bluuebunny/crossref_metadata_2025 huggingface dataset:
Does regular exercise in pregnancy influence duration of labor? A secondary analysis of a randomized controlled trial
Authors: Salvesen Kjell Å. , Stafne Signe N. , Eggebø Torbjørn M. , Mørkved Siv
Published: October 2013

Objectives

To study effects of regular physical exercise in pregnancy on duration of the active phase of labor and the proportions of women with prolonged active second stage.

Design

A two‐armed, two‐center randomized controlled trial.

Setting

St. Olavs Hospital, Trondheim University Hospital and Stavanger University Hospital.

Population

A total of 855 women were randomized to intervention or control groups.

Methods

The intervention was a 12‐week exercise program, including aerobic and strengthening exercises, conducted between the 20th and 36th week of gestation. One weekly group session was led by physiotherapists and home exercises were encouraged twice a week. Controls received standard antenatal care.

Main outcome measures

The duration of active phase of labor and number of prolonged second stage deliveries (active pushing > 60 min). We also studied labor outcomes. Supplementary analyses were done in a subgroup of nulliparous women with a singleton cephalic fetus and spontaneous start of term delivery.

Results

Duration of labor was similar in the two groups, and there were no differences in labor outcomes. In a subgroup analysis the duration of active second stage labor was shorter in the control group (p = 0.01).

Conclusions

Regular physical exercise during pregnancy did not influence duration of the active phase of labor or the proportion of women with prolonged active second stage.
The homoeobox gene SIX1 alters myosin heavy chain isoform expression in mouse skeletal muscle
Authors: Hetzler K. L. , Collins B. C. , Shanely R. A. , Sue H. , Kostek M. C.
Published: October 2013

Aim

Six1 is necessary for the genesis of several tissues, but in adults, it is expressed primarily in skeletal muscle where its function is unclear. Overexpression of Six1 with a cofactor in skeletal muscle causes slow‐to‐fast fibre‐type transition. We sought to characterize the effects of a physiologically relevant Six1 knockdown.

Methods

The tibialis anterior (TA) muscles of C57BL/6 mice were electroporated with Six1 knockdown vector (siRNA) or empty vector. Muscles were collected at 2 or 14 days after transfection for Six1 and myosin heavy chain (MHC) expression analysis. C2C12 mouse myoblasts were grown in standard conditions. Cells were cotransfected with MHC promoter vectors and Six1 expression vectors. Cells were harvested after 4 days of differentiation.

Results

In vivo, the Six1 siRNA caused a decreased expression of Six1,1.8‐fold (±0.1, P < 0.05). With decreased Six1, MHC IIB expression decreased 2.7‐fold (±0.7, P = 0.04). Proportion of muscle fibres expressing MHC IIB decreased (45.3 ± 4.8% vs. 65.1 ± 7.3% in control group, P = 0.04), and total area expressing MHC IIB decreased with decreased Six1 (59.6 ± 4.3% vs. 75.2 ± 5.4% in control group, P < 0.05). Decreased Six1 increased MHC IIA expression 1.9‐fold (±0.3, P = 0.04). In vitro, Six1 overexpression increased promoter activation of MHC IIB 2.9‐fold (±0.3, P < 0.01). Six1 knockdown repressed MHC IIB promoter 2.9‐fold (±0.1, P < 0.05) and MHC IIX 3.7‐fold (±0.08, P < 0.01).

Conclusion

Six1 knockdown caused a fast‐to‐slow shift in MHC isoform, and this was confirmed by promoter activity of MHC genes. Six1 may ultimately control the contractile and metabolic properties that define muscle fibre phenotype.
DEFENCE AND NON‐DEFENCE SPENDING IN THE USA: STIMULI TO ECONOMIC GROWTH? COMPARATIVE FINDINGS FROM A SEMIPARAMETRIC APPROACH
Authors: Kollias Christos , Paleologou Suzanna‐Maria
Published: October 2013

Given its significant policy implications, the nexus between public expenditures and economic growth has been the subject of an extensive and often emotive theoretical and empirical debate. In this paper, a semiparametric model is used to explore the link between GDP and defence and non‐defence government spending in the USA over the period 1929–2009. Evidence reported herein indicates that the latter represents a greater stimulus vis‐à‐vis the former.
Consequences of Seed Dispersal for Plant Recruitment in Tropical Forests: Interactions Within the Seedscape
Authors: Beckman Noelle G. , Rogers Haldre S.
Published: October 2013

Seed dispersal sets the stage for the suite of biotic and abiotic interactions that determine the fate of individual seeds. In this review, we first focus on how dispersal influences the ‘seedscape’, or the combination of abiotic and biotic factors that affect the probability of recruitment once a seed has reached its final location. We review recent papers that examine the effect of different dispersal vectors on (1) the quality of the habitat in which a seed lands; (2) the distance seeds are dispersed from the parent tree; and (3) the density and composition of plants within the neighborhood of a seed following deposition. Next, we explore methods used to scale these processes up to the level of populations. We highlight demographic models that integrate across multiple life history stages and predict the impact of dispersal in variable environments on population growth. We also review studies that analyze existing spatial patterns of trees within large forest plots and use various strategies to infer the processes that led to those patterns. We continue to scale up from populations to communities, and discuss approaches that have been taken to understand how dispersal may affect diversity and abundance in the community. We then turn to human disturbances and discuss the implications of frugivore defaunation for plant communities. We finish by highlighting several areas of research that are particularly promising for future directions of study.
Factors Supporting Knowledge Integration in Global Innovation Projects: An Exploratory Study
Authors: Baxter David , Goffin Keith , Szwejczewski Marek
Published: October 2013

This exploratory study identifies the factors which contribute to effective knowledge integration in global innovation projects through an in‐depth analysis of two case studies. Knowledge integration is analysed in two components: knowledge (individual expertise), and integration (working together). Our analysis highlights three distinct ways that individuals think about individual expertise: individual knowledge and competence; feeling valued; and unfamiliar areas. We also identify four ways in which individuals think about working together: good social relations; cultural distance; negotiation skills; and better results through working with others. Using examples from the case studies, we discuss how these factors enable knowledge integration in globally distributed innovation projects. We also propose a model indicating how these factors impact on knowledge integration and innovation performance. This study contributes towards management guidance, which is currently lacking in the area of knowledge integration.
Synthesis and Antimycobacterial Activity of Novel Thiadiazolylhydrazones of 1‐Substituted Indole‐3‐carboxaldehydes
Authors: Haj Mohammad Ebrahim Tehrani Kamaleddin , Mashayekhi Vida , Azerang Parisa , Sardari Soroush , Kobarfard Farzad , Rostamizadeh Kobra
Published: October 2013

A series of novel thiocarbohydrazones of substituted indoles and their corresponding thiadiazole derivatives were prepared, and their structures were confirmed by different analytical and spectroscopic methods. The derivatives were prepared by a sequential synthetic strategy including substitution at N‐1 position of indole ring by various aliphatic and benzylic substituents, followed by condensation with thiocarbohydrazide, and finally cyclization by triethyl orthoformate. The derivatives were tested for their antimycobacterial activity against Mycobacterium bovis BCG, and the results revealed that among the synthesized compounds, thiadiazole derivatives 4e, 4f, 4n, 4p, 4q, and 4t exhibited the highest activity with IC50 value of 3.91 μg/mL. The results indicate that the thiadiazole moiety plays a vital role in exerting antimycobacterial activity.
Potentially preventable admissions to New Zealand public hospitals for dental care: a 20‐year review
Authors: Whyman Robin A. , Mahoney Erin K. , Morrison David , Stanley James
Published: October 2013

Objective

To describe the prevalence of admissions to New Zealand public hospitals for dental care and associated time trends for people of all ages during the 20‐year period 1990–2009.

Methods

The New Zealand Ministry of Health National Minimum Data Set (NMDS), a collection that covers all publicly funded hospital discharges, was the primary data source for this study. Data over a 20‐year period from 1 January 1990 to 31 December 2009 were included, and a subset of ICD 10 codes (K02–K09 and K12 and K13) were selected to identify potentially preventable or ambulatory care sensitive conditions (ACSC) leading to admission to hospital. Volumes, proportions and rates of admission are presented to describe the patterns of admission to hospital.

Results

There were 120 046 admissions to public hospitals in New Zealand between 1990 and 2009 for which the provision of dental care was the primary reason for admission. The rate of admission to hospital for dental care increased from 0.92 per 1000 population in the period 1990–1994 to 2.15 per 1000 population in 2005–2009. Dental admission rates were greatest in the 3‐ to 4‐year‐old age group, for Maori and Pacific people and for people in the most deprived quintile of the NZDep 2006 index. Almost one‐third of people aged 18–34 years who were admitted to hospital primarily for dental care were acute admissions.

Conclusion

Both the volume and the rate of admission to New Zealand public hospitals for dental care have increased over the period of this study. A continued focus on strategies to reduce the impact of dental disease, particularly in the early childhood population and on ensuring accessible primary dental care for the adult population, is required.
Evaluation of a new experimental model to study bone healing after ridge expansion with simultaneous implant placement – a pilot study in minipigs
Authors: Stricker Andres , Fleiner Jonathan , Dard Michel , Voss Pit , Sauerbier Sebastian , Bosshardt Dieter D.
Published: October 2013

Objective

To evaluate the suitability of a minipig model for the study of bone healing and osseointegration of dental implants following bone splitting and expansion of narrow ridges.

Material and Methods

In four minipigs, the mandibular premolars and first molars were extracted together with removal of the buccal bone plate. Three months later, ridge splitting and expansion was performed with simultaneous placement of three titanium implants per quadrant. On one side of the mandible, the expanded bone gap between the implants was filled with an alloplastic biphasic calcium phosphate (BCP) material, while the gap on the other side was left unfilled. A barrier membrane was placed in half of the quadrants. After a healing period of 6 weeks, the animals were sacrificed for histological evaluation.

Results

In all groups, no bone fractures occurred, no implants were lost, all 24 implants were osseointegrated, and the gap created by bone splitting was filled with new bone, irrespective of whether BCP or a barrier membrane was used. Slight exposure of five implants was observed, but did not lead to implant loss. The level of the most coronal bone‐to‐implant contact varied without being dependent on the use of BCP or a barrier membrane. In all groups, the BCP particles were not present deep in the bone‐filled gap. However, BCP particles were seen at the crestal bone margin, where they were partly integrated in the new bone.

Conclusions

This new minipig model holds great promise for studying experimental ridge splitting/expansion. However, efforts must be undertaken to reduce implant exposure and buccal bone resorption.
Systemic allergic dermatitis caused by Apiaceae root vegetables
Authors: Paulsen Evy , Petersen Thomas H. , Fretté Xavier C. , Andersen Klaus E. , Christensen Lars P.
Published: October 2013

Background

Immediate hypersensitivity reactions to root vegetables of the Umbelliferae plant family (Apiaceae) is well known. Delayed‐type hypersensitivity is rarely reported.

Objective

To report the first case of systemic contact dermatitis caused by root vegetables and some chemical implications.

Materials and methods

Prick and patch testing were performed with fresh vegetables and selected allergens, and this was followed by high‐performance liquid chromatography–mass spectrometry (MS)/MS analysis of the falcarinol syringe.

Results

The patient was contact‐sensitive to celeriac, parsnip, and carrot, but tested negative to falcarinol. Subsequent analysis showed that the syringe contained falcarinol.

Conclusion

The non‐occupational sensitization resulting from both direct and systemic contact with Apiaceae root vegetables was apparently not caused by falcarinol.
Patch testing with serial dilutions and thin‐layer chromatograms of oak moss absolutes containing high and low levels of atranol and chloroatranol
Authors: Mowitz Martin , Zimerson Erik , Svedman Cecilia , Bruze Magnus
Published: October 2013

Background

Oak moss absolute (Evernia prunastri extract) contains a large number of substances, among them the potent allergens atranol and chloroatranol. Since 2008, their content in oak moss absolute has been restricted by the International Fragrance Association to a maximum level of 100 ppm each.

Objectives

To compare the elicitation capacities of a traditional (sample A) and a treated (sample B) oak moss absolute containing, in total, 27 000 and 66 ppm of atranol and chloroatranol, respectively, and to investigate reactions to components of oak moss absolute separated by thin‐layer chromatography (TLC).

Methods

Fifteen oak moss‐allergic subjects were patch tested with serial dilutions and TLC strips of samples A and B.

Results

Fifteen subjects reacted to sample A at concentrations ≤ 2.0%, and 2 subjects reacted to sample B at 2.0% but not to lower concentrations. Among 13 subjects reacting to the TLC strip of sample A, 11 reacted to spots with retardation factor values corresponding to those of atranol and/or chloroatranol, and 11 reacted to other areas on the TLC strip. Only one subject reacted to the TLC strip of sample B.

Conclusions

The patch test reactivity of sample B was significantly lower than that of sample A. The TLC patch tests indicate the presence of sensitizers other than atranol and chloroatranol in oak moss absolute.
Cost and quality of life in patients with severe chronic hand eczema refractory to standard therapy with topical potent corticosteroids
Authors: Cortesi Paolo A. , Scalone Luciana , Belisari Andrea , Bonamonte Domenico , Cannavò Serafinella Patrizia , Cristaudo Antonio , De Pità Ornella , Gallo Rosella , Giannetti Alberto , Gola Massimo , Pigatto Paolo D. , Mantovani Lorenzo G.
Published: October 2013

Background

Little is known about the socio‐economic burden of severe chronic hand eczema in patients refractory to treatment with potent corticosteroids.

Objectives

To estimate the socio‐economic burden of severe chronic hand eczema refractory to potent topical corticosteroids, and to establish an algorithm for the estimation of the health‐related quality of life EuroQol five‐dimensional (EQ‐5D) utility index from theDermatologyLifeQualityIndex (DLQI) summary score.

Methods

A multicentre cost of illness study was conducted, adopting the societal perspective. Adult patients with severe and refractory chronic hand eczema were enrolled. Direct (e.g. drug treatment and travel) and indirect (i.e. loss of productivity) mean costs/patient‐month were estimated. Health‐related quality of life was assessed with theEQ‐5DandDLQIquestionnaires. An ordinary least square regression model was used to investigate relationships between health‐related quality of life scores.

Results

One hundred and four valid patients (mean age 44.5 years, 39.4% male) participated. Overall mean costs were €418.3/patient‐month: loss of productivity contributed 43.7%, followed by hospitalization (16.1%) and travel (10.3%). Health‐related quality of life scores were, on average, 0.50 (EQ‐5Dutility) and 11.3 (DLQI). Utility andDLQIsummary were significantly related to each other.

Conclusions

Wellbeing and loss of productivity are the most important consequences in these patients. Appropriate treatment is necessary to improve patient health and productivity, which will contribute to reducing societal costs.
Wet work and hand eczema in apprentice nurses; part I of a prospective cohort study
Authors: Visser Maaike J. , Verberk Maarten M. , van Dijk Frank J. H. , Bakker Jan G. , Bos Jan D. , Kezic Sanja
Published: October 2013

Background /objectives

Environmental exposure and personal susceptibility both contribute to the development of hand eczema. Here, we report an investigation on wet work exposure and its influence on the risk of developing hand eczema in apprentice nurses.

Methods

A prospective cohort study was performed among 721 Dutch apprentice nurses. Participants recorded wet work exposure and symptoms of hand eczema using specially designed diary cards.

Results

For 533 apprentice nurses, a follow‐up time of 1–3 years was completed. Diary cards were supplied by 383 students. The 1‐year period prevalence of hand eczema was 23% in the first year, 25% in the second year and 31% in the third year of follow‐up. Eighty‐one new cases of hand eczema developed, most of which occurred during the first year of follow‐up. In approximately one‐third of the participants, wet work exposure exceeded the national guidelines. Frequent hand washing during traineeships [odds ratio (OR) 1.5; 90% confidence interval (CI) 1.0–2.3], frequent hand washing at home (OR 2.3; 90% CI 1.5–3.7) and having a side job involving wet work (OR 1.6; 90% CI 1.0–2.4) were independent risk factors for hand eczema.

Conclusion

As a considerable number of apprentice nurses had already developed hand eczema during traineeships, more attention should be paid to skin protection in vocational education.
Comparison of the long‐term outcome of two therapeutic strategies for the management of abdominal abscess complicating Crohn's disease: percutaneous drainage or immediate surgical treatment
Authors: Lobatón T. , Guardiola J. , Rodriguez‐Moranta F. , Millán‐Scheiding M. , Peñalva M. , De Oca J. , Biondo S.
Published: October 2013

Aim

The management of abdominal abscesses complicating Crohn's disease is complex and involves a difficult choice between medical, radiological and surgical procedures. The long‐term outcome was compared for two strategies for the management of abdominal abscess: percutaneous drainage (PD) followed by rescue surgery in the case of failure vs direct immediate surgery (IS). We also compared the results of IS with surgery performed after PD failure.

Methods

We retrospectively identified 44 patients with Crohn's disease with an abdominal abscess from January 2000 to December 2009. Therapeutic success was defined as abscess resolution and no reappearance within 1 year of follow‐up.

Results

The first therapeutic approach was PD in 22 cases and IS in the other 22 cases. IS had a higher therapeutic success rate than PD (95.5% vs 27.2% respectively; P < 0.001). PD was the only independent variable related to treatment failure in the multivariate analysis after adjustment for possible confounders such as abscess size, multilocularity, presence of fistula and corticosteroid use (OR 88.26, 95% CI 7.38–1055.36; P < 0.001). Surgery after failure of PD (n = 16) was associated with longer total hospitalization (56.12 ± 35.89 vs 27.52 ± 15.11 days; P = 0.017) and longer postoperative stay (44.0 ± 83.7 vs 14.3 ± 30 days; P = 0.179) and needed a second operation more often (5/16, 31% vs 1/22, 4.5%; P = 0.065) than IS.

Conclusions

Percutaneous drainage provided durable abscess resolution in only one‐third of the patients compared with more than 90% of those treated with IS. In addition, surgery performed after PD failure results in a poorer outcome than IS.
Two‐week wait symptoms are prevalent in screened patients with a positive faecal occult blood test but do not predict cancer
Authors: Vaughan‐Shaw P. G. , Cutting J. , Borley N. , Brooklyn T. , Wheeler J. M. D.
Published: October 2013

Aim

Lower gastrointestinal (LGI) symptoms are prevalent in patients screened for bowel cancer yet do not predict a finding of cancer. This study evaluates symptoms in patients with these characteristics against the 2‐week wait (2ww) criteria to determine whether they predicted cancer in these patients.

Method

A prospective cohort study was performed. Patients with a positive faecal occult blood (FOB) test attending our unit over a 7‐month period were included. Data on symptom prevalence, frequency and duration were collected and assessed against the 2ww criteria. Associations between symptom prevalence and patient outcome were investigated using the χ2 test.

Results

Three hundred and ninety‐seven patients were included and 37 (9%) were found to have colorectal cancer (CRC). The prevalence of undefined LGI symptoms was 71% and appeared comparable between those with and without CRC (65 vs 72%, P = 0.385). 2ww symptoms were reported in 147 (37%), with 2ww change in bowel habit in 10% and 2ww rectal bleeding in 31%. 2ww symptom prevalence was similar in those with and without cancer (38 vs 37%, P = 0.915). No significant differences in overall 2ww prevalence or prevalence of individual 2ww symptoms were demonstrated between those with a normal colonoscopy or one showing cancer, polyps or other pathology. Twenty nine per cent of patients with 2ww symptoms had reported these to their GP.

Conclusion

Undefined LGI symptoms are prevalent in FOB‐positive patients but do not predict CRC. 2ww symptoms are also highly prevalent, yet similarly fail to predict cancer. Further efforts to increase public awareness of cancer symptoms are required, whilst false reassurance from a negative FOB result should be discouraged.
Obesity as a barrier to living kidney donation: a center‐based analysis
Authors: Sachdeva Mala , Sunday Suzanne , Israel Ezra , Varghese Jeny , Rosen Lisa , Bhaskaran Madhu , Molmenti Ernesto P. , Mattana Joseph
Published: October 2013

Background

Obesity is a major epidemic and may present a significant barrier to living kidney donation. The purpose of our study was to determine the frequency of obesity as an exclusion factor and assess how often these donors lose weight and donate.

Methods

A single center, retrospective analysis of 104 potential living kidney donors between 2008 and 2012.

Results

Of the 104 donors, 19 (18%) had a normal body mass index (BMI) of <25. Eighty‐five of the 104 (82%) donors spanned the overweight to morbidly obese classifications. Thirty‐eight (37%) were overweight (BMI 25–29.9). Twenty‐four (23%) were categorized as class I obesity (BMI 30–34.9), 17 (16%) as class II obesity (BMI 35–39.9), and six (6%) as class III obesity (BMI >40). There were a total of 23 donors (22%) who were considered moderately and morbidly obese (BMI >35). Of these, only three (13%) succeeded at losing weight and donating.

Conclusions

Obesity may be a frequent barrier to living kidney donation, directly leading to exclusion as a potential kidney donor in about one in five instances. Successful weight loss leading to donation appears to be infrequent, suggesting need to address obesity in the donor population.
Adolescents let sufficient evidence accumulate before making a decision when large incentives are at stake
Authors: Teslovich Theresa , Mulder Martijn , Franklin Nicholas T. , Ruberry Erika J. , Millner Alex , Somerville Leah H. , Simen Patrick , Durston Sarah , Casey B. J.
Published: October 2013

Adolescent decision‐making has been described as impulsive and suboptimal in the presence of incentives. In this study we examined the neural substrates of adolescent decision‐making using a perceptual discrimination task for which small and large rewards were associated with correctly detecting the direction of motion of a cloud of moving dots. Adults showed a reward bias of faster reaction times on trials for which the direction of motion was associated with a large reward. Adolescents, in contrast, were slower to make decisions on trials associated with large rewards. This behavioral pattern in adolescents was paralleled by greater recruitment of fronto‐parietal regions important in representing the accumulation of evidence sufficient for selecting one choice over its alternative and the certainty of that choice. The findings suggest that when large incentives are dependent on performance, adolescents may require more evidence to accumulate prior to responding, to be certain to maximize their gains. Adults, in contrast, appear to be quicker in evaluating the evidence for a decision when primed by rewards. Overall these findings suggest that rather than reacting hastily, adolescents can be incentivized to take more time to make decisions when large rewards are at stake.

A video abstract of this article can be viewed at http://youtu.be/1g4F5vzFDl0
Urinary type IV collagen as a predictor for the incidence of microalbuminuria in young patients with Type 1 diabetes
Authors: Morita M. , Hanai K. , Uchigata Y.
Published: October 2013

Aims

To clarify whether urinary type IV collagen‐to‐creatinine ratio is a predictor for the incidence of microalbuminuria in patients with Type 1 diabetes.

Methods

A longitudinal observational cohort study was conducted; the subjects included normoalbuminuric patients diagnosed with Type 1 diabetes before the age of 30 years and who were less than 40 years old at the start of the observation. In total, 225 patients were enrolled (age, mean ± SD: 25 ± 5 years; male: 32.9%). The endpoint was the incidence of microalbuminuria, defined as 30 mg/g Cr ≤ urinary albumin‐to‐creatinine ratio < 300 mg/g Cr. Patients were divided into two groups based on the median of urinary type IV collagen‐to‐creatinine ratio levels.

Results

During the median follow‐up period of 8.8 years (range 1.0–12.8 years), 13 patients with high urinary type IV collagen‐to‐creatinine ratio progressed to microalbuminuria. Meanwhile, only one patient with low urinary type IV collagen‐to‐creatinine ratio reached the endpoint. Kaplan–Meier estimates for the time to reach the endpoint were significantly faster for patients with a high ratio than for those with a low ratio (log‐rank test, P < 0.001). In the multivariate Cox hazard analysis, the hazard ratio for patients with high vs. low urinary type IV collagen‐to‐creatinine ratio was 13.51 (95% CI 1.59–115.02, P = 0.017). When urinary type IV collagen‐to‐creatinine ratio was treated as a continuous variable, logarithmically transformed urinary type IV collagen‐to‐creatinine ratio, but not baseline albumin‐to‐creatinine ratio, was independently associated with reaching the endpoint (hazard ratio 19.23, 95% CI 1.53–242.30, P = 0.022).

Conclusions

Urinary type IV collagen may be an important predictor for the incidence of microalbuminuria in young patients with Type 1 diabetes.
Stimulating effects of quercetin and phenamil on differentiation of human dental pulp cells
Authors: Kim Jong‐Gil , Son Kyung M. , Park Hee C. , Zhu Tingting , Kwon Ji H. , Yang Hyeong‐Cheol
Published: October 2013

Dentin formation is preferred in the healing response of the pulp to pulp‐capping agents during vital pulp therapy. Enhancement of the dentinogenic differentiation of dental pulp cells is thought to accelerate pulp repair. The aim of this study was to evaluate the dentinogenic activity of small molecules (three flavonoids and phenamil) that have been shown previously to induce osteoblast differentiation. Among the flavonoids (quercetin, genistein and baicalin), quercetin induced the highest alkaline phosphatase (ALP) activity of human dental pulp (HDP) cells. Phenamil, an amiloride derivative, elicited higher ALP activity than quercetin. However, increased expression of dentin sialophosphoprotein (DSPP) mRNA and mineral deposition were seen in cultures treated with quercetin compared with phenamil. This would seem to suggest that quercetin is the most dentinogenic agent among the tested chemicals. The increase in ALP activity in the quercetin‐treated cells was not affected by ICI 182,780, an estrogen receptor inhibitor, and was partially blocked by PD98059, an extracellular signal‐regulated kinase 1/2 (ERK1/2) inhibitor. This suggests that ERK1/2 is activated in the quercetin‐induced differentiation of HDP cells without the mediation of estrogen receptors, which are known to be involved in osteoblast differentiation induced by quercetin.
Bite the Bullet
Authors: Hoekman Bernard M. , Mavroidis Petros C.
Published: October 2013

This paper discusses the Fedon case‐law of the European Court of Justice (Court of Justice), which involved a claim for compensation by Fedon (an Italian producer of eyeglass cases) from the EU for the imposition of World Trade Organization (WTO)‐authorised retaliatory trade barriers by the USA following the failure by the EU to comply with an adverse ruling by the WTO regarding its import regime for bananas. As a result of the EU non‐compliance, European banana distributors and some bananas producers benefited from WTO‐illegal protection, at the expense of a set of EU exporters, including Fedon, that were hit by US countermeasures. Fedon contested the non‐compliance by the EU before the Court of Justice and sought compensation. This paper assesses the ruling of the Court of Justice against Fedon and argues that the Court got it wrong, both in terms of legal principle and as a matter of legal technicalities.
Flow intermittency decreases nestedness and specialisation of diatom communities in Mediterranean rivers
Authors: Tornés Elisabet , Ruhí Albert
Published: October 2013

Due to their ubiquity and highly efficient passive dispersal, benthic diatoms are an ideal group in which to explore the drivers of community spatial structure and the ultimate links between such patterns and species autoecology. However, studies addressing these issues have largely overlooked unicellular taxa to date.

We examined the spatial order (i.e. nestedness) of a diatom meta‐community of 122 lotic sites in the north‐east Iberian Peninsula and the relationship between the contributions of individual species to nestedness and their niche breadths [measured using outlying mean index (OMI) analyses].

We observed a significantly nested pattern in the meta‐community (T = 14.05, NODF = 22.57), although idiosyncratic species accounted for a substantial fraction (34%) of the global species pool. Hydrological stability was identified as the main driver of nestedness. Highly stable, moderately stable and intermittent sites differed in nestedness and in alpha diversity, with intermittent sites being the most species poor and the least nested.

We also observed a significant association between nestedness and niche attributes, with idiosyncratic species exhibiting wider distributions and larger niche breadths compared with nested species. Overall, our results indicate that diatom communities inhabiting hydrologically stable rivers present a higher level of order in community spatial pattern and a higher proportion of specialist taxa than communities in intermittent streams.

Because recent hydroclimatic models predict an increase in stream intermittency in the Mediterranean region, our findings may help anticipate future diatom biodiversity patterns resulting from global change. We suggest that the current need to protect a diverse network of sites (as opposed to a few species‐rich sites) will be even greater in the near future because local communities are not only probably to become taxonomically and functionally poorer but also less predictable, making it more difficult to implement efficient programmes for biodiversity conservation at the regional scale.
A Background Color Scheme for Piper Plots to Spatially Visualize Hydrochemical Patterns
Authors: Peeters Luk
Published: October 2013

The combination of ternary diagrams of cations and anions with a central diamond graph make the Piper plot very useful in visualizing groundwater chemistry datasets. One of the major drawbacks is that it is hard to link spatial attributes of the dataset to the plot. In this study, we propose a background color scheme of the Piper plot so that spatial representations of these data can be colored according to their location in the Piper plot. The color scheme is chosen to have maximum resolution while still being perceptually uniform. The linking between Piper plot and maps through this color scheme allows the interpretation of the trends and processes deduced from the Piper plot in terms of the location in the aquifer, the geology, and the groundwater flow dynamics. The colored Piper plot is applied to a groundwater quality dataset of the Condamine Alluvium in Queensland, Australia.
Potential of a no‐touch pincer ablation procedure for small hepatocellular carcinoma that uses a multipolar radiofrequency ablation system: An experimental animal study
Authors: Kawamura Yusuke , Ikeda Kenji , Fukushima Taito , Hara Tasuku , Hosaka Tetsuya , Kobayashi Masahiro , Saitoh Satoshi , Sezaki Hitomi , Akuta Norio , Suzuki Fumitaka , Suzuki Yoshiyuki , Arase Yasuji , Kumada Hiromitsu
Published: October 2013

Aim

Treatment of hepatocellular carcinoma located on the liver surface is frequently difficult because direct puncture of the tumor must be avoided during needle insertion. The aim of this study was to investigate the utility of a no‐touch pincer ablation procedure that uses a multipolar radiofrequency ablation (RFA) system for a tumor located on the liver surface.

Methods

The experimental animals were three pigs, and RFA was performed with two internally cooled bipolar electrodes. Three ablative procedures were compared: linear insertion at regular 13‐mm intervals (pattern 1; virtual target tumor size, <10 mm); fan‐shape insertion, maximum interval 20 mm (pattern 2; virtual target tumor size, <15 mm); and 25 mm (pattern 3; virtual target tumor size, <20 mm). All electrodes were inserted at a 30‐mm depth. For patterns 1 and 2, ablation was performed on three other parts of the liver, and for pattern 3, ablation was performed on two other parts.

Results

For the median transverse and longitudinal diameter to the shaft, with the pattern 1 procedure, the ablative areas were 32 mm × 30 mm, and with the pattern 2 procedure, the ablative areas were 27 mm × 30 mm with carbonization of the liver surface. In contrast, with the pattern 3 procedure, the ablative areas were 45 mm × 26 mm; however, the ablative margin did not reach the surface, and carbonization was not apparent.

Conclusion

The no‐touch pincer ablation procedure (with an electrode interval of ≤20 mm) may be useful when performed with two internally cooled bipolar electrodes for small nodules that protrude from the liver surface.
The Consumer Quality Index in an accident and emergency department: internal consistency, validity and discriminative capacity
Authors: Bos Nanne , Sturms Leontien M. , Stellato Rebecca K. , Schrijvers Augustinus J.P. , van Stel Henk F.
Published: October 2013

Background

Patients’ experiences are an indicator of health‐care performance in the accident and emergency department (A&E). The Consumer Quality Index for the Accident and Emergency department (CQI A&E), a questionnaire to assess the quality of care as experienced by patients, was investigated. The internal consistency, construct validity and discriminative capacity of the questionnaire were examined.

Methods

In the Netherlands, twenty‐one A&Es participated in a cross‐sectional survey, covering 4883 patients. The questionnaire consisted of 78 questions. Principal components analysis determined underlying domains. Internal consistency was determined by Cronbach's alpha coefficients, construct validity by Pearson's correlation coefficients and the discriminative capacity by intraclass correlation coefficients and reliability of A&E‐level mean scores (G‐coefficient).

Results

Seven quality domains emerged from the principal components analysis: information before treatment, timeliness, attitude of health‐care professionals, professionalism of received care, information during treatment, environment and facilities, and discharge management. Domains were internally consistent (range: 0.67–0.84). Five domains and the ‘global quality rating’ had the capacity to discriminate among A&Es (significant intraclass correlation coefficient). Four domains and the ‘global quality rating’ were close to or above the threshold for reliably demonstrating differences among A&Es. The patients’ experiences score on the domain timeliness showed the largest range between the worst‐ and best‐performing A&E.

Conclusions

The CQI A&E is a validated survey to measure health‐care performance in the A&E from patients’ perspective. Five domains regarding quality of care aspects and the ‘global quality rating’ had the capacity to discriminate among A&Es.
Acid adaptation to improve viability and X‐prolyl dipeptidyl aminopeptidase activity of the probiotic bacterium Lactobacillus fermentum HA6 exposed to simulated gastrointestinal tract conditions
Authors: Chu‐Ky Son , Bui Thi‐Khanh , Nguyen Tien‐Long , Ho Phu‐Ha
Published: October 2013

In this work, the viability of the probiotic bacterium Lactobacillus fermentum HA6 isolated from naturally fermented vegetables in Vietnam was improved by growing the bacterium into a mild acid condition (pH 4.0). Viability and probiotic functionality [X‐prolyl dipeptidyl aminopeptidase (PepX) activity] of the acid‐adapted bacterium exposed to simulated gastrointestinal conditions were investigated. After 180 min in the simulated gastric juice (0.3 g/L pepsin, pH 2.0), the viability of acid‐adapted L. fermentum HA6 (11.5%) was higher than that of control L. fermentum HA6 (2.2%). Specific PepX activity of acid‐adapted cells (24.5 U/mg) was higher than that of control cells (17.8 U/mg). After 180‐min exposure to the simulated small intestinal medium (0.3 g/L bile salts, 0.1 g/L pancreatin, pH 8.0), the viability of acid‐adapted L. fermentum HA6 (13.5%) was twofold as high as that of control L  fermentum HA6 (8.0%). Our results suggested that acid adaptation has a key role in acquiring cross‐protection mechanism, which in this study resulted in higher survival of L. fermentum HA6 after simulated gastrointestinal stresses. The strategy of acid adaptation could be valuable for the production of robust probiotics.
Drying kinetics and thermal degradation of phenolic compounds and anthocyanins in pomegranate arils dried under vacuum conditions
Authors: Karaaslan Mehmet , Yilmaz Fatih Mehmet , Cesur Özge , Vardin Hasan , Ikinci Ali , Dalgiç Ali Coşkun
Published: October 2013

The effects of temperature and pretreatment on drying kinetics and thermal degradation of phytonutrients present in pomegranate arils were investigated. The arils were divided into two groups, and half of the samples were pretreated by dipping into 80 °C hot water for 2 min. The drying process was conducted in the vacuum drier at the temperatures of 55, 65 and 75 °C. The fastest drying was completed at 75 °C after pretreatment of the samples. The highest anthocyanin–phenolic compound contents and antioxidant capacity were detected in the arils dried at 55 °C. Seven thin‐layer drying models were used to predict drying curves, and Arrhenius and Eyring–Polanyi models were employed to predict phytonutrient degradation kinetics. Activation energy for drying was 24.26 kJ mol−1 for pretreated samples and 31.54 kJ mol−1 for untreated samples. Effective moisture diffusivities were ranged from 1.43 × 10−9 to 6.03 × 10−9 m2 s−1.
Four novel HLA alleles, DRB1*04:11:03, DRB1*10:05, DRB1*15:94 and DRB1*16:22, identified in Brazilian individuals
Authors: Fabreti‐Oliveira R. A. , Nascimento E. , Oliveira C. K. F. , Vale E. M. G. , Vilela B. , Santos M. A.
Published: October 2013

Four novel human leucocyte antigen (HLA) class II alleles were identified by sequencing‐based typing (SBT) and analysis of the closest‐matching alleles from volunteer subjects from the Brazilian Bone Marrow Donor Register (REDOME, Brazil). The new HLA alleles discovered include DRB1*04:11:03, DRB1*10:05, DRB1*15:94 and DRB1*16:22. Three of the novel alleles had single‐nucleotide substitution polymorphisms when compared to their most homologous allele. Of these, one harboured a single‐nucleotide polymorphism (SNP) identified as a silent substitution.
Amputations and foot‐related hospitalisations disproportionately affect dialysis patients
Authors: Lavery Lawrence A , Lavery David C , Hunt Nathan A , La Fontaine Javier , Ndip Agbor , Boulton Andrew J
Published: October 2013

Patients with diabetes have increased risk for foot ulcers, amputations and hospitalisations. We evaluated a closed cohort of patients with diabetes and established risk factors in two high risk groups: (i) dialysis patients and (ii) patients with previous foot ulceration. We used claims data for diabetes (ICD‐9 250.X), ulceration (ICD‐9 707·10, 707·14 and 707·15) and dialysis (CPT 90935–90937) from the Scott and White Health Plan to identify 150 consecutive patients with diabetes on dialysis (dialysis group) and 150 patients with a history of foot ulceration (ulcer history group). We verified these diagnoses by manually reviewing corresponding electronic medical records. Each patient was provided 30 months follow‐up period. The incidence of foot ulcers was the same in dialysis patients and patients with an ulcer history (210 per 1000 person‐years). The amputation incidence rate was higher in dialysis patients (58·0 versus 13·3, P < 0·001). Hospital admission was common in both study groups. The incidence of hospitalisation was higher in the ulcer history group (477·3 versus 381·3, P < 0·001); however, there were more foot‐related hospital admissions in the dialysis group (32·9% versus 14·0%, P < 0·001) during the 30‐month evaluation period. The incidence of ulcers, amputations and all‐cause hospitalisations is high in persons with diabetes and a history of foot ulceration or on dialysis treatment; however, those on dialysis treatment have disproportionately higher rates of foot‐related hospitalisations. Intervention strategies to reduce the burden of diabetic foot disease must target dialysis patients as a high‐risk group.
Liparis rubescenssp. nov. (Orchidaceae) from Thailand
Authors: Tetsana Naiyana , Pedersen Henrik Æ. , Sridith Kitichate
Published: October 2013

In the context of an ongoing revision of the orchid genusLiparisin Thailand, we describe and illustrate a new species under the nameL. rubescensTetsana, H. A. Pedersen & Sridith. Morphologically, it is particularly similar toL. dumaguetensisAmes from the Philippines, but it differs in the shape of the lateral sepals and in several characters of the labellum. Among theLiparisspecies already known from Thailand,L. atrosanguineaRidl. bears a certain resemblance to the new species, but not so much as to make misidentifications likely. So far,L. rubescensis only known from Khao Nan National Park in the southern Thai province of Nakhon Si Thammarat, but we suggest that it should also be searched for in other parts of peninsular Thailand, southernmost Myanmar and Peninsular Malaysia.
Evaluation of internal peer‐review to train nurses recruiting to a randomized controlled trial – Internal Peer‐review for Recruitment Training in Trials (InterPReTiT)
Authors: Mann Cindy , Delgado Debbie , Horwood Jeremy
Published: October 2013

Aim

A discussion and qualitative evaluation of the use of peer‐review to train nurses and optimize recruitment practice in a randomized controlled trial.

Background

Sound recruitment processes are critical to the success of randomized controlled trials. Nurses recruiting to trials must obtain consent for an intervention that is administered for reasons other than anticipated benefit to the patient. This requires not only patients' acquiescence but also evidence that they have weighed the relevant information in reaching their decision. How trial information is explained is vital, but communication and training can be inadequate.

Design

A discussion of a new process to train nurses recruiting to a randomized controlled trial.

Data Sources

Literature from 1999–2013 about consenting to trials is included. Over 3 months from 2009–2010, recruiting nurses reviewed recruitment interviews recorded during the pilot phase of a single‐site randomized controlled trial and noted content, communication style and interactions. They discussed their findings during peer‐review meetings, which were audio‐recorded and analysed using qualitative methodology.

Implications for Nursing

Peer‐review can enhance nurses' training in trial recruitment procedures by supporting development of the necessary communication skills, facilitating consistency in information provision and sharing best practice.

Conclusions

Nurse‐led peer‐review can provide a forum to share communication strategies that will elicit and address participant concerns and obtain evidence of participant understanding prior to consent. Comparing practice can improve consistency and accuracy of trial information and facilitate identification of recruitment issues. Internal peer‐review was well accepted and promoted team cohesion. Further evaluation is needed.
Spiritual care of the child with cancer at the end of life: a concept analysis
Authors: Petersen Cheryl L.
Published: October 2013

Aim

The aim of this paper is to report an analysis of the concept of spiritual care of a child with cancer at the end of life.

Background

Spirituality is a vital dimension of a child's experience at the end of life; providing comfort; support; and a sense of connection. Spiritual care is paramount to address the substantial spiritual distress that may develop.

Design

Rodgers' method of evolutionary concept analysis guided the review process.

Data sources

The literature search was not limited by start date and literature through the end of 2012 was included. English, peer‐reviewed texts in the databases CINAHL, ATLA and PubMed were included.

Methods

Critical analysis of the literature identified surrogate terms, related concepts, attributes, antecedents and consequences.

Results

The analysis identified six attributes: assessing spiritual needs; assisting the child to express feelings; guiding the child in strengthening relationships; helping the child to be remembered; assisting the child to find meaning; and aiding the child to find hope. Antecedents include existential questions and spiritual distress. Consequences include a peaceful death, spiritual growth, a relationship of trust and enhanced end‐of‐life care.

Conclusion

Spiritual care is a vital aspect of holistic nursing care; however, gaps in knowledge and practice prevent children from receiving adequate spiritual care at the end of life. Nurses would benefit from increased awareness, skills and knowledge about spiritual care. Research is needed to identify interventions that exert the greatest effect on patient care outcomes.
The impacts of goal orientation, terminology effect, and source credibility on communication effectiveness
Authors: Kao Danny Tengti
Published: October 2013

This research explores the interaction effect of terminology and source credibility on communication effectiveness between prevention‐focused and promotion‐focused individuals. Results reveal that communication messages containing terminologies are more effective than those containing no terminologies for promotion‐focused individuals, whereas messages containing no terminologies are more effective than those containing terminologies for prevention‐focused individuals. Furthermore, messages containing terminologies endorsed by either a high‐ or a low‐credibility source are more effective than those containing no terminology information for promotion‐focused individuals. However, for prevention‐focused individuals, communication messages containing terminologies endorsed by a highly credible source are more effective than those containing no terminology information. Alternatively, communication messages containing no terminology information are more effective than those containing terminologies endorsed by a low credible source.