have not been recently transferred from an acute care hospital.

Objective.

To assess the incidence and outcome of CDI in a long-term care facility.

Methods.

Retrospective cohort study in a 262-bed long-term care Veterans Affairs facility in Pittsburgh, Pennsylvania, for the period January 2004 through June 2010. CDI was identified by positive stoolC. difficiletoxin assay and acute diarrhea. Patients were categorized as hospital-associated CDI (HACDI) or long-term care facility–associated CDI (LACDI) and followed for 6 months.

Results.

The annual rate of CDI varied between 0.11 and 0.23 per 1,000 resident-days for HACDI patients and between 0.04 and 0.28 per 1,000 resident-days for LACDI patients. We identified 162 patients, 96 patients (59.3%) with HACDI and 66 patients (40.7%) with LACDI. Median age was 74 and 77 years, respectively, for HACDI and LACDI (P= .055) patients. There were more patients with at least 1 relapse of CDI during 6 months of follow up in LACDI patients (32/66, 48.5%) than in HACDI patients (28/96, 29.2%;P= .009). Logistic regression showed that ages of at least 75 years (odds ratio [OR], 2.33; 95% confidence interval [CI], 1.07–5.07;P= .033), more than 2 transfers to an acute care hospital (OR, 7.88; 95% CI, 1.88–32.95;P= .005), and LACDI (OR, 3.15; 95% CI, 1.41–7.05;P= .005) were associated with relapse of CDI.

Conclusions.

Forty percent of CDI cases were acquired within the long-term care facility, indicating a substantial degree of transmission. Optimal strategies to prevent CDI in the long-term care facility are needed.
Microscopic investigation of surface and interfacial magnetic domain structure of Fe–NiO(1 0 0) system
Authors: Mandal Suman , Menon Krishnakumar S R , Maccherozzi Francesco , Belkhou Rachid
Published: June 2011

We report our experimental observation of microscopic modification, reconstruction and evolution of the antiferromagnetic domain structure of the NiO(1 0 0) surface in view of the exchange bias effect. Some domain patterns (called non-equilibrium domains) as observed on the as-cleaved surface do not follow the well-known bulk symmetry traces on the (1 0 0) surface. But, bulk-terminated domains (called equilibrium domains) are found to be renucleated up on cooling the sample from above the Néel temperature, unless domains are strongly pinned by crystalline defects. We also observe certain domain evolution after annealing the crystal at various temperatures above the Néel temperature. Influence of growth condition on the ferromagnetic domain structure of the Fe film deposited on NiO(1 0 0) has been followed in situ. While for thin film case (7 ML), no influence of growth has been observed, for thicker film (21 ML) the Fe domain structure is found to be determined by both growth-induced and exchange anisotropy. Thus, our observations depict a thickness-dependent interplay between growth-induced and exchange anisotropy in ferromagnetic film grown on the antiferromagnetic substrate.
All-ZnO-based transparent resistance random access memory device fully fabricated at room temperature
Authors: Cao Xun , Li Xiaomin , Gao Xiangdong , Liu Xinjun , Yang Chang , Yang Rui , Jin Ping
Published: June 2011

A transparent resistance random access memory (RRAM) structure consisted of all-ZnO-based film is fabricated by the pulsed laser deposition method at room temperature. The device is based on transparent Mg-doped ZnO films, sandwiched by Al-doped ZnO as electrodes. Reliable and reproducible bipolar resistance memory switching performances are achieved. Fast and stable switching behaviour in the voltage pulse mode is demonstrated with set and reset durations of 50 ns and 100 ns, respectively. The transmittance of the device is from 64% to 82% in the visible region. All-ZnO-based transparent RRAM will open a route towards see-through memory devices.
Simulation of partial discharge sequences using fluid equations
Authors: Pan Cheng , Meng Yongpeng , Wu Kai , Han Zenghui , Qin Kai , Cheng Yonghong
Published: June 2011

Simulation methods employing continuity equations to describe particle transportation are used to examine the process of single discharge. However, it is difficult to simulate partial discharge (PD) behaviour accurately by these methods, because it will take too much computation time to simulate consecutive PD sequences. In this report, in order to save computation time, a simple three-dimensional network is used to simulate PD sequences in a small void under ac voltage. The model considers charge generation, charge transport and charge disappearance, and electrical field redistribution in three dimensions. The continuity equations for electrons, positive ions and negative ions, including the effects of ionization, attachment, recombination, electron diffusion and the transport of charge under electrical field are solved simultaneously with Poisson's equation. With this model, the phase-resolved PD pattern and the current forms of each PD are obtained. Moreover, considering the propagation process of each PD and its influence on surface charge distribution, the fall part of PD current form and the effect of previous discharge on the subsequent one are also studied.
Low threshold parametric decay instabilities in ECRH experiments at toroidal devices
Authors: Gusakov E.Z. , Popov A.Yu.
Published: June 2011

Experimental conditions leading to a substantial reduction in the backscattering decay instability threshold in electron cyclotron resonance heating (ECRH) experiments in toroidal devices are analysed. It is shown that the drastic decrease in threshold due to suppression of convective losses is provided by the nonmonotonic behaviour of plasma density, which is often observed due to the so-called density-pump-out effect or the presence of magnetic islands, and by poloidal magnetic field inhomogeneity making localization of ion Bernstein decay waves possible. The corresponding ion Bernstein wave gain and the convective parametric decay instability pump power threshold are calculated. The possible experimental consequences of easy backscattering decay instability excitation are discussed.
Lipschitz class, narrow class, and counting lattice points
Authors: Widmer Martin
Published: June 2011

A well-known principle says that the number of lattice points in a bounded subset

S
S

of Euclidean space is about the ratio of the volume and the lattice determinant, subject to some relatively mild conditions on

S
S

. In the literature one finds two different types of such conditions: one asserts the Lipschitz parameterizability of the boundary

∂
S

\partial S

, and the other one is based on intersection properties of lines with

S
S

and its projections to linear subspaces. We compare these conditions and address a question, which we answer in some special cases. Then we give some simple upper bounds on the number of lattice points in a convex set, and finally, we apply these results to obtain estimates for the number of rational points of bounded height on certain projective varieties.
Bounds on the heat kernel under the Ricci flow
Authors: Băileşteanu Mihai
Published: June 2011

We establish an estimate for the fundamental solution of the heat equation on a closed Riemannian manifold

M
M

of dimension at least

3
3

, evolving under the Ricci flow. The estimate depends on some constants arising from a Sobolev imbedding theorem. Considering the case when the scalar curvature is positive throughout the manifold, at any time, we will obtain, as a corollary, a bound similar to the one known for the fixed metric case.
Quantitative uniqueness estimate for the Maxwell system with Lipschitz anisotropic media
Authors: Nguyen Tu , Wang Jenn-Nan
Published: June 2011

We study quantitative uniqueness estimates for the time harmonic Maxwell system with Lipschitz anisotropic media. Our main results are a three-balls inequality and a minimal vanishing rate at a point of any nontrivial solution. The proof relies on a Carleman estimate with a divergence term.
Clinical practices, complications, and mortality in neurological patients with acute severe hypertension: The Studying the Treatment of Acute hyperTension registry
Authors: Mayer Stephan A. , Kurtz Pedro , Wyman Allison , Sung Gene Y. , Multz Alan S. , Varon Joseph , Granger Christopher B. , Kleinschmidt Kurt , Lapointe Marc , Peacock W. Frank , Katz Jason N. , Gore Joel M. , O'Neil Brian , Anderson Frederick A.
Published: June 2011

Objective:

To determine the demographic and clinical features, hospital complications, and predictors of 90-day mortality in neurologic patients with acute severe hypertension.

Design:

Studying the Treatment of Acute hyperTension (STAT) was a multicenter (n = 25) observational registry of adult critical care patients with severe hypertension treated with intravenous therapy.

Setting:

Emergency department or intensive care unit.

Patients:

A qualifying blood pressure measurement >180 mm Hg systolic or >110 mm Hg diastolic (>140/90 mm Hg for subarachnoid hemorrhage) was required for inclusion in the STAT registry. Patients with a primary neurologic admission diagnosis were included in the present analysis.

Interventions:

All patients were treated with at least one parenteral (bolus or continuous infusion) antihypertensive agent.

Measurements and Main Results:

Of 1,566 patients included in the STAT registry, 432 (28%) had a primary neurologic diagnosis. The most common diagnoses were subarachnoid hemorrhage (38%), intracerebral hemorrhage (31%), and acute ischemic stroke (18%). The most common initial drug was labetalol (48%), followed by nicardipine (15%), hydralazine (15%), and sodium nitroprusside (13%). Mortality at 90 days was substantially higher in neurologic than in non-neurologic patients (24% vs. 6%, p < .0001). Median initial blood pressure was 183/95 mm Hg and did not differ between survivors and nonsurvivors. In a multivariable analysis, neurologic patients who died experienced lower minimal blood pressure values (median 103/45 vs. 118/55 mm Hg, p < .0001) and were less likely to experience recurrent hypertension requiring intravenous treatment (29% vs. 51%, p = .0001) than those who survived. Mortality was also associated with an increased frequency of neurologic deterioration (32% vs. 10%, p < .0001).

Conclusion:

Neurologic emergencies account for approximately 30% of hospitalized patients with severe acute hypertension, and the majority of those who die. Mortality in hypertensive neurologic patients is associated with lower minimum blood pressure values, less rebound hypertension, and a higher frequency of neurologic deterioration. Excessive blood pressure reduction may contribute to poor outcome after severe brain injury.
Levosimendan reduces heart failure after cardiac surgery: A prospective, randomized, placebo-controlled trial*
Authors: Lahtinen Pasi , Pitkänen Otto , Pölönen Pekka , Turpeinen Anu , Kiviniemi Vesa , Uusaro Ari
Published: June 2011

Objective:

To investigate whether levosimendan diminishes the incidence of heart failure after cardiac surgery.

Design:

Prospective, randomized, placebo-controlled clinical study.

Setting:

Cardiac surgery operating room and postanesthesia care unit in a university hospital.

Patients:

Two hundred patients assigned to undergo heart valve or combined heart valve and coronary artery bypass grafting surgery.

Interventions:

Patients were randomized to receive a 24-hr infusion of placebo or levosimendan administered as a 24 μg/kg bolus over 30-mins and thereafter at a dose of 0.2 μg/kg/min.

Measurements and Main Results:

Heart failure was defined as cardiac index <2.0 L/min/m2 or failure to wean from cardiopulmonary bypass necessitating inotrope administration for at least 2 hrs postoperatively. Heart failure was less frequent in the levosimendan compared to the placebo group: 15 patients (15%) in the levosimendan and 59 patients (58%) in the placebo group experienced heart failure postoperatively (risk ratio 0.26; 95% confidence interval 0.16–0.43; p < .001). Accordingly, a rescue inotrope (adrenaline) was needed less frequently in the levosimendan compared to the placebo group (risk ratio 0.11; 95% confidence interval 0.01–0.89), p = .005. Intra-aortic balloon pump was utilized in one patient (1%) in the levosimendan and in nine patients (9%) in the placebo group (risk ratio 0.11; 95% confidence interval 0.01–0.87), p = .018. The hospital and the 6-month mortality were comparable between groups. There were no significant differences in major organ failures postoperatively. Eighty-three patients were hypotensive and needed noradrenaline in the levosimendan compared to 52 patients in the placebo group, p < .001. The cardiac enzymes (creatine kinase MB isoenzyme mass) indicating myocardial damage were lower in the levosimendan group on the first postoperative day, p = .011.

Conclusions:

In the present study, levosimendan infusion reduced the incidence of heart failure in cardiac surgery patients but was associated with arterial hypotension and increased requirement of vasopressor agents postoperatively. Improved mortality or morbidity was not demonstrated.
Hypoglycemia at admission is associated with inhospital mortality in Ugandan patients with severe sepsis*
Authors: Ssekitoleko Richard , Jacob Shevin T. , Banura Patrick , Pinkerton Relana , Meya David B. , Reynolds Steven J. , Kenya-Mugisha Nathan , Mayanja-Kizza Harriet , Muhindo Rose , Bhagani Sanjay , Scheld W. Michael , Moore Christopher C.
Published: June 2011

Objective:

Dysglycemia during sepsis is associated with poor outcomes in resource-rich settings. In resource-limited settings, hypoglycemia is often diagnosed clinically without the benefit of laboratory support. We studied the utility of point-of-care glucose monitoring to predict mortality in severely septic patients in Uganda.

Design:

Prospective observational study.

Setting:

One national and two regional referral hospitals in Uganda.

Patients:

We enrolled 532 patients with sepsis at three hospitals in Uganda. The analysis included 418 patients from the three sites with inhospital mortality data, a documented admission blood glucose concentration, and evidence of organ dysfunction at admission (systolic blood pressure ≤100 mm Hg, lactate >4 mmol/L, platelet number <100,000/μL, or altered mental status).

Interventions:

None.

Measurements and Main Results:

We evaluated the association between admission point-of-care blood glucose concentration and inhospital mortality. We also assessed the accuracy of altered mental status as a predictor of hypoglycemia. Euglycemia occurred in 33.5% (140 of 418) of patients, whereas 16.3% (68 of 418) of patients were hypoglycemic and 50.2% (210 of 418) were hyperglycemic. Univariate Cox regression analyses comparing in-hospital mortality among hypoglycemic (35.3% [24 of 68], hazard ratio 2.0, 95% confidence interval 1.2–3.6, p = .013) and hyperglycemic (29.5% [62 of 210], hazard ratio 1.5, 95% confidence interval 0.96–2.4, p = .08) patients to euglycemic (19.3% [27 of 140]) patients showed statistically significantly higher rates of inhospital mortality for patients with hypoglycemia. Hypoglycemia (adjusted hazard ratio 1.9, 95% confidence interval 1.1–3.3, p = .03) remained significantly and independently associated with inhospital mortality in the multivariate model. The sensitivity and specificity of altered mental status for hypoglycemia were 25% and 86%, respectively.

Conclusion:

Hypoglycemia is an independent risk factor for inhospital mortality in patients with severe sepsis and cannot be adequately assessed by clinical examination. Correction of hypoglycemia may improve outcomes of critically ill patients in resource-limited settings.
Accuracy of a continuous noninvasive hemoglobin monitor in intensive care unit patients*
Authors: Frasca Denis , Dahyot-Fizelier Claire , Catherine Karen , Levrat Quentin , Debaene Bertrand , Mimoz Olivier
Published: June 2011

Objective:

To determine whether noninvasive hemoglobin measurement by Pulse CO-Oximetry could provide clinically acceptable absolute and trend accuracy in critically ill patients, compared to other invasive methods of hemoglobin assessment available at bedside and the gold standard, the laboratory analyzer.

Design:

Prospective study.

Setting:

Surgical intensive care unit of a university teaching hospital.

Patients:

Sixty-two patients continuously monitored with Pulse CO-Oximetry (Masimo Radical-7).

Interventions:

None.

Measurements and Results:

Four hundred seventy-one blood samples were analyzed by a point-of-care device (HemoCue 301), a satellite lab CO-Oximeter (Siemens RapidPoint 405), and a laboratory hematology analyzer (Sysmex XT-2000i), which was considered the reference device. Hemoglobin values reported from the invasive methods were compared to the values reported by the Pulse CO-Oximeter at the time of blood draw. When the case-to-case variation was assessed, the bias and limits of agreement were 0.0 ± 1.0 g/dL for the Pulse CO-Oximeter, 0.3 ± 1.3g/dL for the point-of-care device, and 0.9 ± 0.6 g/dL for the satellite lab CO-Oximeter compared to the reference method. Pulse CO-Oximetry showed similar trend accuracy as satellite lab CO-Oximetry, whereas the point-of-care device did not appear to follow the trend of the laboratory analyzer as well as the other test devices.

Conclusion:

When compared to laboratory reference values, hemoglobin measurement with Pulse CO-Oximetry has absolute accuracy and trending accuracy similar to widely used, invasive methods of hemoglobin measurement at bedside. Hemoglobin measurement with pulse CO-Oximetry has the additional advantages of providing continuous measurements, noninvasively, which may facilitate hemoglobin monitoring in the intensive care unit.
Simvastatin in traumatic brain injury: Effect on brain edema mechanisms
Authors: Béziaud Tiphaine , Ru Chen Xiao , El Shafey Nelly , Fréchou Magalie , Teng Fei , Palmier Bruno , Beray-Berthat Virginie , Soustrat Mathieu , Margaill Isabelle , Plotkine Michel , Marchand-Leroux Catherine , Besson Valérie C.
Published: June 2011

Objectives:

Traumatic brain injury causes deleterious brain edema, leading to high mortality and morbidity. Brain edema exacerbates neurologic deficits and may be attributable to the breakdown of endothelial cell junction protein, leukocyte infiltration, and matrix metalloproteinase activation. These all contribute to loss of blood–brain barrier integrity. The pleiotropic effects of statins, hydroxymethylglutaryl-coenzyme A reductase inhibitors, may inhibit posttraumatic brain edema. We therefore investigated the effect of acute simvastatin on neurologic deficits, cerebral edema, and its origins.

Design:

Randomized laboratory animal study.

Settings:

University-affiliated research laboratory.

Subjects:

Male Sprague-Dawley rats.

Interventions:

Rats were subjected to lateral fluid percussion traumatic brain injury. Our preliminary dose–effect study indicated that 37.5 mg/kg simvastatin, administered orally 1 hr and 6 hrs after traumatic brain injury, has the greatest anti-edematous effect. This dose was used to study its effects on brain edema and on its mechanisms.

Measurements and Main Results:

We first assessed the effects of simvastatin 24 hrs after traumatic brain injury on brain edema, brain claudin-5 expression, and the vascular endothelial–cadherin (pTyr731)/total vascular endothelial–cadherin ratio, matrix metalloproteinase-9 activity, intercellular adhesion molecule-1 expression, and polymorphonuclear neutrophil infiltration. We also evaluated blood–brain barrier permeability by measuring Evans blue and fluorescein sodium salt extravasation into the cerebral parenchyma. We then investigated whether simvastatin reduces neurologic deficits, edema, and blood–brain barrier permeability earlier than 24 hrs; these effects were evaluated 6 hrs after traumatic brain injury. The anti-edematous effect of simvastatin 24 hrs after traumatic brain injury was associated with increased claudin-5 and decreased intercellular adhesion molecule-1, polymorphonuclear neutrophil infiltration, and blood–brain barrier permeability, with no effect on matrix metalloproteinase-9 activity or vascular endothelial–cadherin phosphorylation. Earlier, 6-hrs after traumatic brain injury, simvastatin reduced neurologic deficits, cerebral edema, and blood–brain barrier permeability.

Conclusions:

Simvastatin could be a new therapy for reducing posttraumatic edema by preventing damage to tight junctions and neutrophil infiltration into the parenchyma, thus preserving blood–brain barrier integrity.
Effect of pressure support on end-expiratory lung volume and lung diffusion for carbon monoxide
Authors: Pinto Da Costa Nathalina , Di Marco Fabiano , Lyazidi Aissam , Carteaux Guillaume , Sarni Mourad , Brochard Laurent
Published: June 2011

Objectives:

The level of pressure-support ventilation can affect mean airway pressure and potentially lung volume, but its increase is usually associated with a reduced respiratory rate, and the net effects on the gas exchange process and its components, including end-expiratory lung volume, have not been carefully studied. We measured pulmonary conductance for gas exchange based on lung diffusion for carbon monoxide in patients receiving pressure-support ventilation.

Design:

Prospective, randomized, crossover study.

Setting:

Medical intensive care unit of a university hospital.

Patients:

Sixteen patients mechanically ventilated in pressure-support ventilation mode and free from chronic obstructive pulmonary disease.

Interventions:

Two pressure-support ventilation levels (5 cm H2O difference) at the same level of positive end-expiratory pressure.

Measurements and Main Results:

End-expiratory lung volume, lung diffusion for carbon monoxide, and SpO2/Fio2 were evaluated. Increasing pressure-support ventilation by 5 cm H2O significantly increased the mean tidal volume from 6.8 to 8.5 mL/kg of predicted body weight and decreased the mean respiratory rate by 6.6 breaths per minute. Although SpO2/Fio2 did not change significantly, there was a slight but significant decrease in lung diffusion for carbon monoxide (average decay rate of 4.5%) at high pressure-support ventilation. The pressure-support ventilation level did not significantly affect end-expiratory lung volume (1737 ± 629 mL at 9.6 ± 2.5 cm H2O pressure-support ventilation level vs. 1749 ± 657 mL at 14.9 ± 2.1 cm H2O pressure-support ventilation level).

Conclusions:

A 5-cm H2O increase in pressure-support ventilation neither affected end-expiratory lung volume nor increased the pulmonary volume participating in gas exchange. A target tidal volume closer to 6 mL/kg of predicted body weight than to 8 mL/kg during pressure-support ventilation was associated with better gas exchange.
Organization of ribonucleoside diphosphate reductase during multifork chromosome replication in Escherichia coli
Authors: Sánchez-Romero María Antonia , Molina Felipe , Jiménez-Sánchez Alfonso
Published: June 2011

Ribonucleoside diphosphate reductase (RNR) is located in discrete foci in a number that increases with the overlapping of replication cycles in Escherichia coli. Comparison of the numbers of RNR, DnaX and SeqA protein foci with the number of replication forks at different growth rates reveals that fork : focus ratios augment with increasing growth rates, suggesting a higher cohesion of the three protein foci with increasing number of forks per cell. Quantification of NrdB and SeqA proteins per cell showed: (i) a higher amount of RNR per focus at faster growth rates, which sustains the higher cohesion of RNR foci with higher numbers of forks per cell; and (ii) an equivalent amount of RNR per replication fork, independent of the number of the latter.
Quantitative evaluation of all hexamers as exonic splicing elements
Authors: Ke Shengdong , Shang Shulian , Kalachikov Sergey M. , Morozova Irina , Yu Lin , Russo James J. , Ju Jingyue , Chasin Lawrence A.
Published: June 2011

We describe a comprehensive quantitative measure of the splicing impact of a complete set of RNA 6-mer sequences by deep sequencing successfully spliced transcripts. All 4096 6-mers were substituted at five positions within two different internal exons in a 3-exon minigene, and millions of successfully spliced transcripts were sequenced after transfection of human cells. The results allowed the assignment of a relative splicing strength score to each mutant molecule. The effect of 6-mers on splicing often depended on their location; much of this context effect could be ascribed to the creation of different overlapping sequences at each site. Taking these overlaps into account, the splicing effect of each 6-mer could be quantified, and 6-mers could be designated as enhancers (ESEseqs) and silencers (ESSseqs), with an ESRseq score indicating their strength. Some 6-mers exhibited positional bias relative to the two splice sites. The distribution and conservation of these ESRseqs in and around human exons supported their classification. Predicted RNA secondary structure effects were also seen: Effective enhancers, silencers and 3′ splice sites tend to be single stranded, and effective 5′ splice sites tend to be double stranded. 6-mers that may form positive or negative synergy with another were also identified. Chromatin structure may also influence the splicing enhancement observed, as a good correspondence was found between splicing performance and the predicted nucleosome occupancy scores of 6-mers. This approach may prove of general use in defining nucleic acid regulatory motifs, substitute for functional SELEX in most cases, and provide insights about splicing mechanisms.
Serous fluid cytology of multicentric Castleman’s disease and other lymphoproliferative disorders associated with Kaposi sarcoma‐associated herpes virus: a review with case reports
Authors: Lobo C. , Amin S. , Ramsay A. , Diss T. , Kocjan G.
Published: June 2011

C. Lobo, S. Amin, A. Ramsay, T. Diss and G. KocjanSerous fluid cytology of multicentric Castleman’s disease and other lymphoproliferative disorders associated with Kaposi sarcoma‐associated herpes virus: a review with case reports

Objective:  The aim of this study is to describe and review the cytological features of Kaposi sarcoma‐associated herpes virus (KSHV) related entities, such as multicentric Castleman’s disease (MCD), plasmablastic‐lymphoma (PBL) and primary effusion lymphoma (PEL), which all may present as body cavity effusions. Serous fluid cytology of MCD and PBL has not, to our knowledge, thus far been described. Although different in nature, MCD, PBL and PEL are characterized by similar morphological features.

Materials and methods:  Body cavity effusions from four different patients with previously known or unknown KSHV‐related lymphoproliferations have been examined by routine cytology, immunocytochemistry (IC) and polymerase chain reaction (PCR).

Results:  MCD, PBL and PEL are all characterized by increased cellularity, comprising mainly lymphoid and plasmacytoid cells with variable proportions of immunoblasts. Immunocytochemistry and PCR results show the MCD to be CD138 and KSHV positive, CD30 negative, IgM, IgH and lambda restricted but IgH polyclonal. PBL was CD138 positive, kappa restricted, weakly positive with VS38 and over 80% positive with MIB 1. PEL was CD45, EMA, CD138, KSHV, p53 and CD3 positive, CD20, EBV, CD30, CD2, CD4, ALK1, epithelial and mesothelial markers negative, and PCR monoclonal B‐cell expanded (Ig‐kappa bands).

Conclusion:  Cytological examination of effusions in KSHV‐related lymphoproliferative disorders may show similar morphological features but clonality studies and immunocytochemistry are very helpful in distinguishing between these rare benign and malignant lymphoproliferative diseases.
Loss of capacity to recover from acidosis on repeat exercise in chronic fatigue syndrome: a case–control study
Authors: Jones David E. J. , Hollingsworth Kieren G. , Jakovljevic Djordje G. , Fattakhova Gulnar , Pairman Jessie , Blamire Andrew M. , Trenell Michael I. , Newton Julia L.
Published: June 2011

Eur J Clin Invest 2011

Background  Chronic fatigue syndrome (CFS) patients frequently describe difficulties with repeat exercise. Here, we explore muscle bioenergetic function in response to three bouts of exercise.

Methods  A total of 18 CFS (CDC 1994) patients and 12 sedentary controls underwent assessment of maximal voluntary contraction (MVC), repeat exercise with magnetic resonance spectroscopy and cardio‐respiratory fitness test to determine anaerobic threshold.

Results  Chronic fatigue syndrome patients undertaking MVC fell into two distinct groups: 8 (45%) showed normal PCr depletion in response to exercise at 35% of MVC (PCr depletion >33%; lower 95% CI for controls); 10 CFS patients had low PCr depletion (generating abnormally low MVC values). The CFS whole group exhibited significantly reduced anaerobic threshold, heart rate, VO2, VO2 peak and peak work compared to controls. Resting muscle pH was similar in controls and both CFS patient groups. However, the CFS group achieving normal PCr depletion values showed increased intramuscular acidosis compared to controls after similar work after each of the three exercise periods with no apparent reduction in acidosis with repeat exercise of the type reported in normal subjects. This CFS group also exhibited significant prolongation (almost 4‐fold) of the time taken for pH to recover to baseline.

Conclusion  When exercising to comparable levels to normal controls, CFS patients exhibit profound abnormality in bioenergetic function and response to it. Although exercise intervention is the logical treatment for patients showing acidosis, any trial must exclude subjects who do not initiate exercise as they will not benefit. This potentially explains previous mixed results in CFS exercise trials.
Early response of the platypus to climate warming
Authors: Klamt Melissa , Thompson Ross , Davis Jenny
Published: June 2011

Combining a climatic envelope modelling technique with more than two centuries (1800–2009) of distribution records has revealed the effects of a changing climate on the egg‐laying monotreme, the platypus, Ornithorhynchus anatinus. We show that the main factor associated with platypus occurrence switched from aquatic habitat availability (estimated by rainfall) to thermal tolerances (estimated by annual maximum temperature) in the 1960s. This correlates directly with the change in the annual maximum temperature anomaly from cooler to warmer conditions in southeastern Australia. Modelling of platypus habitat under emission scenarios (A1B, A2, B1 and B2) revealed large decreases (>30%) in thermally suitable habitat by 2070. This reduction, compounded by increasing demands for water for agriculture and potable use, suggests that there is real cause for concern over the future status of this species, and highlights the need for restoration of thermal refugia within the platypus’ modelled range.
A survey evaluating nurses’ perception and expectations towards the role of pharmacist in Pakistan’s healthcare system
Authors: Azhar Saira , Hassali Mohamed Azmi , Mohamed Ibrahim Mohamed Izham , Saleem Fahad , Siow Yen Liau
Published: June 2011

azhar s., hassali m.a., mohamed ibrahim m.i., saleem f. & siow yen l. (2012) A survey evaluating nurses’ perception and expectations towards the role of pharmacist in Pakistan’s healthcare system. Journal of Advanced Nursing68(1), 199–205.

Aim.  This paper is a report of a study of nurses’ perception towards the role of pharmacist in Pakistan healthcare setup.

Background.  Collaborative care by the healthcare professionals has the potential to improve patient care, enhance patient safety and to reduce workload issues that cause burn out among healthcare professionals.

Design.  A quantitative (cross‐sectional) study design was adopted.

Method.  A sample of 458 nurses was selected from government hospitals of three cities of Punjab, Pakistan. The study took place from 10 January 2009 to 15 March 2009.

Results.  Two hundred and sixty‐six questionnaires were returned, giving the response rate of (58·07%). Three‐fifths of the nurses reported that they had once a day interaction with the pharmacist. Seven‐tenths of the nurses expected the pharmacist to take personal responsibility for resolving any drug‐related problems. Moreover they appear to have high expectations of the pharmacist, almost nine‐tenths regarded pharmacists as knowledgeable drug therapy experts, and almost two‐thirds of the nurses emphasized on counselling of patient by the pharmacist.

Conclusion.  Nurses in Pakistan showed negative perception towards the role of pharmacist in healthcare setting. Although nurses considered pharmacist as a drug information expert but their expectation did not match their experience. A possible factor for this behaviour could be due to nurses’ belief that incorporating the role of pharmacist in patient care, may decrease their worth and can result in intrusion into their duties.
Complementary and alternative medicine in children attending gastroenterology clinics: Usage patterns and reasons for use
Authors: Wadhera Veena , Lemberg Daniel A , Leach Steven T , Day Andrew S
Published: June 2011

Background:  The use of complementary and alternative medicines (CAM) appears to be increasing. This cross‐sectional study aimed to assess the use of CAM in children, investigate factors influencing their use and attitudes towards them and to contrast to previous usage patterns.

Methods:  Parents of children attending gastroenterology outpatient clinics at a tertiary paediatric hospital completed a questionnaire providing details of CAM usage, awareness and attitudes.

Results:  Sixty‐nine percent of the 98 respondents were using or had used CAM (n= 66). Nutritional supplements (n= 37, 56% of CAM users) and probiotics (n= 33, 50%) were most commonly used. Most CAM users sought complementary therapy to help a chronic problem (n= 43, 69.4%) and had been referred by a friend or family member (n= 33, 53.2%). Self‐reported well‐being was associated with CAM use (P= 0.0009) and CAM were described as partially effective by 40 parents (67.8%). Forty‐six parents (75.4%) expressed that they would use CAM again. Seventy‐two respondents (80%) believed that doctors should support the use of CAM.

Conclusion:  Children attending this gastroenterology clinic are commonly given CAM. Awareness and acceptance of CAM by carers of children with gastroenterology conditions is high.
Vincristine pharmacodynamics and pharmacogenetics in children with cancer: A limited‐sampling, population modelling approach
Authors: Moore Andrew S , Norris Ross , Price Gareth , Nguyen Thu , Ni Ming , George Rani , van Breda Karin , Duley John , Charles Bruce , Pinkerton Ross
Published: June 2011

Background:  Vincristine is a key component of many childhood cancer treatment regimens. Pharmacodynamic parameters such as clinical efficacy and toxicity may be influenced by polymorphisms of CYP3A.

Aim:  The aim of this study was to document CYP3A5 genotype, vincristine pharmacokinetics (PK) and neurotoxicity profile for 50 children with cancer and determine whether, in a population of Australian children, the CYP3A5 genotype influenced the pharmacodynamics of vincristine as reflected by peripheral neurotoxicity.

Methods:  Blood for PK analysis was collected after any single dose of vincristine and assayed using high performance liquid chromatography with tandem mass spectrometry detection. CYP3A5*3 and CYP3A5*6 genotype was determined using gel‐electrophoresis or automated microfluidic electrophoresis. Neurotoxicity was determined by physical examination.

Results:  The median age of children sampled was 6.5 years (range 1–16.25). Half the patients received concurrent corticosteroids for acute lymphoblastic leukaemia. Six patients (12%) had experienced grade 3 or 4 neurotoxicity. The median clearance, area under the curve and Cmax of vincristine was 482 mL/min/m2 (range 132–698), 49.7 mcg/L.h (16.5–143.1) and 3.5 mcg/L (1.0–31.2), respectively. In contrast to prediction, all but three children were homozygous for wild‐type CYP3A5*3. No CYP3A5*6 polymorphisms were identified.

Conclusions:  No correlation was identified between vincristine clearance, vincristine neurotoxicity, age, sex or concomitant steroid therapy. The limited sampling methodology proved acceptable to patients and families and would be suitable for larger scale studies including a wider range of genotypic variants and more detailed prospective evaluation of neurotoxicity.
Stimulant medication in pre‐school children in New South Wales
Authors: Eysbouts Yalcke , Poulton Alison , Salmelainen Pia
Published: June 2011

Aims:  The aims of this study were: (i) to examine the annual treatment rate of children under 4 years from 1997 to 2006; (ii) to compare their treatment rate and attrition with that of children starting treatment at the modal age; (iii) to describe the clinical characteristics of children aged less than 4 years and their response to stimulant medication for the treatment of attention‐deficit hyperactivity disorder.

Methods:  Retrospective study of electronic prescription and authority records of the New South Wales Department of Health and a review of clinical reports.

Results:  The annual treatment initiation rate for children under 4 years showed a progressive decline over the decade. In 2001, 13.6% of the children starting treatment were aged 7 years (modal age); those aged <4 years represented 1.1% of the total. There was no significant difference in attrition rate between these two groups. For those aged <4 years with clinical reports available (n= 235), oppositional behaviour and developmental problems were reported frequently (78 and 43%, respectively). Non‐pharmacological interventions were implemented in 77% and non‐stimulant medications were prescribed in 50%. For 76% of children, an improvement in behaviour was reported after stimulant therapy.

Conclusions:  Children treated with stimulant medication aged <4 years were a small subgroup with a high rate of co‐morbidity. The majority were perceived to have a favourable response to stimulant medication. However, there was a disturbingly high rate of prescribing of other psychotropic medications of known toxicity and unproven efficacy.
Photodynamic diagnosis of positive margin during radical prostatectomy: Preliminary experience with 5‐aminolevulinic acid
Authors: Fukuhara Hideo , Inoue Keiji , Satake Hirofumi , Tamura Kenji , Karashima Takashi , Yamasaki Ichiro , Tatsuo Iiyama , Kurabayashi Atsushi , Furihata Mutsuo , Shuin Taro
Published: June 2011

Objectives:  To investigate the feasibility of intraoperative photodynamic diagnosis (PDD) by 5‐aminolevulinic acid (ALA) for the identification of positive surgical margins (PSM) during retropubic radical prostatectomy (RRP) in patients with prostate cancer (PCa).

Methods:  Intraoperative PDD was carried out in 16 patients with pathologically confirmed PCa by biopsy of the apex, or carrying >25% of probability of extraprostatic extension as defined by Japan PC Table. Before operation, 1.0 g of ALA was given orally. During open RRP, the resection margins inside the body were examined by PDD system with a fluorescence laparoscope. After their removal, 12 harvested prostates were divided and also investigated by PDD. Red fluorescent‐positive lesions were biopsied and compared with the pathological result.

Results:  All 16 patients were fluorescence‐negative inside the body, and negative margins were pathologically confirmed during PDD. Among the 43 specimens of 12 cases obtained by biopsy under PDD, 11 specimens (25.6%) were pathologically diagnosed as malignant tissue (adenocarcinoma, 10 specimens; high grade prostatic intraepithelial neoplasia, 1 specimen) and 19 specimens (44.2%) were evaluated as positive fluorescence by PDD with a sensitivity of 81.8%, a specificity of 68.8% and a predictive accuracy of 72.1%. No side‐effects were observed and the procedures were well tolerated.

Conclusions:  PDD mediated by ALA during RRP might be a feasible and safe modality for detection of surgical margins. Further prospective randomized studies with larger populations are required.
Development of male reproductive system of the blue land crab Cardisoma guanhumi Latreille, 1828 (Decapoda: Gecarcinidae)
Authors: Shinozaki‐Mendes Renata A. , Silva José R.F. , Hazin Fábio H.V.
Published: June 2011

Shinozaki‐Mendes, R.A., Silva, J.R.F. and Hazin, F.H.V. 2011. Development of male reproductive system of the blue land crab Cardisoma guanhumi Latreille, 1828 (Decapoda: Gecarcinidae). —Acta Zoologica (Stockholm) 93: 390–399.

In this study, the reproductive tract of the Cardisoma guanhumi was described both macroscopically and microscopically. The maturation stages of the reproductive system were defined, and the development of germ cells was described. The reproductive tract is made up of a pair of testis, a pair of vas deferentia, and a pair of ejaculatory ducts. The germ cells were classified in the order of development as spermatogonia (diameter: 10.5 ± 0.11 μm), spermatocytes (9.7 ± 0.07 μm), spermatids (initial phase: 5.5 ± 0.06 μm; final phase: 4.3 ± 0.05), and spermatozoa (SPZ) (4.0 ± 0.03 μm). The testis is made up of a germ zone, a maturation zone and collector ducts, which lead to the anterior vas deferens (AVD), containing solely SPZ. The spermatophores (SPH) start to be formed in the AVD, through the secretion of spermatophoric and protein matrices. In the median vas deferens, the SPH, already fully formed, are stored, while in the posterior vas deferens, a large production of a glycoprotein matrix is observed. Based on macroscopic and microscopic description of the male reproductive tract, three maturation stages are proposed: immature, maturing, and mature.
Patients as team members: opportunities, challenges and paradoxes of including patients in multi‐professional healthcare teams
Authors: Martin Graham P. , Finn Rachael
Published: June 2011

Current healthcare policy emphasises the need for more collaborative, team‐based approaches to providing care, and for a greater voice for service users in the management and delivery of care. Increasingly, policy encourages ‘partnerships’ between users and professionals so that users, too, effectively become team members. In examining this phenomenon, this paper draws on insights from the organisational‐sociological literature on team work, which highlights the challenges of bringing together diverse professional groups, but which has not, to date, been applied in contexts where users, too, are included in teams. Using data from a qualitative study of five pilot cancer‐genetics projects, in which service users were included in teams responsible for managing and developing new services, it highlights the difficulties involved in making teams of such heterogeneous members—and the paradoxes that arise when this task is achieved. It reveals how the tension between integration and specialisation of team members, highlighted in the literature on teams in general, is especially acute for service users, the distinctiveness of whose contribution is more fragile, and open to blurring.
The swan effect in midwifery talk and practice: a tension between normality and the language of risk
Authors: Scamell Mandie
Published: June 2011

Midwifery activity in the labour room coalesces around routine surveillance practices. When engaging in such practice, midwives have to cope with attempting to instil a sense of confidence in the mother’s embodied ability to give birth to her baby spontaneously while concurrently attending to an array of risk‐focused tests and measurements. Midwives are vigilant about the potential harm that may come to mother and baby while at the same time they are responsible for facilitating a normal birth. This article sets out to explore the tension between these two tasks and shows how routine midwifery practice during labour can communicate certain understandings about birth. Using empirical evidence taken from an ethnographic study of midwifery talk and practice, attention is given to how midwives’ activity during labour and birth implicitly introduces a sense of danger, an imagined risk that confines practice and operates to unsettle normality.
ECONOMIC DEVELOPMENT THROUGH SECOND HOME DEVELOPMENT: EVIDENCE FROM SOUTH AFRICA
Authors: HOOGENDOORN GIJSBERT , VISSER GUSTAV
Published: June 2011

This investigation aims to make a contribution towards addressing the general lack of academic reflection on second homes in South Africa. In particular, it aims to provide insight into the economic impact of second home development on smaller settlements in remote rural towns in the country. While the empirical evidence demonstrates the unique development characteristics and impact of South African second home development, the investigation also highlights the stimulation of new capital inflow, employment creation and property price appreciation.