bluuebunny/crossref_metadata_2025 huggingface dataset:
Optimal qualifications, staffing and scope of practice for first responder nurses in disaster
Authors: Yin Huahua , He Haiyan , Arbon Paul , Zhu Jingci , Tan Jing , Zhang Limei
Published: September 2011

Aims and objectives.  To explore: the selection criteria for first responder nurses during disaster; scope of practice for disaster relief nurses; appropriate nurse – medical practitioner ratio at the disaster site.

Background.  Nurses are key members of disaster response medical teams. A scarcity of literature exists relating to nurses attending disasters, their qualifications, experience, scope of practice and appropriate staffing ratios.

Design.  Qualitative and quantitative data were collected via survey using self‐developed questionnaires. Participants were 95 medical workers, who participated in emergency rescue teams following the 2008 Wenchuan earthquake in China. A response rate of 93·7% achieved.

Method.  The questionnaire included questions relating to nurses: previous experience in disaster relief; scope of practice at the disaster site; optimal ratio of medical practitioners to nurses in disaster relief teams.

Results.  Following a disaster, first responder nurses considered most suitable were those with at least three years clinical experience, particularly in the emergency department or having emergency rescue skills training. The scope of practice for disaster relief nurses was different to that of nurses working in a hospital. The majority of participants reported insufficient nurses during the relief effort, concluding the optimal ratio of medical practitioner to nurse should range between 1:1–1:2 depending on the task and situation.

Conclusion.  At the scene of disaster, the preferred first responder nurses were nurses: with emergency rescue training; experienced in the emergency department; with at least three years clinical experience. The scope of practice for first responder nurses needs to be extended. Appropriate nurse – medical practitioner ratios in responding medical teams is dependant on the specific medical requirements of the disaster.

Relevance to clinical practice.  The recommendations made by this study provide a guide to ensure that nurses can contribute effectively as essential members of first responder emergency disaster relief teams.
Peginterferon alfa‐2b plus weight‐based ribavirin for 24 weeks in patients with chronic hepatitis C virus genotype 1 with low viral load who achieve rapid viral response
Authors: Craxi A. , Koutsounas S. , Ogurtsov P. , Chemello L. , Maticic M. , Torras J. , Diago M. , Tartaglione M. T. , Witthoeft T. , Yu X. , Faruqi R. , Chaudhri E. , Pedicone L. D. , Zuckerman E.
Published: September 2011

Summary.  In chronic hepatitis C (CHC), treatment duration may be individualized according to time to first undetectable hepatitis C virus (HCV) RNA, with patients who attain undetectable HCV RNA early in treatment being candidates for shorter regimens. The aim of this study was to determine the relapse rate in patients with CHC genotype (G) 1 infection and low baseline viral load who achieved undetectable HCV RNA by week 4 [rapid virologic response (RVR)] when treated for 24 weeks. This was an open‐label, multicentre, noninterventional study. Adult patients with G1 CHC infection and baseline viral load <600,000 IU/mL who attained RVR were treated with peginterferon alfa‐2b (1.5 μg/kg/week) plus ribavirin (800–1200 mg/day) for 24 weeks, then followed for a further 24 weeks. The primary endpoint was relapse rate, defined as the proportion of patients with undetectable HCV RNA at treatment week 24 and detectable HCV RNA at week 24 follow‐up. The secondary efficacy endpoint was sustained virologic response (SVR). Overall, 170 patients were included in the efficacy‐evaluable population. The relapse rate was 9.7% (16/165, 95% confidence interval: 0.06–0.15), and SVR was attained by 149 of 170 patients (87.6%). Virologic outcomes were consistent regardless of age, gender, body weight and genotype. Seven patients reported treatment‐emergent serious adverse events (AEs), and four patients discontinued treatment because of an AE. This study further demonstrates that peginterferon alfa‐2b plus weight‐based ribavirin for 24 weeks is an effective treatment strategy for treatment‐naive patients with G1 CHC and low viral load who attain RVR.
Active ROP2 GTPase inhibits ABA‐ and CO2‐induced stomatal closure
Authors: HWANG JAE‐UNG , JEON BYEONG WOOK , HONG DAEWOONG , LEE YOUNGSOOK
Published: September 2011

ROP GTPases function as molecular switches in diverse cellular processes. Previously, we showed that ROP2 GTPase is activated upon light irradiation, and thereby negatively regulates light‐induced stomatal opening. Here we studied the role of ROP2 during stomatal closure. The expression of a constitutively active form of ROP2 (CA‐rop2) in Arabidopsis thaliana and Vicia faba resulted in slower and reduced stomatal closure in response to abscisic acid (ABA) and CO2. In contrast, the expression of a dominant‐negative form of ROP2 (DN‐rop2) and the knockout mutation of ROP2 (rop2 KO) promoted ABA‐induced stomatal closure in Arabidopsis. As early as 10 min after ABA treatment, ROP2 was inactivated and translocated to the cytoplasm of the stomatal guard cells. To elucidate the mechanism by which active ROP2 suppresses stomatal closure, we monitored endocytotic membrane trafficking, which is regulated by Rho GTPases in animal cells. We found that the endocytosis of plasma membrane (PM), as tracked by FM4‐64, was lower in CA‐rop2‐expressing guard cells than in those of wild‐type plants, which suggests that active ROP2 suppresses the endocytotic internalization of PM, a process required for stomatal closure. Together, our results suggest that ROP2 is inactivated by ABA, and that this inactivation is required for the timely stomatal closure.
Chromoblastomycosis presenting as a phagedenic ulcer on the face
Authors: Naveen Kikkeri N. , Shetty Praveen C. , Naik Ashok S. , Pai Varadraj V. , Hanumanthayya Keloji , Udupishastry Dinesh
Published: September 2011

Background  Chromoblastomycosis is a chronic fungal infection which presents as a small ulcer, plaques, papulonodular lesion to cauliflower‐like warty masses and cicatricial forms. The disease is relatively uncommon, with only a few published case report.

Methods  A 35‐year‐old female presented with phagedenic ulcer on the face since 15 years. Examination identified a plaque with central perforation on the right side of the face with crusting and oozing and a scar at the periphery with visible underlying turbinates. A biopsy was done and sent for histopathologic examination and culture. Treatment was started with oral fluconazole, 150 mg daily orally, suspecting subcutaneous fungal infection.

Results  Biopsy revealed branched, septate, brown‐colored dematiaceous hypae in the dermis indicating chromoblastomycosis. Fungal culture revealed Fonsecaea pedrosoi. Patient responded well to treatment, and still she is on treatment.

Conclusions  We believe that this is the first case report of chromoblastomycosis presenting as phagedenic ulcer.
Development of a standardized low‐dose double‐blind placebo‐controlled challenge vehicle for the EuroPrevall project
Authors: Cochrane S. A. , Salt L. J. , Wantling E. , Rogers A. , Coutts J. , Ballmer‐Weber B. K. , Fritsche P. , Fernández‐Rivas M. , Reig I. , Knulst A. , Le T.‐M. , Asero R. , Beyer K. , Golding M. , Crevel R. , Clare Mills E. N. , Mackie A. R.
Published: September 2011

To cite this article: Cochrane SA, Salt LJ, Wantling E, Rogers A, Coutts J, Ballmer‐Weber BK, Fritsche P, Fernández‐Rivas M, Reig I, Knulst A, Le T‐M, Asero R, Beyer K, Golding M, Crevel R, Clare Mills EN, Mackie AR. Development of a standardized low‐dose double‐blind placebo‐controlled challenge vehicle for the EuroPrevall Project. Allergy 2012; 67: 107–113.

Background:  Double‐blind placebo‐controlled food challenge (DBPCFC) is the gold standard for diagnosing food allergy. Standardized materials and protocols are essential for comparing DBPCFC results for multicentre studies such as EuroPrevall. This required the development and piloting of a standardized vehicle and low‐dose protocol for confirming food allergy and determination of minimum eliciting doses (MEDs).

Methods:  A low‐dose DBPCFC protocol was developed, with eight titrated protein doses from 3 μg to 1 g. This was delivered using a simple, microbiologically stable food base incorporating allergenic food ingredients manufactured at three sites and centrally distributed to clinical centres. Allergen blinding was assessed by a professional sensory testing panel using a triangle test. Homogeneity and allergen content were confirmed by ELISA and clinical efficacy was assessed in a pilot study, using celeriac and hazelnut as exemplars.

Results:  Celeriac and hazelnut ingredients were sufficiently blinded in the dessert. The dessert meals were successfully piloted with hazelnut in allergy clinics in Spain, the Netherlands and Italy and with celeriac and hazelnut in Zurich. The challenges elicited a range of subjective and objective reactions ranging in severity from mild itching of the oral mucosa to bronchospasm.

Conclusions:  A standardized challenge vehicle proven to sufficiently blind processed, powdered hazelnut and celeriac ingredients and that can be reproducibly manufactured has been developed. This pilot study shows that the vehicle is promising for the confirmation of food allergy and determination of MEDs in adults and children with body weight >28.8 kg (approximately 7–11 years old).
Target levels of functional C1‐inhibitor in hereditary angioedema
Authors: Hack C. E. , Relan A. , van Amersfoort E. S. , Cicardi M.
Published: September 2011

To cite this article: Hack CE, Relan A, van Amersfoort ES, Cicardi M. Target levels of functional C1‐inhibitor in hereditary angioedema. Allergy 2012; 67: 123–130.

Background:  Hereditary angioedema (HAE) is a heterozygous deficiency of first component of complement‐inhibitor (C1INH). Insufficient C1INH activity leads to uncontrolled activation of plasma cascade systems, which results in acute angioedema attacks in patients with HAE. Plasma‐derived or recombinant C1INH products are approved for the treatment of such angioedema attacks. The target level of C1INH activity needed to achieve optimal efficacy, however, remains unknown. We determined the plasma level of C1INH associated with optimal clinical efficacy in the treatment of angioedema attacks.

Methods:  Efficacy and pharmacokinetic data were reviewed from recently published placebo‐controlled randomized trials in the treatment of HAE with either plasma‐derived or recombinant C1INH products, tested at various doses.

Results:  A dose‐dependent effect was observed on time to the beginning of relief of symptoms, on time to resolution of symptoms, and on the response rate within 4 h. Optimal efficacy of C1INH therapy is achieved at doses ≥50 U/kg. This dose increases plasma C1INH activity in almost all patients to values ≥0.7 U/ml (70% of normal), the lower limit of the normal range. The differences in half‐lives of the various C1INH products do not have an obvious effect on clinical efficacy.

Conclusion:  A review of the efficacy and pharmacokinetic data from recently published controlled studies in the treatment of HAE attacks suggests that efficacy of C1INH therapy is optimal when C1INH activity levels are restored to the normal range.
Effect of dietary Rhodobacter capsulatus on lipid fractions and egg‐yolk fatty acid composition in laying hens
Authors: Salma U. , Miah A. G. , Tsujii H. , Schellander K. , Südekum K.‐H.
Published: September 2011

The present study was conducted to investigate the effect of dietary Rhodobacter capsulatus on lipid fractions and egg‐yolk fatty acid composition in laying hens. Thirty‐six laying hens (30 weeks old) were randomly assigned into two dietary groups fed diets with (0.04%) or without (control) R. capsulatus for a 60‐day feeding trial. Dietary R. capsulatus decreased (p < 0.05) serum and hepatic cholesterol and increased (p < 0.05) the excreta cholesterol, and resultant lower (p < 0.05) cholesterol contents in egg yolk. The concentration of polyunsaturated fatty acids (PUFA) and ratio to saturated fatty acids in egg yolk was improved (p < 0.05) by dietary R. capsulatus. The concentration of hepatic bile acid was increased (p < 0.05) and excreta bile acid was decreased (p < 0.01) in the laying hens fed R. capsulatus diet. The incorporation of 1‐14C‐palmitic acid into hepatic lipids and lipid fractions was increased (p < 0.05) in laying hens fed R. capsulatus diet. Moreover, dietary R. capsulatus did not appear to cause any adverse effects on laying hen performances. Therefore, dietary supplementation of R. capsulatus in layer diets may be a feasible means of producing eggs with lower cholesterol and higher PUFA contents for health conscious consumers.
Comparison of clinical findings between histologically confirmed type 1 and type 2 autoimmune pancreatitis
Authors: Song Tae Jun , Kim Ji Hoon , Kim Myung‐Hwan , Jang Ji Woong , Park Do Hyun , Lee Sang Soo , Seo Dong Wan , Lee Sung Koo , Yu Eunsil
Published: September 2011

Background and Aim:  Type 2 autoimmune pancreatitis (AIP) has been reported mainly in Western countries and is thought to be very rare in Asia. The aim of this study was to compare the prevalence, clinical profiles, detailed radiological findings, and steroid responsiveness between type 1 and type 2 AIP in Korea.

Methods:  From 120 patients diagnosed with AIP between January 2003 and August 2010, 52 patients with histologically confirmed type 1 (n = 37) or type 2 (n = 15) AIP were included.

Results:  The median age of patients with type 2 AIP was significantly lower than that of patients with type 1 AIP (61 vs 34 years, P < 0.05). At initial presentation, severe abdominal pain and presentation with acute pancreatitis were more frequent in patients with type 2 AIP (P < 0.05). On computed tomography scan, the extent of pancreatic enlargement and the frequency of low‐density mass did not differ significantly between the two groups. Detailed pancreatographic findings on endoscopic retrograde cholangiopancreatography/magnetic resonance cholangiopancreatography were not significantly different between the two groups. All patients with steroids therapy improved clinically and radiologically in response (25/25 in type 1 AIP and 14/14 in type 2 AIP). During the follow‐up period, none of the patients with type 2 AIP experienced relapse.

Conclusions:  Type 2 AIP in all histologically confirmed AIP cases in Korea may not be as rare as originally thought, with an estimated prevalence rate of 28.8% (15/52). The detailed radiological findings of type 1 and type 2 AIP were not significantly different, and both subtypes responded well to steroids.
Diabetes mellitus correlates with increased risk of pancreatic cancer: A population‐based cohort study in Taiwan
Authors: Liao Kuan‐Fu , Lai Shih‐Wei , Li Chia‐Ing , Chen Wen‐Chi
Published: September 2011

Background and Aim:  This study investigated whether diabetes mellitus (DM) increased the risk of pancreatic cancer and whether anti‐diabetic drugs reduced the risk in Taiwan.

Methods:  We designed a population‐based cohort study using the Taiwan National Health Insurance Database, which consisted of 49 803 patients aged 20 years and older with newly diagnosed DM as the diabetic group and 199 212 people without DM as the non‐diabetic group during 1998–2007.

Results:  The incidence of pancreatic cancer was higher in patients with diabetic duration less than 2 years, as compared to the non‐diabetic group (27.81 vs 6.96 per 10 000 person‐years, 95% confidence interval = 2.11–7.54). Age (aged 40–64, hazard ratio [HR] = 5.22, and aged 65 and older, HR = 7.59, respectively), chronic pancreatitis (HR = 19.40), gallstones (HR = 2.56), and hepatitis C infection (HR = 3.08) were also significant factors predicting pancreatic cancer. Patients with concurrent DM and chronic pancreatitis had an appreciably elevated risk of developing pancreatic cancer (HR = 33.52), as compared with subjects without these comorbidities. The association was not statistically significant between use of anti‐diabetic drugs and the risk of pancreatic cancer.

Conclusions:  Diabetes < 2 years' duration is associated with pancreatic cancer and could be an early manifestation of pancreatic cancer. Long‐standing diabetes was not found to be a risk factor for pancreatic cancer in Taiwan's patients. Old age, chronic pancreatitis, gallstones and hepatitis C infection are other risk factors for pancreatic cancer. These high‐risk patients should undergo close follow‐up programs for pancreatic cancer.
Sexually dimorphic distribution of orbitofrontal sulcogyral pattern in schizophrenia
Authors: Uehara‐Aoyama Kumi , Nakamura Motoaki , Asami Takeshi , Yoshida Takeshi , Hayano Fumi , Roppongi Tomohide , Fujiwara Akiko , Inoue Tomio , Shenton Martha E. , Hirayasu Yoshio
Published: September 2011

Aim:  The sulcogyral pattern of the orbitofrontal cortex (OFC) is characterized by a remarkable inter‐individual variability that likely reflects neurobehavioral traits and genetic aspects of neurodevelopment. The aim of the present study was to evaluate the OFC sulcogyral pattern of patients with schizophrenia (SZ) and healthy controls (HC) to determine group differences in OFC sulcogyral pattern as well as gender differences between groups.

Methods:  Forty‐seven SZ patients (M/F, 23/24) and forty‐seven HC (M/F, 17/30), matched on age and gender, were analyzed using magnetic resonance imaging. The sulcogyral pattern was classified into type I, II, or III based on the guidelines set by Chiavaras and Petrides in a previous paper. Chi‐squared analysis was used to investigate group and gender differences in the sulcogyral pattern distribution, and categorical regression was used to explore clinical correlations.

Results:  The distribution of OFC sulcogyral pattern in HC replicated the results found in the previous study (left, χ2 = 0.02, P = 0.989; right, χ2 = 0.97, P = 0.616), in that there were no gender differences. Moreover, the distribution in SZ‐M was in accordance with that in the previous study (left, χ2 = 1.59, P = 0.451; right, χ2 = 0.14, P = 0.933). Additionally, within SZ‐M, patients with the type III pattern had a higher total positive and negative syndrome scale score (β = 0.902, F = 14.75, P = 0.001). In contrast, the distribution in the right hemisphere in the SZ‐F group differed significantly from that observed in SZ‐M (χ2 = 6.017, P = 0.046), but did not differ from HC (χ2 = 2.557, P = 0.110).

Conclusion:  OFC sulcogyral pattern is altered in SZ‐M but not in SZ‐F, possibly reflecting gender differences in early neurodevelopment.
Tachyphylaxis/tolerance to antidepressants in treatment of dysthymia: Results of a retrospective naturalistic chart review study
Authors: Katz Gregory
Published: September 2011

Aim:  The main goals of this chart‐review study were to examine the rate of tachyphylaxis during treatment of dysthymia with antidepressants, to compare the incidence of tolerance during trials of selective serotonin reuptake inhibitors (SSRI) and non‐SSRI and to give descriptive analysis of the cases of tachyphylaxis.

Methods:  The retrospective naturalistic chart review study included 52 cases of successfully treated (with different antidepressants) patients suffering from dysthymia. The overall number of the cases of tolerance to antidepressants were registered as well as the rate of these phenomena in the groups treated with SSRI and non‐SSRI.

Results:  The cases of tolerance/tachyphylaxis were observed in 12 patients (23% of patients) and in 13 trials (22.4% of trials). All cases of tolerance occurred during monotherapy. No cases of tachyphylaxis were observed in the non‐SSRI group while in the SSRI group, tolerance at some stage of the treatment was detected in 41.9% of the successful cases (P < 0.001).

Conclusion:  During the treatment of dysthymia with antidepressants in the SSRI group, tachyphylaxis/tolerance might be observed in a relatively in high proportion of cases.
Heart rate reactivity and current post‐traumatic stress disorder when data are missing
Authors: Jeon‐Slaughter Haekyung , Tucker Phebe , Pfefferbaum Betty , North Carol S. , de Andrade Bernardo Borba , Neas Barbara
Published: September 2011

Aims:  This study demonstrates that auxiliary and exclusion criteria variables increase the effectiveness of missing imputation in correcting underestimation of physiologic reactivity in relation to post‐traumatic stress disorder (PTSD) caused by deleting cases with missing physiologic data.

Methods:  This study used data from survivors of the 1995 Oklahoma City bombing and imputed missing heart rate data using auxiliary and exclusion criteria variables. Logistic regression was used to examine heart rate reactivity in relation to current PTSD.

Results:  Of 113 survivors who participated in the bombing study's 7‐year follow‐up interview, 42 (37%) had missing data on heart rate reactivity due to exclusion criteria (medical illness or use of cardiovascular or psychotropic medications) or non‐participation. Logistic regression results based on imputed heart rate data using exclusion criteria and auxiliary (the presence of any current PTSD arousal symptoms) variables showed that survivors with current bombing‐related PTSD had significantly higher heart rates at baseline and recovered more slowly back to baseline heart rate during resting periods than survivors without current PTSD, while results based on complete cases failed to show significant correlations between current PTSD and heart rates at any assessment points.

Conclusions:  Suggested methods yielded an otherwise undetectable link between physiology and current PTSD.
Depressive symptoms and other factors associated with poor self‐rated health in the elderly: Gender differences
Authors: Millán‐Calenti José C , Sánchez Alba , Lorenzo Trinidad , Maseda Ana
Published: September 2011

Aim:  The main objective of this study was to identify determinants of poor self‐rated health. We hypothesized that poor self‐rated health reflects not only health, but also physical, functional, psychological and social factors.

Methods:  We conducted a cross‐sectional analysis of a representative Spanish population sample of 600 subjects aged 65 years and older. Self‐rated health status was measured and dichotomized into good (excellent and good) and poor (fair and poor). Univariate and multiple logistic regression analyses were used to determine these independent variables modifying poor self‐rated health.

Results:  Of the participants, 43.9% perceived their health as poor. Depressive symptoms were a factor that showed the strongest relation to poor self‐rated health (odds ration [OR] 5.06), even when distributed by sex (women, OR 4.70 and men, OR 5.19), followed by the need for caregiver support 24 h a day in both the total population (OR 3.67) and women (OR 3.53), but having a connective tissue disease was the second strongest factor in men (OR 2.07). When depressive symptoms and the need for caregiver support were present, the likelihood for poor self‐rated health was 91.5% in the total population and 94.4% in women. In men, the likelihood reached 78.4% in the presence of depressive symptoms and connective tissue disease.

Conclusions:  Self‐rated health is a multidimensional construct, which includes physical, psychological, functional and social variables. To recognize and intervene on the different factors involved, especially depressive symptoms, caregiver support and connective tissue disease, may contribute to improving self‐rated health and ultimately the welfare for this group. Geriatr Gerontol Int 2012; 12: 198–206.
Effects of telmisartan on cognition and regional cerebral blood flow in hypertensive patients with Alzheimer's disease
Authors: Kume Kazumasa , Hanyu Haruo , Sakurai Hirofumi , Takada Yusuke , Onuma Takeshi , Iwamoto Toshihiko
Published: September 2011

Aim:  Recent studies have shown that some antihypertensive medications are associated with a significant reduction in the incidence of Alzheimer's disease (AD). However, it remains uncertain whether antihypertensive drugs may have a preventive effect on cognitive decline in patients with AD. We investigated the effects of telmisartan, an angiotensin II type 1 receptor blocker with peroxisome proliferator‐activated receptor γ‐stimulating activity, on cognition and regional cerebral blood flow (rCBF) in elderly hypertensive patients with AD.

Methods:  A total of 20 patients with probable AD and essential hypertension were randomly assigned to the telmisartan group (n = 10, 40–80 mg daily) or the amlodipine group (n = 10, 5–10 mg daily) for 6 months.

Results:  The groups had a similar significant reduction in systolic and diastolic blood pressure after treatment. The telmisartan group did not show any changes in cognitive function test scores, while the amlodipine group showed significantly higher scores on the AD Assessment Scale‐Cognitive Subscale (Japanese version). Analysis of covariance to analyze treatment effect revealed that the telmisartan group showed increased rCBF in the right supramarginal gyrus, superior parietal lobule, cuneus, and lingual gyrus compared with the amlodipine group, while the amlodipine group showed increased rCBF only in the right cingulate gyrus compared with the telmisartan group at 6 months.

Conclusion:  These findings suggest that telmisartan may have additional benefits and be useful for the treatment of elderly hypertensive patients with AD. Geriatr Gerontol Int 2012; 12: 207–214.
Factors associated with functional recovery and home discharge in stroke patients admitted to a convalescent rehabilitation ward
Authors: Mutai Hitoshi , Furukawa Tomomi , Araki Kasumi , Misawa Kousuke , Hanihara Tokiji
Published: September 2011

Aims:  This study aimed to determine the predictive factors for functional recovery and home discharge in stroke patients receiving in‐hospital rehabilitation.

Methods:  This study included a consecutive series of 174 stroke patients (average age 73.0 ± 10.8) admitted to the convalescent rehabilitation ward at Azumino Red Cross Hospital in Japan after acute rehabilitation. The main outcome measures were functional recovery (functional independence measure [FIM] at discharge and Montebello rehabilitation factor score [MRFS]) and home discharge.

Results:  Total FIM improved from 72.6 ± 27.6 to 87.7 ± 29.9 during the hospital stay (P < 0.001). The average MRFS was 0.30 ± 0.28. Of the 174 patients, 151 were discharged home (87%). Age, stroke type, premorbid independence, motor FIM, and cognitive FIM at admission showed a significant association with FIM at discharge, while age, premorbid independence, motor FIM at admission, and cognitive FIM at admission were statistically significant predictors of MRFS. Female sex, not living with family, premorbid independence, and neglect were negatively associated with home discharge.

Conclusions:  Premorbid disability and cognitive dysfunction at admission were both negatively associated with functional recovery and home discharge in patients undergoing inpatient stroke rehabilitation. Geriatr Gerontol Int 2012; 12: 215–222.
Massively parallel rRNA gene sequencing exacerbates the potential for biased community diversity comparisons due to variable library sizes
Authors: Gihring Thomas M. , Green Stefan J. , Schadt Christopher W.
Published: September 2011

Technologies for massively parallel sequencing are revolutionizing microbial ecology and are vastly increasing the scale of ribosomal RNA (rRNA) gene studies. Although pyrosequencing has increased the breadth and depth of possible rRNA gene sampling, one drawback is that the number of reads obtained per sample is difficult to control. Pyrosequencing libraries typically vary widely in the number of sequences per sample, even within individual studies, and there is a need to revisit the behaviour of richness estimators and diversity indices with variable gene sequence library sizes. Multiple reports and review papers have demonstrated the bias in non‐parametric richness estimators (e.g. Chao1 and ACE) and diversity indices when using clone libraries. However, we found that biased community comparisons are accumulating in the literature. Here we demonstrate the effects of sample size on Chao1, ACE, CatchAll, Shannon, Chao–Shen and Simpson's estimations specifically using pyrosequencing libraries. The need to equalize the number of reads being compared across libraries is reiterated, and investigators are directed towards available tools for making unbiased diversity comparisons.
ETHICAL REASONING IN PANDEMIC PREPAREDNES PLANS – SOUTHEAST ASIA AND THE WESTERN PACIFIC
Authors: DERPMANN SIMON
Published: September 2011

The emergence of H1N1 in 2009 shows that it is a mistake to regard the scenario of having to implement pandemic plans as merely hypothetical. This recent experience provides an opportunity to inquire into the current state of pandemic preparedness plans with regard to their ethical adequacy. One aspect that deserves consideration in this context is the disclosure of ethical reasoning. Accordingly, the following is an analysis of examples of pandemic plans and drafts of plans from Southeast Asia and the Western Pacific. It is an analysis of the occurrence of explicit ethical reflection in these documents as well an inquiry into the related question of how ethical reflection can be understood as a constitutive element of ethical pandemic preparedness.

In the analysis, different fields of ethical consideration concerning equity, personal rights and accountability are distinguished. There are both pragmatic and genuinely ethical reasons to explicitly address issues of these types in pandemic plans. The extent to which ethical language appears in the national plans in South East Asia and the Western Pacific suggests that there is limited awareness of ethical considerations, or at least insufficient ethical substantiation of pandemic action. The aim of the analysis is to show that further inclusion of ethical considerations into pandemic plans is ethically demanded. It is of particular significance that these considerations are formulated and remain discernible as instances of ethical deliberation.
IAB PRESIDENTIAL ADDRESS: BIOETHICS IN A GLOBALIZED WORLD – CREATING SPACE FOR FLOURISHING HUMAN RELATIONSHIPS
Authors: BILLER‐ANDORNO NIKOLA
Published: September 2011

Bioethics in a globalized world is meeting a number of challenges – fundamentalism in its different forms, and a focus on economic growth neglecting issues such as equity and sustainability, being prominent among them. How well are we as bioethicists equipped to make meaningful contributions in these times? The paper identifies a number of restraints and proceeds to probe potential resources such as the capability approach, care ethics, cosmopolitanism, and pragmatism. These elements serve to outline a perspective that focuses on the preconditions for flourishing human relationships as a way to address bioethical challenges in a globalized world.
Egg donation for stem cell research: ideas of surplus and deficit in Australian IVF patients’ and reproductive donors’ accounts
Authors: Waldby Catherine , Carroll Katherine
Published: September 2011

We report on a study undertaken with an Australian in vitro fertilisation (IVF) clinic to understand IVF patients’ and reproductive donors’ perceptions of oocyte (egg) donation for stem cell research. Such perspectives are particularly valuable because IVF patients form a major recruitment group for oocyte donation for research, and because patients and donors have direct experience of the medical procedures involved. Similar studies of oocyte donation have been carried out elsewhere in the world, but to date very little social science research has been published that reports on donation for research, as distinct from donation for reproduction. Our respondents expressed a distinct unwillingness to donate viable oocytes for stem cell research. In our analysis we consider a number of factors that explain this unwillingness. These include the labour of oocyte production, the inscrutability of oocytes (the lack of a test to identify degrees of fertility) and the extent to which the oocytes’ fertility sets the parameters for all downstream reproductive possibilities. We draw on the science studies literature on affordances to make sense of the social intractability of oocytes, and compare them with the respondents’ much greater willingness to donate frozen embryos for human embryonic stem cells research.
Growth Optimal Investment Strategy: The Impact of Reallocation Frequency and Heavy Tails
Authors: Bamberg G. , Neuhierl A.
Published: September 2011

The strategy to maximize the long-term growth rate of final wealth (maximum expected log strategy, maximum geometric mean strategy, Kelly criterion) is based on probability theoretic underpinnings and has asymptotic optimality properties. This article reviews the allocation of wealth in a two-asset economy with one risky asset and a risk-free asset. It is also shown that the optimal fraction to be invested in the risky asset (i) depends on the length of the basic return period and (ii) is lower for heavy-tailed log returns than for light-tailed log returns.
Collapsing the Sacred and the Profane: Pan‐Sacramental & Panentheistic Possibilities in Aquinas and Their Implications for Spirituality
Authors: Gustafson Hans
Published: September 2011

The study of spirituality examines ‘lived religious experience’ in the cosmos. Drawing on Aquinas' Christology, the following article presents the cosmos as panentheistic and pan‐sacramental. Taking a cue from Thomas Merton's anthropology and Bede Griffiths' spirituality, various implications and challenges are examined.
Do generalists and specialists agree on descriptive acne morphology?
Authors: Yazdanyar S. , Bryld L.E. , Heidenheim M. , Jemec G.B.E.
Published: September 2011

Background  Acne is a common skin disease, which is treated by many different specialities. Clinical guidelines for treatment are based on the recognition of acne morphology. The assessment of acne morphology is therefore an important element of the proper diagnosis and treatment of acne.

Objective  To evaluate the level of congruence in the assessment of acne morphology in General Practitioners (GPs) and Dermatologists compared to the assessment of an expert.

Methods  The study was conducted during 2008–2009. Randomly selected GP and Dermatologists Practitioners, (DPs) from Denmark were invited to complete an on‐line questionnaire. The questionnaire was based on seven cases, each presented with digital photos and a short history. The respondents were asked to identify the morphology by marking their answer on a closed list. Congruence, variation and the participants’ assessment were compared with a priori expert assessment using odds ratios, Fishers exact test and Index of Qualitative Variation.

Results  Of the 1700 GPs and 110 DPs invited, 355 GPs and 99 DPs participated. In all seven cases, DPs were more in accordance with expert opinion than were GPs. In addition, the GPs had a greater variation in the distribution of answers.

Conclusion  GPs described acne morphology recognized clinical hallmarks of severity in acne less well than dermatologists and were far less consistent.
Glacial impacts on hydrologic processes in sedimentary basins: evidence from natural tracer studies
Authors: McINTOSH J. C. , SCHLEGEL M. E. , PERSON M.
Published: September 2011

This study reviews and synthesizes the results from geochemical and isotopic case studies across Europe, North America, Antarctica, and Greenland to evaluate the effects of Pleistocene glaciation on continental‐scale groundwater circulation in sedimentary basins. The most effective studies, in terms of delineating high‐resolution records of paleorecharge to aquifers, combine solute chemistry, stable isotopes of water, age tracers, and dissolved noble gases. Some of the lowest δ18O values (−22‰), and noble gas temperatures (0°C), and high excess air concentrations were found in confined groundwaters in northern Estonia, likely derived from Scandinavian Ice Sheet subglacial recharge. These results are consistent with groundwater systems in North America that were recharged beneath the Laurentide Ice Sheet. Late Pleistocene precipitation may have also been an important source of recharge, as indicated by low‐temperature, isotopically enriched groundwaters in several basins. Detectable age gaps have been observed in several aquifer systems in North America and Europe, likely caused by a hiatus of groundwater recharge in areas covered by permafrost during the Last Glacial Maximum (10–21 ka). Aquifers that were not covered by ice sheets or permafrost contain continuous records of Pleistocene to Holocene recharge with variable δ18O values and low paleotemperatures (4–9°C lower than today). The maximum depth of glacial meltwater penetration into sedimentary basins is approximately 50–1000 m. Infiltration of dilute meltwaters dissolved large quantities of halite in evaporite‐bearing basins. The presence of clay‐rich glacial deposits and bedrock confining units enhanced the storage of meltwaters within low‐permeability sediments and limited flushing of paleowaters in underlying aquifers. These results demonstrate the importance of continental glaciation as a driver for basinal‐scale fluid and solute transport and have implications for long‐term storage of radioactive waste and carbon dioxide at depth in high‐latitude sedimentary basins.
Stress‐induced temperature variations in groundwater of the Monferrato area (north‐western Italy)
Authors: DE GREGORIO S. , FEDERICO C. , CAPPUZZO S. , FAVARA R. , GIUDICE G. , GURRIERI S. , BOSCHI E.
Published: September 2011

Although characterized by low seismicity, the Monferrato area of north‐western Italy was affected by earthquakes, of magnitude M5.1 and M4.8, in 2000 and 2001. At the same time, marked changes were recorded in water temperature and chemistry in several wells within the epicentral area. In May 2004, an automatic network for the continuous monitoring of groundwater was installed in selected wells to study the phenomenon. Here, we report on data collected during a 3‐year period of groundwater monitoring. During the first year, episodes of water heating (by up to 20°C) were observed in one monitored well. The temporal analysis of the seismic activity recorded in the area revealed as almost all seismic events occurred during the period of elevated water temperatures. The similar timing of earthquakes and groundwater‐temperature anomalies suggests that both may be triggered by the same processes acting in the crust.
The influence of fundamental traits on mechanisms controlling appendage regeneration
Authors: Seifert Ashley W. , Monaghan James R. , Smith Matthew D. , Pasch Bret , Stier Adrian C. , Michonneau François , Maden Malcolm
Published: September 2011

One of the most compelling questions in evolutionary biology is why some animals can regenerate injured structures while others cannot. Appendage regeneration appears to be common when viewed across the metazoan phylogeny, yet this ability has been lost in many taxa to varying degrees. Within species, the capacity for regeneration also can vary ontogenetically among individuals. Here we argue that appendage regeneration along the secondary body axis may be constrained by fundamental traits such as body size, aging, life stage, and growth pattern. Studies of the molecular mechanisms affecting regeneration have been conducted primarily with small organisms at early life stages. Such investigations disregard the dramatic shifts in morphology and physiology that organisms undergo as they age, grow, and mature. To help explain interspecific and intraspecific constraints on regeneration, we link particular fundamental traits to specific molecular mechanisms that control regeneration. We present a new synthesis for how these fundamental traits may affect the molecular mechanisms of regeneration at the tissue, cellular, and genomic levels of biological organization. Future studies that explore regeneration in organisms across a broad phylogenetic scale, and within an ontogenetic framework, will help elucidate the proximate mechanisms that modulate regeneration and may reveal new biomedical applications for use in regenerative medicine.
Is New Zealand vegetation really ‘problematic’? Dansereau's puzzles revisited
Authors: Wilson J. Bastow , Lee William G.
Published: September 2011

Over four decades ago, Pierre Dansereau, the noted North American ecologist, proposed six features of New Zealand vegetation as being problematic or unusual in a global context. We examine his propositions in the light of current ecological knowledge to determine whether or not these can still be considered unusual characteristics of New Zealand vegetation.

(1) ‘Climatic change is still progressing’ resulting in disequilibrium between species' distributions and the present climate. New data and methods of analysis now available have removed the impression that Dansereau gained of imprecise zonation, unclear vegetation/climate relations and missing vegetation types. Communities cited as having regeneration failure can now be seen as even‐aged stands that developed after major disturbance, although there are other, also non‐climatic, explanations. However, the cause of the Westland ‘Nothofagus gap’ has become more, rather than less, controversial.

(2) ‘Continuity of community composition defies classification’ and ‘Very few New Zealand associations have faithful species' are correct observations, but perhaps equally true of vegetation elsewhere. Dansereau's assertion of low species richness in New Zealand is not supported by the comparative data available.

(3) ‘Lack of intolerant [i.e. mid‐seral] trees …’ is not evident with newer information. The order of species in succession, seen as unclear by Dansereau, has been determined by a range of approaches, largely confirming each other.

(4) ‘Discrepancies of form and function …’ in divaricate shrubs and widespread heteroblasty are still controversial, with many more explanations. Several abiotic explanations have failed to stand up to investigation. Explanations in terms of herbivory have been well supported, although the extinction of the large avian herbivores makes certainty impossible.

(5) ‘Incidence of hybridization …’ remains problematic. We do not know whether the incidence is unusually high, as Dansereau alleged, but the limited comparative data available suggest not.

(6) The ‘overwhelming … competing power of exotics' is strongly context dependent. They are prominent in many non‐forest habitats. It seems that they are drivers of the vegetation change in some habitats, yet passengers after disturbance in others. Invasions can be slow, and may still be very incomplete in some ecosystem types. Whether exotics will eventually take over in most communities, or whether the native species will ‘laugh them to scorn’ as Cockayne suggested, only time will tell.

In conclusion, some aspects of New Zealand's vegetation seem less unusual with increased knowledge, but others remain ‘problems’.
Electrodermal activity reliably captures physiological differences between wins and losses during gambling on electronic machines
Authors: Lole Lisa , Gonsalvez Craig J. , Blaszczynski Alex , Clarke Adam R.
Published: September 2011

Differential patterns of physiological arousal to win and loss events during gambling is central to psychological conceptualizations of gambling behaviors but is poorly researched. We recorded heart rate (HR) and skin conductance responses (SCRs) to wins and losses while 23 healthy participants played for small incentives on a simulated electronic gambling task. Wins produced largeSCRswhereas losses did not, and large wins produced largerSCRsthan small wins. Electrodermal measures also correlated with reward responsiveness on a personality measure and with ratings of excitement during gambling.HRevidenced a slight deceleration before event outcomes, and the reboundHRwas larger after wins than after losses. The study demonstrates that physiological changes to gambling events can be reliably captured, and that these changes are sensitive to differential outcomes. These findings establish a foundation for future research in field settings.
Engaging with, and understanding children whose parents have a dual diagnosis
Authors: Reupert Andrea , Goodyear Melinda , Maybery Darryl
Published: September 2011

Background:  The perspective of children whose parents have a mental health and a substance use disorder (dual diagnosis) are rarely considered in either research or clinical practice. This study sought to (i) identify the issues when engaging children whose parents have a dual diagnosis into research, and (ii) present their needs and preferred supports.

Method:  Semi‐structured, qualitative interviews were conducted with 12 children whose parent had a dual diagnosis. Analyses involved thematic analysis, inter‐rater reliability and respondent validation.

Results:  Building trust with parents was crucial to gain access to children. Children described the importance of family, the secrecy around their parent’s substance abuse, and various maladaptive coping strategies. Children requested more positive times in their families and specific support for their parent’s substance abuse.

Conclusion:  The primacy of family in the child’s life is highlighted. The need to acknowledge and work with the individual needs of children and parents, as well as family dynamics, is indicated.
Review: A systematic review of the impact of physical activity programmes on social and emotional well‐being in at‐risk youth
Authors: Lubans David R. , Plotnikoff Ron C. , Lubans Nicole J.
Published: September 2011

Background:  Physical activity programmes have been identified as a potential strategy for improving social and emotional well‐being in at‐risk youth, who have a prevalence of depression and low self‐esteem exceeding the general population.

Methods:  A systematic search of six electronic databases (EMBASE, OVID MEDLINE, PsychINFO, PubMed, Scopus and SPORTDiscus) was conducted to identify physical activity programmes designed to improve social and emotional well‐being in at‐risk youth.

Results:  The search identified 15 studies, which reported the effects of three types of physical activity programmes (i.e. outdoor adventure, sport and skill‐based and physical fitness programmes) on social and emotional well‐being. While many of the interventions resulted in significant positive effects, the risk of bias was high in all of the included studies.

Conclusion:  Due to the mixed findings and the high risk of bias, it is difficult to determine the efficacy of physical activity programmes for improving social and emotional well being in at‐risk youth.