bluuebunny/crossref_metadata_2025 huggingface dataset:
Acknowledging illness and treatment needs in first-time admitted psychiatric patients
Authors: Sorgaard K.W. , Nivison M. , Hansen V. , Øiesvold T.
Published: May 2011

Purpose

Help-seeking and service utilization depends on the patients’ interpretation of their illness and treatment needs. Worry, denial of illness, need for treatment and need for hospitalization in first-time admitted patients was studied.

Subjects

New patients in two mental hospitals were consecutively recruited. Three hundred and thirty-four satisfied the inclusion criteria and 251 gave informed consent. One hundred and ninety-six had complete datasets (56% of those eligible).

Methods

Demography was recorded with the Minimal Basic Dataset by Ruud et al. (1993) [45]. Experiences of hospitalisation were measured with the Patient's Experience of Hospitalisation Questionnaire by Carskey et al. (1992) [9]. MINI was used for diagnosing and SCL-90-R by Derogatis (1997) [13] for subjective symptoms. Standard multiple regressions were performed with the PEH subscales (Denial, Worry, Need for treatment and Need for hospitalisation) as dependents and demography, diagnosis and SCL-90-R subscales as explanatory variables.

Results

(a) Psychoticism and the diagnosis of schizophrenia were associated with little worrying, denial of illness, of treatment needs and of need for hospitalisation. (b) Anxiety and affective disorders were related to worries, acknowledgement of illness, need for treatment and for hospitalisation.

Conclusions

In contrast to patients with mainly anxiety and affective disorders, psychotic patient tended to deny illness-related worries, that they had an illness and that they needed treatment and hospitalisation. An affective disorder together with suicidal thoughts (not attempts) was a strong drive towards hospital admission.
Comparative exposure to antipsychotic medications in immigrant and native-born populations of a Spanish health region
Authors: Cruz I. , Serna C. , Rué M. , Real J. , Galván L. , Pifarré J.
Published: May 2011

Background

Raised rates of psychoses among ethnic minorities have been reported. Exposure to antipsychotic medications can give information on mental illness management and ethnic-related differences.

Objective

To compare exposure to antipsychotic medications in immigrant and native-born populations in Spain.

Method

Descriptive cross-sectional study of the dispensation of antipsychotic medications to the population aged 15 to 64 years, in a Spanish Health Region during 2008.

Results

1.9% of the native-born population was exposed to antipsychotic medications as compared to 0.4% of the immigrant population. Native-born women were exposed from 1.8 to 5.3 times more and native-born men from 3.6 to 6.3 times more than immigrants of the same gender. The least exposed were persons from Eastern Europe and men from sub-Saharan Africa. Active ingredients prescribed were similar between the two groups. Of the immigrant group, 15.7% were admitted to a psychiatric ward as compared to 6.4% of the native-born population. In the former, non-specific diagnoses were predominant.

Conclusions

All immigrant groups had lower exposure to antipsychotic medications, were admitted to inpatient care more often and had less specific diagnoses. Both diagnostic processes and adherence to treatment need improvement in the regional immigrant population.
Type-2 diabetes mellitus in schizophrenia: Increased prevalence and major risk factor of excess mortality in a naturalistic 7-year follow-up
Authors: Schoepf D. , Potluri R. , Uppal H. , Natalwala A. , Narendran P. , Heun R.
Published: May 2011

Objective

Physical co-morbidity including type 2 diabetes mellitus is more prevalent in patients with schizophrenia compared to the general population. However, there is little consistent evidence that co-morbidity with diabetes mellitus and/or other diseases leads to excess mortality in schizophrenia. Thus, we investigated whether co-morbidity with diabetes and other somatic diseases is increased in schizophrenics, and if these are equally or more relevant predictors of mortality in schizophrenia than in age- and gender-matched hospitalised controls.

Methods

During 2000–2007, 679 patients with schizophrenia were admitted to University Hospital Birmingham NHS Trust. Co-morbidities were compared with 88,778 age- and gender group-matched hospital controls. Predictors of mortality were identified using forward Cox regression models.

Results

The prevalence of type 2 diabetes mellitus was increased in schizophrenia compared to hospitalised controls (11.3% versus 6.3%). The initial prevalence of type 2 diabetes mellitus was significantly higher in the 100 later deceased schizophrenic patients (24.0%) than in those 579 surviving over 7 years (9.2%). Predictors of mortality in schizophrenia were found to be age (relative risk [RR] = 1.1/year), type 2 diabetes mellitus (RR = 2.2), pneumonia (RR = 2.7), heart failure (RR = 2.9) and chronic renal failure (RR = 3.2). The impact of diabetes mellitus on mortality was significantly higher in schizophrenia than in hospital controls (RR = 2.2 versus RR = 1.1). In agreement, deceased schizophrenics had significantly suffered more diabetes mellitus than deceased controls (24.0 versus 10.5%). The relative risks of mortality for other disorders and their prevalence in later deceased subjects did not significantly differ between schizophrenia and controls.

Conclusion

Schizophrenics have more and additionally suffer more from diabetes: co-morbidity with diabetes mellitus is increased in schizophrenia in comparison with hospital controls; type 2 diabetes mellitus causes significant excess mortality in schizophrenia. Thus, monitoring for and prevention of type 2 diabetes mellitus is of utmost relevance in hospitalised patients with schizophrenia.
Association between flashbacks and structural brain abnormalities in posttraumatic stress disorder
Authors: Kroes M.C.W. , Whalley M.G. , Rugg M.D. , Brewin C.R.
Published: May 2011

Objective

Posttraumatic stress disorder (PTSD) is reliably associated with reduced brain volume relative to healthy controls, in areas similar to those found in depression. We investigated whether in a PTSD sample brain volumes in these areas were related to reporting specific symptoms of PTSD or to overall symptom severity.

Method

Structural MRI scans were obtained from 28 participants diagnosed with PTSD according to DSM-IV-TR. Participants reported the extent of individual PTSD symptoms using the Posttraumatic Diagnostic Scale. Voxel-based morphometry applying the Dartel algorithm implemented within SPM5 was used to identify volumetric changes, related to PTSD total, symptom cluster, and individual symptom scores.

Results

Brain volume was unrelated to overall PTSD severity, but greater reexperiencing scores predicted reduced volumes in the middle temporal and inferior occipital cortices. Increased reports of flashbacks predicted reduced volume in the insula/parietal operculum and in the inferior temporal gyrus.

Conclusion

The data illustrate the value of analyses at the symptom level within a patient population to supplement group comparisons of patients and healthy controls. Areas identified were consistent with a neurobiological account of flashbacks implicating specific abnormalities in the ventral visual stream.
Polycomb proteins in mammalian cell differentiation and plasticity
Authors: Prezioso Carolina , Orlando Valerio
Published: May 2011

During development cell differentiation is accompanied by progressive restriction of the developmental potential and increased structural and functional specialization of cells. In this context, mechanisms of cell memory guarantee that cells maintain different identities previously determined by the integrated action of signalling and specific sets of transcription factors. Unraveling the molecular basis by which cells build and maintain their memory represents one of the most fascinating problems in biology. PcG proteins were originally identified as part of an epigenetic cellular memory system that controls gene silencing via chromatin structure. However, recent reports suggest that they are also involved in controlling dynamics and plasticity of gene regulation, particularly during differentiation, by interacting with other components of the transcriptional apparatus. In this review, we discuss the role of PcG proteins in pluripotent ES cells and in well known mammalian cell differentiation systems including skeletal muscle, epidermal, neuronal differentiation. The emerging picture suggests that indeed, plasticity and not rigidity is a fundamental aspect of PcG physiology and cell memory function.
MicroRNAs in rheumatoid arthritis
Authors: Ceribelli Angela , Nahid Md A. , Satoh Minoru , Chan Edward K.L.
Published: May 2011

Rheumatoid arthritis (RA) is a chronic and severe autoimmune disease that affects joint tissues, bone, and cartilage. However, the pathogenesis of RA is still unclear. Autoantibodies such as rheumatoid factor and anti‐cyclic citrullinated peptide are useful tools for early diagnosis, monitoring disease activity, and predicting prognosis. Recently, many groups have focused their attention on the role of microRNAs in the pathogenesis of RA, as well as a potential biomarker to monitor RA. In fact, the expression of some microRNAs, such as miR‐146a, is upregulated in different cell types and tissues in RA patients. MicroRNAs in RA could also be considered as possible future targets for new therapeutic approaches.
Umbilical cord‐cutting practices and place of delivery in Bangladesh
Authors: Andrews Johanna Y. , Dalal Koustuv
Published: May 2011

Objective

To investigate place of delivery, umbilical cord‐cutting instruments used, and substances applied to the cord stump in Bangladesh.

Methods

A cross‐sectional data analysis was performed on a nationally representative sample of 4925 women of reproductive age (15–49 years) with at least 1 child.

Results

More than 80% of women delivered at home. In 6% of cases, blades from a clean‐delivery kit (CDK) were used to cut the cord; in 90% of cases, the blades used were from another source; in 4% of cases, other instruments such as bamboo strips and scissors were used to cut the cord. In 51% of cases, a substance (e.g. antibiotic powder/ointment, alcohol/spirit, mustard oil with garlic, boric powder, turmeric, and chewed rice) was applied to the stump after the cord was cut.

Conclusion

The present findings underscore the need for further advocacy, availability, and use of cord‐cutting instruments from CDKs, especially for deliveries that occur outside healthcare facilities.
Perspectives of Chinese healthcare providers on medical abortion
Authors: Gan Kang , Zhang Yuhan , Jiang Xiaomei , Meng Yucui , Hou Liyan , Cheng Yimin
Published: May 2011

Objective

To evaluate Chinese healthcare providers’ knowledge regarding medical abortion, to understand provider preferences for abortion methods, and to investigate the role of remuneration on providers’ decision making.

Methods

Between November 2009 and May 2010, 658 abortion service providers from family‐planning service centers and hospitals in Shenzhen and Henan, China, were surveyed via self‐administered questionnaires.

Results

The knowledge score (out of a maximum of 32) regarding medical abortion was 16–20 for 60.9% of the providers; 20.4% of the providers preferred medical abortion to surgical abortion, whereas 35.0% preferred surgical abortion. Overall, 72.2% of providers stated that they did not receive any commission for providing medical abortion or surgical abortion.

Conclusion

Most healthcare providers believed that surgical abortion was preferable to medical abortion. Efforts should be made to overcome the perceived disadvantages of medical abortion.
Efficacy of peripartum antiviral treatment for hepatic failure due to hepatitis B virus
Authors: Yu Minmin , Ji Ying , Jiang Hongxiu , Ju Lili , Wu Kaihua , Kan Naiying
Published: May 2011

Objective

To investigate the efficacy of oral nucleosides in preventing hepatic failure during pregnancy (HFP) caused by hepatitis B virus (HBV) infection.

Methods

Besides receiving standard treatment, 70 women with HFP caused by HBV infection joined a study group (n = 40) or a control group (n = 30) according to their preference. In the study group, 14 women were given lamivudine in the third trimester and an antiviral treatment was continued postpartum. The 26 remaining patients were treated postpartum only, with lamivudine (n = 16) or entecavir (n = 10).

Results

In the study group, the values for serum HBV DNA and hepatitis B envelope antigen were markedly lower at 1 and 2 months than they were at baseline (P < 0.001 and P < 0.001, respectively). Moreover, the HBV DNA values at 1 and 2 months were significantly lower in the study than in the control group (P < 0.05). Overall mortality and incidence of intrauterine infection were also significantly lower in the study group (P < 0.05). No newborns had any apparent abnormalities in either group.

Conclusion

Treatment with nucleosides suppressed the replication of HBV DNA and led to biochemical improvement. It also reduced maternal mortality and safely decreased mother‐to‐child HBV transmission.
Development of a Novel Automated Cell Isolation, Expansion, and Characterization Platform
Authors: Franscini Nicola , Wuertz Karin , Patocchi-Tenzer Isabel , Durner Roland , Boos Norbert , Graf-Hausner Ursula
Published: May 2011

Implementation of regenerative medicine in the clinical setting requires not only biological inventions, but also the development of reproducible and safe method for cell isolation and expansion. As the currently used manual techniques do not fulfill these requirements, there is a clear need to develop an adequate robotic platform for automated, large-scale production of cells or cell-based products. Here, we demonstrate an automated liquid-handling cell-culture platform that can be used to isolate, expand, and characterize human primary cells (e.g., from intervertebral disc tissue) with results that are comparable to the manual procedure. Specifically, no differences could be observed for cell yield, viability, aggregation rate, growth rate, and phenotype. Importantly, all steps-from the enzymatic isolation of cells through the biopsy to the final quality control-can be performed completely by the automated system because of novel tools that were incorporated into the platform. This automated cell-culture platform can therefore replace entirely manual processes in areas that require high throughput while maintaining stability and safety, such as clinical or industrial settings.
Executive function and instrumental activities of daily living in mild cognitive impairment and Alzheimer's disease
Authors: Marshall Gad A. , Rentz Dorene M. , Frey Meghan T. , Locascio Joseph J. , Johnson Keith A. , Sperling Reisa A. ,   Alzheimer's Disease Neuroimaging Initiative
Published: May 2011

Background

Impairment in instrumental activities of daily living (IADL) leads to early loss in productivity and adds significant burden to caregivers. Executive dysfunction is thought to be an important contributor to functional impairment. The objective of this study was to investigate the relationship between executive function and IADL in a large cohort of well‐characterized normal older controls, mild cognitive impairment (MCI), and patients with mild Alzheimer's disease, separately as well as across the entire sample, while accounting for demographic, cognitive, and behavioral factors.

Methods

Subjects with baseline clinical datasets (n = 793) from the Alzheimer's Disease Neuroimaging Initiative study (228 normal older controls, 387 MCI, 178 Alzheimer's disease) were included in the analysis. A multiple regression model was used to assess the relationship between executive function and IADL.

Results

A multiple regression model, including diagnosis, global cognitive impairment, memory performance, and other covariates demonstrated a significant relationship between executive dysfunction and IADL impairment across all subjects (R2 = .60, P < .0001 for model; Digit Symbol, partial ß = −.044, P = .005; Trailmaking Test B–A, quadratic relation, P = .01). Similarly, an analysis using MCI subjects only yielded a significant relationship (R2 = .16, P < .0001 for model; Digit Symbol, partial ß = −.08, P = .001).

Conclusions

These results suggest that executive dysfunction is a key contributor to impairment in IADL. This relationship was evident even after accounting for degree of memory deficit across the continuum of cognitive impairment and dementia.
Assessment of cognition in mild cognitive impairment: A comparative study
Authors: Snyder Peter J. , Jackson Colleen E. , Petersen Ronald C. , Khachaturian Ara S. , Kaye Jeffrey , Albert Marilyn S. , Weintraub Sandra
Published: May 2011

The demand for rapidly administered, sensitive, and reliable cognitive assessments that are specifically designed for identifying individuals in the earliest stages of cognitive decline (and to measure subtle change over time) has escalated as the emphasis in Alzheimer's disease clinical research has shifted from clinical diagnosis and treatment toward the goal of developing presymptomatic neuroprotective therapies. To meet these changing clinical requirements, cognitive measures or tailored batteries of tests must be validated and determined to be fit‐for‐use for the discrimination between cognitively healthy individuals and persons who are experiencing very subtle cognitive changes that likely signal the emergence of early mild cognitive impairment. We sought to collect and review data systematically from a wide variety of (mostly computer‐administered) cognitive measures, all of which are currently marketed or distributed with the claims that these instruments are sensitive and reliable for the early identification of disease or, if untested for this purpose, are promising tools based on other variables. The survey responses for 16 measures/batteries are presented in brief in this review; full survey responses and summary tables are archived and publicly available on the Campaign to Prevent Alzheimer's Disease by 2020 Web site (http://pad2020.org). A decision tree diagram highlighting critical decision points for selecting measures to meet varying clinical trials requirements has also been provided. Ultimately, the survey questionnaire, framework, and decision guidelines provided in this review should remain as useful aids for the evaluation of any new or updated sets of instruments in the years to come.
Prevalence of Bartonella species, haemoplasmas and Toxoplasma gondii in cats in Scotland
Authors: Bennett Alexander D. , Gunn-Moore Danielle A. , Brewer Melissa , Lappin Michael R.
Published: May 2011

The objective of this study was to determine the prevalence rates for select infectious agents of cats presented to the Royal (Dick) School of Veterinary Studies at the University of Edinburgh, Scotland. Whole blood, serum, and oral mucosal and nail bed swabs were collected. While Ehrlichia species, Anaplasma species or Rickettsia felis DNA were not amplified from any cat, 44.2% of the cats had evidence of infection or exposure to either a Bartonella species (15.3% were seropositive and 5.8% polymerase chain reaction (PCR) positive), a haemoplasma (28.6% PCR positive), and/or Toxoplasma gondii (19.2% seropositive). No Bartonella species DNA was amplified from the nail or oral mucosal swabs despite a 5.8% amplification rate from the blood samples. This finding likely reflects the absence of Ctenocephalides felis infection from our study population, as this organism is a key component for Bartonella species translocation in cats. The results from this study support the use of flea control products to lessen exposure of cats (and people) to Bartonella species and support discouraging the feeding of raw meat to cats and preventing them from hunting to lessen T gondii infection.
Suspected epidural morphine analgesia induced chronic urinary and bowel dysfunction in a cat
Authors: Song Rachel B. , Cross Johnny R. , Golder Francis J. , Callan Mary Beth
Published: May 2011

A 12-year-old male castrated domestic shorthair developed chronic urinary retention, constipation and a decreased perineal reflex following a single lumbo-sacral epidural injection of morphine during general anesthesia. Similar adverse effects have been reported in humans following epidural analgesia, but this is the first reported case of both urinary and bowel dysfunction in a cat purportedly from an epidural. The cat was medically managed with manual bladder expressions, intermittent enemas, and various medications including bethanechol, cisapride and stool softeners. The cat continues to have long-term neurologic dysfunction 15 months post-onset. This case report describes a rare but serious potential risk of lumbo-sacral epidural injections in cats.
Importance of sampling across an assemblage of glacial landforms for interpreting cosmogenic ages of deglaciation
Authors: Stroeven Arjen P. , Fabel Derek , Harbor Jonathan M. , Fink David , Caffee Marc W. , Dahlgren Torbjørn
Published: May 2011

Deglaciation chronologies for some sectors of former ice sheets are relatively poorly constrained because of the paucity of features or materials traditionally used to constrain the timing of deglaciation. In areas without good deglaciation varve chronologies and/or without widespread occurrence of material that indicates the start of earliest organic radiocarbon accumulations suitable for radiocarbon dating, typically only general patterns and chronologies of deglaciation have been deduced. However, mid-latitude ice sheets that had warm-based conditions close to their margins often produced distinctive deglaciation landform assemblages, including eskers, deltas, meltwater channels and aligned lineation systems. Because these features were formed or significantly altered during the last glaciation, boulder or bedrock samples from them have the potential to yield reliable deglaciation ages using terrestrial cosmogenic nuclides (TCN) for exposure age dating. Here we present the results of a methodological study designed to examine the consistency of TCN-based deglaciation ages from a range of deglaciation landforms at a site in northern Norway. The strong coherence between exposure ages across several landforms indicates great potential for using TCN techniques on features such as eskers, deltas and meltwater channels to enhance the temporal resolution of ice-sheet deglaciation chronologies over a range of spatial scales.
Generation of initial closed flux surfaces by ECH at a conventional aspect ratio of R/a ∼ 3: experiments on the LATE device and JT-60U tokamak
Authors: Uchida M. , Maekawa T. , Tanaka H. , Ide S. , Takase Y. , Watanabe F. , Nishi S.
Published: May 2011

Generation of initial closed flux surfaces by electron cyclotron heating (ECH) at a conventional aspect ratio of R/a ∼ 3 is investigated on the Low Aspect ratio Torus Experiment (LATE) device and further tested on the Japan Atomic Energy Research Institute Tokamak-60 Upgrade (JT-60U) tokamak. In both experiments, a plasma current is initiated and increased by ECH under steady external fields composed of a toroidal field and a weak vertical field. In the LATE experiments, a movable inboard limiter is used to change the aspect ratio of plasmas up to R/a ∼ 3. The results show that the formation of closed flux surfaces is still possible up to R/a ∼ 3 while higher decay indices of vertical field are required as the aspect ratio increases. Similar current start-up discharges are performed on JT-60U, and a plasma current is initiated and increased up to 20 kA under a vertical field having a high decay index.
High-β plasma formation and observation of peaked density profile in RT-1
Authors: Saitoh H. , Yoshida Z. , Morikawa J. , Yano Y. , Mizushima T. , Ogawa Y. , Furukawa M. , Kawai Y. , Harima K. , Kawazura Y. , Kaneko Y. , Tadachi K. , Emoto S. , Kobayashi M. , Sugiura T. , Vogel G.
Published: May 2011

High-β ECH plasma is generated and stably sustained in a magnetospheric configuration, the Ring Trap 1 (RT-1) device, generated by a levitated dipole field magnet. Geomagnetic-field compensation and optimized operation have realized drastic improvements in plasma properties. The maximum local β value has reached 70% and the pressure profiles have a rather steep gradient near the superconducting magnet. Electrons of the high-β plasma typically consist of 70% hot (∼50 keV) and the rest of cold populations. Confinement time of the hot component plasma is 0.5 s with the optimized neutral gas pressure. By removing the coil support structure, the peaked density profile is observed in the strong field region.
The measurement of dissolved and gaseous carbon dioxide concentration
Authors: Zosel J , Oelßner W , Decker M , Gerlach G , Guth U
Published: May 2011

In this review the basic principles of carbon dioxide sensors and their manifold applications in environmental control, biotechnology, biology, medicine and food industry are reported. Electrochemical CO2sensors based on the Severinghaus principle and solid electrolyte sensors operating at high temperatures have been manufactured and widely applied already for a long time. Besides these, nowadays infrared, non-dispersive infrared and acoustic CO2sensors, which use physical measuring methods, are being increasingly used in some fields of application. The advantages and drawbacks of the different sensor technologies are outlined. Electrochemical sensors for the CO2measurement in aqueous media are pointed out in more detail because of their simple setup and the resulting low costs. A detailed knowledge of the basic detection principles and the windows for their applications is necessary to find an appropriate decision on the technology to be applied for measuring dissolved CO2. In particular the pH value and the composition of the analyte matrix exert important influence on the results of the measurements.
A rapid, inexpensive yeast-based dual-fluorescence assay of programmed—1 ribosomal frameshifting for high-throughput screening
Authors: Rakauskaitė Rasa , Liao Pei-Yu , Rhodin Michael H. J. , Lee Kelvin , Dinman Jonathan D.
Published: May 2011

Programmed −1 ribosomal frameshifting (−1 PRF) is a mechanism that directs elongating ribosomes to shift-reading frame by 1 base in the 5′ direction that is utilized by many RNA viruses. Importantly, rates of −1 PRF are fine-tuned by viruses, including Retroviruses, Coronaviruses, Flavivriuses and in two endogenous viruses of the yeast Saccharomyces cerevisiae, to deliver the correct ratios of different viral proteins for efficient replication. Thus, −1 PRF presents a novel target for antiviral therapeutics. The underlying molecular mechanism of −1 PRF is conserved from yeast to mammals, enabling yeast to be used as a logical platform for high-throughput screens. Our understanding of the strengths and pitfalls of assays to monitor −1 PRF have evolved since the initial discovery of −1 PRF. These include controlling for the effects of drugs on protein expression and mRNA stability, as well as minimizing costs and the requirement for multiple processing steps. Here we describe the development of an automated yeast-based dual fluorescence assay of −1 PRF that provides a rapid, inexpensive automated pipeline to screen for compounds that alter rates of −1 PRF which will help to pave the way toward the discovery and development of novel antiviral therapeutics.
Nonselective and NR2B-selective N -methyl-d-aspartic Acid Receptor Antagonists Produce Antinociception and Long-term Relief of Allodynia in Acute and Neuropathic Pain
Authors: Swartjes Maarten , Morariu Aurora , Niesters Marieke , Aarts Leon , Dahan Albert
Published: May 2011

Background

At low dose, the nonselective N-methyl-D-aspartate receptor antagonist ketamine produces potent analgesia. In humans, psychedelic side effects limit its use. To assess whether other N-methyl-D-aspartate receptor antagonist have an improved therapeutic utility index, we compared antinociceptive, side effect, and locomotor activity of three N-methyl-D-aspartate receptor antagonists.

Methods

Ketamine, its active metabolite norketamine, and the NR2B-selective antagonist traxoprodil (CP-101,606) were tested in rat models of acute antinociception (paw-withdrawal response to heat) and chronic neuropathic pain (spared nerve injury). Side effects (stereotypical behavior, activity level) were scored and locomotor function of the nerve-injured paw was assessed using computerized gait analysis. In the chronic pain model, treatment was given 7 days after surgery, for 3 h on 5 consecutive days.

Results

All three N-methyl-D-aspartate receptor antagonists caused dose-dependent antinociception in the acute pain model and relief of mechanical and cold allodynia for 3-6 weeks after treatment in the chronic pain model (P < 0.05 vs. saline). In both tests, ketamine was most potent. Norketamine was as much as two times less potent and traxoprodil was up to 8 times less potent than ketamine (based on area under the curve measures). Nerve injury caused an inability to use the affected paw that either did not improve after treatment (ketamine, traxoprodil) or showed only a limited effect (norketamine). Traxoprodil, but not ketamine or norketamine, showed clear separation between effect and side effect.

Conclusions

The observation that traxoprodil causes relief of chronic pain outlasting the treatment period with no side effects makes it an attractive alternative to ketamine in the treatment of chronic neuropathic pain.
Consequences of Succinylcholine Administration to Patients Using Statins
Authors: Turan Alparslan , Mendoza Maria L. , Gupta Shipra , You Jing , Gottlieb Alexandru , Chu Weihan , Saager Leif , Sessler Daniel I.
Published: May 2011

Background

Statins cause structural changes in myocytes and provoke myotoxicity, myopathy, and myalgias. Thus, patients taking statins may be especially susceptible to succinylcholine-induced muscle injury. The authors tested the hypothesis that succinylcholine increases plasma concentrations of myoglobin, potassium, and creatine kinase more in patients who take statins than in those who do not and that succinylcholine-induced postoperative muscle pain is aggravated in statin users.

Methods

Patients who took statins for at least 3 months and those who had never used statins were enrolled. General anesthesia was induced and included 1.5 mg/kg succinylcholine for intubation. The incidence and degree of fasciculation after succinylcholine administration were recorded. Blood samples were obtained before induction and 5 and 20 min and 24 h after succinylcholine administration. Patients were interviewed 2 and 24 h after surgery to determine the degree of myalgia.

Results

The authors enrolled 38 patients who used statins and 32 who did not. At 20 min, myoglobin was higher in statin users versus nonusers (ratio of medians 1.34 [95% CI: 1.1, 1.7], P = 0.018). Fasciculations in statin users were more intense than in nonusers (P = 0.047). However, plasma potassium and creatine kinase concentrations were similar in statin users and nonusers, as was muscle pain.

Conclusions

The plasma myoglobin concentration at 20 min was significantly greater in statin users than nonusers, although the difference seems unlikely to be clinically important. The study results suggest that the effect of succinylcholine given to patients taking statins is likely to be small and probably of limited clinical consequence.
Changing Healthcare Providers' Behavior during Pediatric Inductions with an Empirically Based Intervention
Authors: Martin Sarah R. , Chorney Jill MacLaren , Tan Edwin T. , Fortier Michelle A. , Blount Ronald L. , Wald Samuel H. , Shapiro Nina L. , Strom Suzanne L. , Patel Swati , Kain Zeev N.
Published: May 2011

Background

Each year more than 4 million children experience significant levels of preoperative anxiety, which has been linked to poor recovery outcomes. Healthcare providers (HCPs) and parents represent key resources for children to help them manage their preoperative anxiety. The current study reports on the development and preliminary feasibility testing of a new intervention designed to change HCP and parent perioperative behaviors that have been reported previously to be associated with children's coping and stress behaviors before surgery.

Methods

An empirically derived intervention, Provider-Tailored Intervention for Perioperative Stress, was developed to train HCPs to increase behaviors that promote children's coping and decrease behaviors that may exacerbate children's distress. Rates of HCP behaviors were coded and compared between preintervention and postintervention. In addition, rates of parents' behaviors were compared between those that interacted with HCPs before training to those interacting with HCPs after the intervention.

Results

Effect sizes indicated that HCPs who underwent training demonstrated increases in rates of desired behaviors (range: 0.22-1.49) and decreases in rates of undesired behaviors (range: 0.15-2.15). In addition, parents, who were indirectly trained, also demonstrated changes to their rates of desired (range: 0.30-0.60) and undesired behaviors (range: 0.16-0.61).

Conclusions

The intervention successfully modified HCP and parent behaviors. It represents a potentially new clinical way to decrease anxiety in children. A multisite randomized control trial funded by the National Institute of Child Health and Development will examine the efficacy of this intervention in reducing children's preoperative anxiety and improving children's postoperative recovery.
Neuromuscular Disorders in Critically Ill Patients: Review and Update
Authors: Lacomis David
Published: May 2011

Neuromuscular disorders that are diagnosed in the intensive care unit (ICU) usually cause substantial limb weakness and contribute to ventilatory dysfunction. Although some lead to ICU admission, ICU-acquired disorders, mainly critical illness myopathy (CIM) and critical illness polyneuropathy (CIP), are more frequent and are associated with considerable morbidity. Approximately 25% to 45% of patients admitted to the ICU develop CIM, CIP, or both. Their clinical features often overlap; therefore, nerve conduction studies and electromyography are particularly helpful diagnostically, and more sophisticated electrodiagnostic studies and histopathologic evaluation are required in some circumstances. A number of prospective studies have identified risk factors for CIP and CIM, but their limitations often include the inability to separate CIM from CIP. Animal models reveal evidence of a channelopathy in both CIM and CIP, and human studies also identified axonal degeneration in CIP and myosin loss in CIM. Outcomes are variable. They tend to be better with CIM, and some patients have longstanding disabilities. Future studies of well-characterized patients with CIP and CIM should refine our understanding of risk factors, outcomes, and pathogenic mechanisms, leading to better interventions.
Guillain-Barré Syndrome After a Jellyfish Sting
Authors: Devere Ronald
Published: May 2011

This is the case of a jellyfish sting associated with the rare development of Guillain-Barré syndrome. The patient, a 66-year-old woman, was stung by a jellyfish on the right thigh while swimming in the Atlantic Ocean, off Charleston, SC. Ten days later, she developed low back and right thigh pain followed by progressive numbness and weakness in all extremities. These symptoms reached their peak in 30 days and slowly began to improve. Initial neurologic examination showed areflexia, weakness, absent vibration and position sense, and hyperesthesia to pin and light touch in the mid to distal region of all four extremities. Serial electromyography and nerve conductions were consistent with an improving predominantly demyelinating polyneuropathy. Spinal fluid analysis showed no cells, elevated protein (108), gammaglobulin 6 (normal less than 5.4), and immunoglobulin G 8.2 (normal less than 6). The only treatment was gabapentin for neuropathy pain. The patient made an excellent recovery in less than 1 year with minimal residual numbness in both thumbs, index fingers, and middle toes.
Metabolic Syndrome in Small Fiber Sensory Neuropathy
Authors: Zhou Lan , Li Jianbo , Ontaneda Daniel , Sperling Joshua
Published: May 2011

Objectives:

To determine the prevalence and risk of metabolic syndrome in patients with small fiber sensory neuropathy (SFSN).

Methods:

We searched our skin biopsy database and identified 194 subjects for this retrospective study. Of these 194 subjects, 43 had normal skin biopsies and 151 had mild, moderate, or severe length-dependent SFSN with no large fiber involvement. Fifty-four subjects had diabetic or prediabetic SFSN and 97 had idiopathic SFSN.

Results:

The mean age of the neuropathy group was older (54.1 ± 11.9 years) than the normal biopsy group (44.8 ± 13.0, P < 0.001). The prevalence of metabolic syndrome was higher in the neuropathy group (27.8%) than in the normal biopsy group (2.3%, P < 0.001). Age was not different among three neuropathy subgroups. The prevalence of metabolic syndrome was higher in the severe (38.1%) than in the moderate (26.0%) and mild (14.7%) neuropathy groups (P = 0.04). Multivariate analysis revealed that age (odds ratio [OR], 1.95; P < 0.001), metabolic syndrome (OR, 3.20; P < 0.001), hypertension (OR, 1.88; P = 0.04), and obesity (OR, 1.93; P = 0.004) were independent risk factors for SFSN.

Conclusions:

The prevalence of metabolic syndrome is increased in patients with SFSN and it correlates with the severity of SFSN. Metabolic syndrome may represent an independent risk factor for SFSN.
Effects of flow and colony morphology on the thermal boundary layer of corals
Authors: Jimenez Isabel M. , Kühl Michael , Larkum Anthony W. D. , Ralph Peter J.
Published: May 2011

The thermal microenvironment of corals and the thermal effects of changing flow and radiation are critical to understanding heat-induced coral bleaching, a stress response resulting from the destruction of the symbiosis between corals and their photosynthetic microalgae. Temperature microsensor measurements at the surface of illuminated stony corals with uneven surface topography (Leptastrea purpureaandPlatygyra sinensis) revealed millimetre-scale variations in surface temperature and thermal boundary layer (TBL) that may help understand the patchy nature of coral bleaching within single colonies. The effect of water flow on the thermal microenvironment was investigated in hemispherical and branching corals (Porites lobataandStylophora pistillata, respectively) in a flow chamber experiment. For both coral types, the thickness of the TBL decreased exponentially from 2.5 mm at quasi-stagnant flow (0.3 cm s−1), to 1 mm at 5 cm s−1, with an exponent approximately 0.5 consistent with predictions from the heat transfer theory for simple geometrical objects and typical of laminar boundary layer processes. Measurements of mass transfer across the diffusive boundary layer using O2microelectrodes revealed a greater exponent for mass transfer when compared with heat transfer, indicating that heat and mass transfer at the surface of corals are not exactly analogous processes.
Description of Anaerobaculum hydrogeniformans sp. nov., an anaerobe that produces hydrogen from glucose, and emended description of the genus Anaerobaculum
Authors: Maune Matthew W. , Tanner Ralph S.
Published: May 2011

A novel anaerobic, moderately thermophilic, NaCl-requiring fermentative bacterium, strain OS1T, was isolated from oil production water collected from Alaska, USA. Cells were Gram-negative, non-motile, non-spore-forming rods (1.7–2.7 × 0.4–0.5 µm). The G+C content of the genomic DNA of strain OS1Twas 46.6 mol%. The optimum temperature, pH and NaCl concentration for growth of strain OS1Twere 55 °C, pH 7 and 10 g l−1, respectively. The bacterium fermentedd-fructose,d-glucose, maltose,d-mannose, α-ketoglutarate,l-glutamate, malonate, pyruvate,l-tartrate,l-asparagine, Casamino acids,l-cysteine,l-histidine,l-leucine,l-phenylalanine,l-serine,l-threonine,l-valine, inositol, inulin, tryptone and yeast extract. When grown ond-glucose, 3.86 mol hydrogen and 1.4 mol acetate were produced per mol substrate. Thiosulfate, sulfur andl-cystine were reduced to sulfide, and crotonate was reduced to butyrate with glucose as the electron donor. 16S rRNA gene sequence analysis indicated that strain OS1Twas related toAnaerobaculum thermoterrenum(99.7 % similarity to the type strain), a member of the phylumSynergistetes. DNA–DNA hybridization between strain OS1TandA. thermoterrenumDSM 13490Tyielded 68 % relatedness. UnlikeA. thermoterrenum, strain OS1Tfermented malonate, maltose, tryptone,l-leucine andl-phenylalanine, but not citrate, fumarate, lactate,l-malate, glycerol, pectin or starch. The major cellular fatty acid of strain OS1Twas iso-C15 : 0(91 % of the total). Strain OS1Talso contained iso-C13 : 03-OH (3 %), which was absent fromA. thermoterrenum, and iso-C13 : 0(2 %), which was absent fromAnaerobaculum mobile. On the basis of these results, strain OS1Trepresents a novel species of the genusAnaerobaculum, for which the nameAnaerobaculum hydrogeniformanssp. nov. is proposed. The type strain is OS1T( = DSM 22491T = ATCC BAA-1850T). An emended description of the genusAnaerobaculumis also given.
BgaA acts as an adhesin to mediate attachment of some pneumococcal strains to human epithelial cells
Authors: Limoli Dominique H. , Sladek Julie A. , Fuller Lindsey A. , Singh Anirudh K. , King Samantha J.
Published: May 2011

Streptococcus pneumoniaecolonization of the respiratory tract is an essential precursor for pneumococcal disease. To colonize efficiently, bacteria must adhere to the epithelial-cell surface.S. pneumoniaepossesses surface-associated exoglycosidases that are capable of sequentially deglycosylating human glycans. Two exoglycosidases, neuraminidase (NanA) and β-galactosidase (BgaA), have previously been shown to contribute toS. pneumoniaeadherence to human epithelial cells, as deletion of either of these genes results in reduced adherence. It has been suggested that these enzymes may modulate adherence by cleaving sugars to reveal a receptor on host cells. Pretreatment of epithelial cells with exogenous neuraminidase restores the adherence of ananAmutant, whereas pretreatment with β-galactosidase does not restore the adherence of abgaAmutant. These data suggest that BgaA may not function to reveal a receptor, and implicate an alternative role for BgaA in adherence. Here we demonstrate that β-galactosidase activity is not required for BgaA-mediated adherence. Addition of recombinant BgaA (rBgaA) to adherence assays and pretreatment of epithelial cells with rBgaA both significantly reduced the level of adherence of the parental strain, but not the BgaA mutant. One possible explanation of these data is that BgaA is acting as an adhesin and that rBgaA is binding to the receptor, preventing bacterial binding. A bead-binding assay demonstrated that BgaA can bind directly to human epithelial cells, supporting the hypothesis that BgaA is an adhesin. Preliminary characterization of the epithelial-cell receptor suggests that it is a glycan in the context of a glycosphingolipid. To further establish the relevance of this adherence mechanism, we demonstrated that BgaA-mediated adherence contributed to adherence of a recent clinical isolate to primary human epithelial cells. Together, these data suggest a novel role for BgaA as an adhesin and suggest that this mechanism could contribute to adherence of at least some pneumococcal strainsin vivo.
Single-cell analysis in situ in a Bacillus subtilis swarming community identifies distinct spatially separated subpopulations differentially expressing hag (flagellin), including specialized swarmers
Authors: Hamze Kassem , Autret Sabine , Hinc Krzysztof , Laalami Soumaya , Julkowska Daria , Briandet Romain , Renault Margareth , Absalon Cédric , Holland I. Barry , Putzer Harald , Séror Simone J.
Published: May 2011

The non-domesticated Bacillus subtilis strain 3610 displays, over a wide range of humidity, hyper-branched, dendritic, swarming-like migration on a minimal agar medium. At high (70 %) humidity, the laboratory strain 168 sfp
+ (producing surfactin) behaves very similarly, although this strain carries a frameshift mutation in swrA, which another group has shown under their conditions (which include low humidity) is essential for swarming. We reconcile these different results by demonstrating that, while swrA is essential for dendritic migration at low humidity (30–40 %), it is dispensable at high humidity. Dendritic migration (flagella- and surfactin-dependent) of strains 168 sfp
+
swrA and 3610 involves elongation of dendrites for several hours as a monolayer of cells in a thin fluid film. This enabled us to determine in situ the spatiotemporal pattern of expression of some key players in migration as dendrites develop, using gfp transcriptional fusions for hag (encoding flagellin), comA (regulation of surfactin synthesis) as well as eps (exopolysaccharide synthesis). Quantitative (single-cell) analysis of hag expression in situ revealed three spatially separated subpopulations or cell types: (i) networks of chains arising early in the mother colony (MC), expressing eps but not hag; (ii) largely immobile cells in dendrite stems expressing intermediate levels of hag; and (iii) a subpopulation of cells with several distinctive features, including very low comA expression but hyper-expression of hag (and flagella). These specialized cells emerge from the MC to spearhead the terminal 1 mm of dendrite tips as swirling and streaming packs, a major characteristic of swarming migration. We discuss a model for this swarming process, emphasizing the importance of population density and of the complementary roles of packs of swarmers driving dendrite extension, while non-mobile cells in the stems extend dendrites by multiplication.
Identification of a novel subgroup of uncultured gammaproteobacterial glycogen-accumulating organisms in enhanced biological phosphorus removal sludge
Authors: Kim Jeong Myeong , Lee Hyo Jung , Lee Dae Sung , Lee Kangseok , Jeon Che Ok
Published: May 2011

The presence of glycogen-accumulating organisms (GAO) has been hypothesized to be a cause of deterioration in enhanced biological phosphorus removal (EBPR) processes due to their abilities to out-compete polyphosphate-accumulating organisms (PAO). Based on 16S rRNA gene sequences, new members of uncultured gammaproteobacterial GAO (GB) were identified from sludge samples of a lab-scale sequencing batch reactor used for EBPR. The new GB formed a phylogenetic lineage (GB8) clearly distinct from the previously reported seven GB subgroups. Because the new GB8 members were not targeted by the known fluorescence in situ hybridization (FISH) oligonucleotide probes, a GB8-specific FISH probe (GB429) and a new FISH probe (GB742) targeting all eight GB subgroups were designed, and the phenotypic properties of the new GB8 members were investigated. FISH and microautoradiography approaches showed that GB429-targeted cells (GB8) were large coccobacilli (2–4 µm in size) with the ability to take up acetate under anaerobic conditions, but unable to accumulate polyphosphate under the subsequent aerobic conditions, consistent with in situ phenotypes of GB. FISH analyses on several sludge samples showed that members of GB8 were commonly detected as the majority of GB in lab- and full-scale EBPR processes. In conclusion, this study showed that members of GB8 could be a subgroup of GB with an important role in EBPR deterioration. Designs of FISH probes which hybridize with broader GB subgroups at different hierarchical levels will contribute to studies of the distributions and ecophysiologies of GB in lab- or full-scale EBPR plants.