bluuebunny/crossref_metadata_2025 huggingface dataset:
The therapeutic role of oral tolerance in dextran sulfate sodium‐induced colitis via Th1–Th2 balance and γδ T cells
Authors: Yue Min , Shen Zhe , Yu Chao Hui , Ye Hua , Li You Ming
Published: May 2013

Objective

To evaluate the state of oral tolerance and its therapeutic role in mice with dextran sulfate sodium (DSS)‐induced colitis.

Methods

Delayed‐type hypersensitivity (DTH) was determined 7 and 14 days after DSS‐induced colitis and control mice. Disease activity index (DAI) score and colonic histopathological score were measured 7 days after colonic extracted protein (CEP) or bovine serum albumin (BSA) (control) was administrated, with the evaluation of Th1–Th2 balance in the spleen, Peyer's patch and γδ T cells in intraepithelial lymphocytes and lamina proper lymphocytes in the intestine.

Results

After fed with 250 μg ovalbumin oral tolerance was induced in 7 days in both DSS‐induced colitis and control mice, while oral tolerance persisted in the control mice but vanished in DSS‐induced colitis 14 days after ovalbumin challenge. DAI and colonic histopathological scores were decreased significantly after the ingestion of CEP (controlled by BSA) in DSS‐induced colitis with significant reduction of Th1 and the ratio of Th1 to Th2 in Peyer's patch as well as the γδ T cells in lamina proper lymphocytes in the intestine. No significant difference in Th1–Th2 balance in the spleen and γδ T cells in intraepithelial lymphocytes in the intestine were observed.

Conclusions

There is a defect in oral tolerance at day 7 in DSS‐induced colitis. If taken orally, CEP may have a protective role in DSS‐induced colitis, which may be related to the deflection from Th1 to Th2 in Peyer's patch and the reduction of γδ T cells in lamina proper lymphocytes in the intestine.
United Nations Peacekeeping and Civilian Protection in Civil War
Authors: Hultman Lisa , Kathman Jacob , Shannon Megan
Published: May 2013

Does United Nations peacekeeping protect civilians in civil war? Civilian protection is a primary purpose of UN peacekeeping, yet there is little systematic evidence for whether peacekeeping prevents civilian deaths. We propose that UN peacekeeping can protect civilians if missions are adequately composed of military troops and police in large numbers. Using unique monthly data on the number and type of UN personnel contributed to peacekeeping operations, along with monthly data on civilian deaths from 1991 to 2008 in armed conflicts in Africa, we find that as the UN commits more military and police forces to a peacekeeping mission, fewer civilians are targeted with violence. The effect is substantial—the analyses show that, on average, deploying several thousand troops and several hundred police dramatically reduces civilian killings. We conclude that although the UN is often criticized for its failures, UN peacekeeping is an effective mechanism of civilian protection.
Pre‐existing IgG antibodies cross‐reacting with the Fab region of infliximab predict efficacy and safety of infliximab therapy in inflammatory bowel disease
Authors: Steenholdt C. , Palarasah Y. , Bendtzen K. , Teisner A. , Brynskov J. , Teisner B. , Nielsen C. H.
Published: May 2013

Background

Infliximab (IFX) is a chimeric murine/human anti‐TNF antibody (Ab) used for the treatment of Crohn's disease (CD) and ulcerative colitis (UC). Loss of response is common and associated with development of anti‐IFX Abs during ongoing therapy. However, human anti‐murine immunoglobulin Abs are common and may cross‐react with the murine part of IFX.

Aim

To investigate if Abs binding to IFX's Fab region (IFX‐Fab) are present in IBD patients before exposure to IFX, and whether they predict efficacy and safety of IFX therapy.

Methods

Observational, retrospective cohort study of patients with CD (n = 29) and UC (n = 22).

Results

Pre‐treatment levels of IFX‐Fab reactive IgG Abs were significantly lower in CD patients in remission after 1 year of maintenance IFX (median 91 mU/L, n = 8) than in the rest of the patients (639 mU/L, n = 21; P < 0.01), and lower than in patients with secondary loss of response in particular (692 mU/L, n = 7; P < 0.01). A cut‐off concentration of <439 mU IFX‐Fab reactive IgG Ab per litre comprised all patients who later obtained long‐term sustained remission on IFX (sensitivity 100%, specificity 67%). Similar trends were observed in UC. The pre‐treatment levels of IFX‐Fab reactive IgG Abs were markedly higher in patients developing infusion reactions to IFX (1037 mU/L, n = 7) than in the remaining patients (349 mU/L, n = 44; P = 0.036).

Conclusions

IFX‐Fab reactive IgG antibodies present in serum from IBD patients before infliximab therapy associate with lack of long‐term efficacy and safety. Assessments of such antibodies may help clinicians to choose between treatment with infliximab and more humanised agents.
Incorporating technologies into a flexible teaching space
Authors: Joy Mike , Foss Jonathan , King Emma , Sinclair Jane , Sitthiworachart Jirarat , Davis Rachel
Published: May 2013

Higher education institutions are increasingly exploring how they can use emerging technologies to develop and enhance the learning experiences offered to students. These activities have mainly focused on developing student‐centred facilities. The University of Warwick has taken the next step by developing a space (the Teaching Grid) specifically designed to meet the needs of teaching staff across the institution. This paper describes how the Teaching Grid supports teachers by providing a flexible experimental space together with a rich collection of established and new technologies, and with comprehensive staff support. We analysed the use of the facility during the first 30 months of operation, using data collected from 119 case studies, in order to present a perspective on how they have used the technologies and how this has impacted on their teaching practice. We present a taxonomy that provides a concrete framework to support future analysis of and comparisons between such spaces.
Local Understandings of Conservation in Southeastern Mexico and Their Implications for Community‐Based Conservation as an Alternative Paradigm
Authors: REYES‐GARCIA VICTORIA , RUIZ‐MALLEN ISABEL , PORTER‐BOLLAND LUCIANA , GARCIA‐FRAPOLLI EDUARDO , ELLIS EDWARD A. , MENDEZ MARIA‐ELENA , PRITCHARD DIANA J. , SANCHEZ‐GONZALEZ MARÍA‐CONSUELO
Published: May 2013

Since the 1990s national and international programs have aimed to legitimize local conservation initiatives that might provide an alternative to the formal systems of state‐managed or otherwise externally driven protected areas. We used discourse analysis (130 semistructured interviews with key informants) and descriptive statistics (679 surveys) to compare local perceptions of and experiences with state‐driven versus community‐driven conservation initiatives. We conducted our research in 6 communities in southeastern Mexico. Formalization of local conservation initiatives did not seem to be based on local knowledge and practices. Although interviewees thought community‐based initiatives generated less conflict than state‐managed conservation initiatives, the community‐based initiatives conformed to the biodiversity conservation paradigm that emphasizes restricted use of and access to resources. This restrictive approach to community‐based conservation in Mexico, promoted through state and international conservation organizations, increased the area of protected land and had local support but was not built on locally relevant and multifunctional landscapes, a model that community‐based conservation is assumed to advance.

Percepciones Locales de Conservación en el Sureste de México e Implicaciones para la Conservación Comunitaria como Paradigma Alternativo
Different Cellular Localization of NF‐κB p65 Expression as an Indicator of Different Prognoses of Stage I–III Gastric Cancer Patients
Authors: Zhou Fang , Wei Hongjun , Ding Aiping , Qiu Wensheng , Feng Lingxin , Zhou Quan , Liang Jun , Yue Lu
Published: May 2013

Background

Nuclear factor‐κB p65 (NF‐κB p65) may play a significant role as a biomarker in tumor progression and metastasis. However, the correlation between cellular localization of NF‐κB p65 expression and the prognosis of gastric cancer (GC) patients has not been studied. The present study was designed to investigate the location of NF‐κB p65 expression in GC, and evaluate its correlation with clinicopathological parameters of GC patients.

Methods

NF‐κB p65 expressions in GC tissue and corresponding nonmalignant tissue from gastrectomy of 115 stage I–III GC patients were detected by immunohistochemistry. In addition, correlations between the staining results and the clinicopathologic features and survival of the GC patients were analyzed.

Results

The percentage of NF‐κB p65 expression in GC tissue and the corresponding nonmalignant tissue was 73.9% and 46.80%, respectively. No significant correlation was found between NF‐κB p65 expression and the clinicopathologic parameters. Cox univariate analysis indicated that both nuclear staining and cytoplasmic staining of NF‐κB p65 expression correlated with the prognosis of GC patients (log‐rank, p = 0.0182; p = 0.0144, respectively).

Conclusion

High nuclear expression of NF‐κB p65 is an independent prognostic marker predicting a better survival, while high cytoplasmic staining indicates a worse prognosis of GC patients.
Mentor Training within Academic Health Centers with Clinical and Translational Science Awards
Authors: Abedin Zainab , Rebello Tahilia J. , Richards Boyd F. , Pincus Harold Alan
Published: May 2013

Multiple studies highlight the benefits of effective mentoring in academic medicine. Thus, we sought to quantify and characterize the mentoring practices at academic health centers (AHCs) with Clinical and Translational Science Awards (CTSA). Here we report findings pertaining specifically to mentor training at the level of the KL2 mentored award program, and at the broader institutional level. We found only four AHCs did not provide any form of training. One‐time orientation was most prevalent at the KL2 level, whereas formal face‐to‐face training was most prevalent at the institutional level. Despite differences in format usage, there was general consensus at both the KL2 and institutional level about the topics of focus of face‐to‐face training sessions. Lower‐resource training formats utilized at the KL2 level may reveal a preference for preselection of qualified mentors, while institutional selection of resource‐heavy formats may be an attempt to raise the mentoring qualifications of the academic community as a whole. The present work fits into the expanding landscape of academic mentoring literature and sets the framework for future longitudinal, outcome studies focused on identifying the most efficient strategies to develop effective mentors.
Photodynamic therapy for skin rejuvenation: treatment options – results of a consensus conference of an expert group for aesthetic photodynamic therapy
Authors: Szeimies Rolf‐Markus , Lischner Stephan , Philipp‐Dormston Wolfgang , Walker Thorsten , Hiepe‐Wegener Dagmar , Feise Konstantin , Podda Maurizio , Prager Welf , Kohl Elisabeth , Karrer Sigrid
Published: May 2013

In addition to providing effective treatment for non‐melanoma skin cancers or their precursors, photodynamic therapy (PDT) has also attracted considerable attention for its use on aesthetic dermatology. In a first consensus publication the mechanisms of action of its photorejuvenation effects and recent studies were presented; in this paper treatment protocols for the different anatomical regions exposed to chronic sun damage like face, neck, décolleté and the back of the hands are given and suitable procedures for pre‐ and after‐care are discussed.
Recent advances in endoscopic management of difficult bile duct stones
Authors: Yasuda Ichiro , Itoi Takao
Published: May 2013

Endoscopic treatment is now recognized worldwide as the first‐line treatment for bile duct stones. Endoscopic sphincterotomy combined with basket and/or balloon catheter is generally carried out for stone extraction. However, some stones are refractory to treatment under certain circumstances, necessitating additional/other therapeutic modalities. Large bile duct stones are typically treated by mechanical lithotripsy. However, if this fails, laser or electrohydraulic lithotripsy (EHL) is carried out under the guidance of conventional mother‐baby cholangioscopy. More recently, direct cholangioscopy using an ultrathin gastroscope and the newly developed single‐use cholangioscope system – the SpyGlass direct visualization system – are also used. In addition, extracorporeal shock wave lithotripsy has also been used for stone fragmentation. Such fragmentation techniques are effective in cases with impacted stones, including Mirizzi syndrome. Most recently, endoscopic papillary large balloon dilationhas been introduced as an easy and effective technique for treating large and multiple stones. In cases of altered anatomy, it is often difficult to reach the papilla; in such cases, a percutaneous transhepatic approach, such as EHL or laser lithotripsy under percutaneous transhepatic cholangioscopy, can be a treatment option. Moreover, enteroscopy has recently been used to reach the papilla. Furthermore, an endoscopic ultrasound‐guided procedure has been attempted most recently. In elderly patients and those with very poor general condition, biliary stenting only is sometimes carried out with or without giving subsequent dissolution agents.
Merits of prophylactic sclerotherapy for esophageal varices concomitant unresectable hepatocellular carcinoma: Prospective randomized study
Authors: Akahoshi Tomohiko , Tomikawa Morimasa , Tsutsumi Norifumi , Hashizume Makoto , Maehara Yoshihiko
Published: May 2013

Background

Several clinical studies of prophylactic therapy for esophageal varices have led to the conclusion that prophylactic therapy is of no value, and it is generally not accepted in the Western world. However, this is not the case in Japan. The present study evaluated the efficacy of prophylactic endoscopic injection sclerotherapy (EIS) in patients with unresectable hepatocellular carcinoma (HCC) and risky esophageal varices.

Patients and Methods

Twenty‐seven patients with ‘likely‐to‐bleed’ esophageal varices concomitant with unresectable HCC were randomly allocated to two groups. Thirteen patients underwent prophylactic EIS (EIS group), whereas the remaining 14 patients were observed conservatively (control group).

Results

No bleeding from esophageal varices occurred in the EIS group during the entire period of this study, whereas in thecontrol group the cumulative bleeding rate was 44.8% in 6 months. Cumulative survival rates of patients in the EIS group and in the control group were 48.8% and 7.7% in 2 years, respectively. There was a statistically significant difference between the two groups in cumulative bleeding rate and survival rate (P < 0.01).

Conclusion

This prospective study demonstrated that prophylactic EIS could prolong the survival of the patients with esophageal varices concomitant with unresectable HCC. Prophylactic EIS for patients with unresectable HCC may be, in part, justified according to the present study.
Mothers vigilantly guard nests after partial brood loss: a cue of nest predation risk in a paper wasp
Authors: FURUICHI SHO , KASUYA EIITI
Published: May 2013

Parental defence behaviour can reduce the probability of nest predation, but also incurs costs (e.g. less time for foraging). Under variable risk, parental strategies that adjust the amount of defence effort to the prevailing risk will be adaptive.

Although nest predation is typically viewed as an all‐or‐none event, many nests are depredated only partially. Therefore, partial brood loss will indicate the occurrence of nest predation and, as a consequence, high predation risk. However, whether parents use loss of offspring as a cue of predation risk and increase their defence effort after partial brood loss has not been examined.

The study examined whether a foundress of a paper wasp Polistes chinensis antennalis Pérez increases defence effort after the experimental removal of a larva from the nest. The foundress maintains a nest alone during the colony‐founding stage. At this stage, larvae in the nest are often depredated by conspecific females of other nests. The foundress can chase off attacking females when it is on the nest, but it needs to leave the nest to gather resources such as food.

For 30 min after the experimental removal of a larva, foundresses increased the time spent on the nest by shortening the time spent on each off‐nest activity and prolonging the interval between off‐nest activities. The time spent on the nest then returned to what it was before the removal. These results suggest that foundresses use the loss of a larva as the cue of high predation risk and increase their defence effort in response.
Persistent firing supported by an intrinsic cellular mechanism in hippocampal CA3 pyramidal cells
Authors: Jochems Arthur , Yoshida Motoharu
Published: May 2013

Short‐term information retention is crucial for information processing in the brain. It has long been suggested that the hippocampal CA3 region is able to support short‐term information retention through persistent neural firing. Theoretical studies have shown that this persistent firing can be supported by abundant excitatory recurrent connections in CA3. However, it remains unclear whether individual cells can support persistent firing. In this study, using in vitro whole‐cell patch‐clamp recordings in a rat hippocampal slice preparation, we show that hippocampal CA3 pyramidal cells support persistent firing under perfusion of the cholinergic agonist carbachol (10 μm). Furthermore, in contrast to earlier theoretical studies, this persistent firing is independent of ionotropic glutamatergic synaptic transmission and is supported by the calcium‐activated non‐selective cationic current. Because cholinergic receptor activation is crucial for short‐term memory tasks, persistent firing in individual cells may support short‐term information retention in the hippocampal CA3 region.
OnKant's Conception of Inner Sense: Self‐Affection by the Understanding
Authors: Schmitz Friederike
Published: May 2013

Among the extensive literature on the firstCritique, very few commentators offer a thorough analysis ofKant's conception of inner sense. This is quite surprising since the notion is central toKant's theoretical philosophy, and it is very difficult to provide a consistent interpretation of this notion. In this paper, I first summarizeKant's claims about inner sense in theTranscendentalAesthetic and show why existing interpretations have been unable to dissolve the tensions arising from the conjunction of these claims. Secondly, I present my own reconstruction ofKant's model of inner sense, relying essentially onKantian considerations found in theB‐version of theTranscendentalDeduction. My main idea is that inner sense, forKant, is a passive faculty that gets affected by the understanding performing its figurative synthesis on material given in outer sense. In the remainder of the paper,Ihighlight a few consequences of my interpretation and outline ways to deal with some objections.
Investigating the Effect of Familiarity on Kin Recognition of Three‐Spined Stickleback (Gasterosteus aculeatus)
Authors: Frommen Joachim G. , Zala Sarah M. , Raveh Shirley , Schaedelin Franziska C. , Wernisch Bettina , Hettyey Attila
Published: May 2013

The ability to discriminate between related and unrelated individuals has been demonstrated in many species. The mechanisms behind this ability might be manifold and depend on the ecological context in which the species lives. In brood‐caring species, both familiarity and phenotype matching are known to be used in kin recognition. However, results of studies disentangling these two phenomena have proved contradictory. We aimed to broaden our knowledge about the mechanisms of kin recognition using shoaling preferences of three‐spined stickleback (Gasterosteus aculeatus) as a model behavior. In our first experiment, focal fish had the choice to shoal either with kin or unfamiliar non‐kin. In half of the trials, kin groups were composed of familiar individuals, while they were unfamiliar in the other half. Focal fish significantly preferred kin as shoaling partner, a result which was not reinforced by familiarity. In our second experiment, focal fish were given the choice between a shoal of familiar kin and a shoal of unfamiliar kin. Here, focal fish did not show any significant preference. These results indicate that familiarity does not impact stickleback's ability to recognize kin. Furthermore, they show that familiarity does not overrule recognition based on phenotype matching or innate recognition, underlining the importance of these mechanisms. Finally, our results lead to the assumption that individual recognition might play a minor role also in non‐kin‐based preferences for familiars.
CDKN2A and MC1R variants influence dermoscopic and confocal features of benign melanocytic lesions in multiple melanoma patients
Authors: Bassoli Sara , Maurichi Andrea , Rodolfo Monica , Casari Alice , Frigerio Simona , Pupelli Gaia , Farnetani Francesca , Pelosi Giuseppe , Santinami Mario , Pellacani Giovanni
Published: May 2013

Non‐invasive diagnostic tools are effective in the histomorphological study of melanocytic lesions. The role of melanoma susceptibility genes on melanocytic nevi histopathological features is not clear. The current study aimed to correlate genetic alterations and histomorphological features of melanocytic nevi. Clinical, dermoscopic and confocal features of 34 multiple melanoma patients and 34 controls were compared. Among patients with melanoma, carriers of CDKN2A mutations and/or MC1R variants, and wild‐type genes were also compared. In patients with melanoma, a lighter phototype (P = 0.051), a higher number of nevi (P < 0.01) and clinically atypical nevi (P < 0.01) were observed. At dermoscopy, these nevi showed a complex pattern (P = 0.011), atypical network (P = 0.018) and irregular pigmentation (P = 0.037); at confocal, an irregular meshwork pattern (P = 0.026) with atypical nests (P = 0.016) and an inflammatory infiltrate (P = 0.048) were observed. Among patients with melanoma genetically tested, CDKN2A G101W mutation carriers were more frequently younger (P = 0.023), with clinically atypical nevi (P = 0.050), with cytological atypia (P = 0.033) at confocal. G101W mutation and MC1R variants carriers showed hypopigmented nevi (P = 0.002) and, at confocal, roundish cells infiltrating the junction (P = 0.019). These data suggest an influence of CDKN2A mutation and MC1R variants in the development of dysplastic melanocytic lesions. Non‐invasive histomorphological evaluation, together with genetic studies, improves melanoma risk identification and early diagnosis, for a patient‐tailored management.
Towards the automatic enrichment of a thesaurus with information in dictionaries
Authors: Oliveira Hugo Gonçalo , Gomes Paulo
Published: May 2013

Regarding that information in broad‐coverage knowledge bases, such as thesauri, is usually incomplete, merging information from different sources is an alternative to amplify coverage. We propose a method for the enrichment of a thesaurus with information acquired automatically from dictionaries. First, synonymy pairs are extracted. Then, these pairs are assigned to the most similar candidate synsets. Finally, the remaining pairs are the target of clustering to identify new synsets. After selecting the adequate experimentation settings, this method was applied to enrich a Portuguese thesaurus with synonyms extracted from three dictionaries, which resulted in TRIP, a larger and broader thesaurus with new words and concepts. The steps towards the creation of this new thesaurus and its evaluation are described here.
Who may not benefit from continuous renal replacement therapy in acute kidney injury?
Authors: Kawarazaki Hiroo , Uchino Shigehiko , Tokuhira Natsuko , Ohnuma Tetsu , Namba Yoshitomo , Katayama Shinshu , Toki Noriyoshi , Takeda Kenta , Yasuda Hideto , Izawa Junichi , Uji Makiko , Nagata Isao ,   JSEPTIC (Japanese Society for Physicians Trainees in Intensive Care) Clinical Trial Group
Published: May 2013

This study aimed to identify factors that may predict early kidney recovery (less than 48 hours) or early death (within 48 hours) after initiating continuous renal replacement therapy (CRRT) in acute kidney injury (AKI) patients. This is a multicenter retrospective observational study of 14 Japanese Intensive care units (ICUs) in 12 tertiary hospitals. Consecutive adult patients with severe AKI requiring CRRT admitted to the participating ICUs in 2010 (n = 343) were included. Patient characteristics, variables at CRRT initiation, settings, and outcomes were collected. Patients were grouped into early kidney recovery group (CRRT discontinuation within 48 hours after initiation, n = 52), early death group (death within 48 hours after CRRT initiation, n = 52), and the rest as the control group (n = 239). The mean duration of CRRT in the early kidney recovery group and early death group was 1.3 and 0.9 days, respectively. In multivariable regression analysis, in comparison with the control group, urine output (mL/h) (odds ratio [OR]: 1.02, 95% confidence interval [CI]: 1.01–1.03), duration between ICU admission to CRRT initiation (days) (OR: 0.65, 95% CI: 0.43–0.87), and the sepsis‐related organ failure assessment score (OR: 0.87, 95% CI; 0.78–0.96) were related to early kidney recovery. Serum lactate (mmol/L) (OR: 1.19, 95% CI: 1.11–1.28), albumin (g/dL) (OR: 0.52, 95% CI: 0.28–0.92), vasopressor use (OR: 3.68, 95% CI: 1.37–12.16), and neurological disease (OR: 9.64, 96% CI: 1.22–92.95) were related to early death. Identifying AKI patients who do not benefit from CRRT and differentiating such patients from the study cohort may allow previous and future studies to effectively evaluate the indication and role of CRRT.
An undetectable polymerase chain reaction signal in routine HIV plasma viral load monitoring is associated with better virological outcomes in patients receiving highly active antiretroviral therapy
Authors: Pugliese P , Delpierre C , Cuzin L , Poizot‐Martin I , Rey D , Saune K , Cottalorda J , Bettinger D , Delaugerre C , Hoen B ,   Dat AIDS Study Group
Published: May 2013

Objectives

The aim of the study was to assess whether patients with undetectable viraemia [a negative polymerase chain reaction result (PCRneg)] and those with plasma viral load (PVL) < 40 HIV‐1 RNA copies/mL but a detectable (positive) PCR signal (PCRpos) had different outcomes in terms of the development of blips and virological failure (VF).

Methods

A multicentre observational database analysis was carried out. Data for patients whose highly active antiretroviral therapy (HAART) regime had been unchanged for ≥ 6 months by 1 January 2008, whose first two PVL measurements of 2008 were < 40 copies/mL and who had at least five PVL measurements between 1 January 2008 and 31 December 2010 were extracted from a multicentre observational database of 4928 patients receiving HAART. PVL assays used during this period had a detection threshold of 20 or 40 copies/mL. Undetectable PVL at baseline (BLPCRneg) was defined as PCRneg at the first two PVL determinations of 2008. Multivariable Cox regression analysis was performed to investigate factors associated with the occurrence of blips and VF, defined as two consecutive PVL measurements > 40 copies/mL.

Results

Of the 1957 patients included in the study (mean age 47 years; median antiretroviral exposure 10.3 years), 1312 had BLPCRneg. Outcome events included 322 blips and 139 VFs, with incidence rates being significantly lower in patients with BLPCRneg than in those with BLPCRpos [13.0% vs. 23.4% (P < 0.0001) and 5.1% vs. 11.2% (P < 0.0001), respectively]. In multivariable analysis, BLPCRneg was associated with a reduced risk of blips [hazard ratio (HR) 0.58; 95% confidence interval (CI) 0.47–0.73; P < 0.0001] and VF (HR 0.44; 95% CI 0.31–0.62; P < 0.0001).

Conclusions

Patients with PCRneg had better virological outcomes than those with PVL < 40 copies/mL but detectable viraemia. This suggests that the ‘no‐signal’ information provided by currently commercially available HIV RNA quantification assays should be used routinely.
Apical extrusion of debris: a literature review of an inherent occurrence during root canal treatment
Authors: Tanalp J. , Güngör T.
Published: May 2013

Extrusion of intracanal debris as well as irrigants is a common occurrence during root canal treatment, and no instrument or technique has thoroughly solved this problem. Because flare‐ups may arise with any irritation directed towards periapical tissues, a shaping or irrigation technique should minimize the risk of apical extrusion, even though it may not be prevented. There has been a rapid evolution of root canal instruments and irrigation systems through the last decade, and many have been assessed for their debris extrusion potential. The purpose of this review was to identify publications regarding the evaluation of debris, bacteria and irrigant extrusion during root canal treatment. A PubMed, Ovid and MEDLINE search was conducted using the keywords “apical extrusion”, “debris extrusion” and “endodontic treatment”. The literature search extended over a period of more than 30 years up to 2012. Content of the review was limited to apical extrusion of debris and irrigants, extrusion of liquid by irrigation methods and bacterial extrusion. Issues relevant to apical extrusion were obtained by further search in the reference sections of the retrieved articles. The review provides an update on the current status of apical extrusion.
The ideological roots of the support for welfare state reform: Support for distributive and commodifying reform in The Netherlands
Authors: Achterberg Peter , van der Veen Romke , Raven Judith
Published: May 2013

This article examines the extent to which four major trends in welfare state reform – privatisation, increasing selectivity, increasing activation and increasing discipline – are supported and how this support can be explained. Using recent public opinion data of the Dutch population, it is found that there are two ideological dimensions underlying welfare reform support, the first tapping distributive reform, the latter tapping commodifying reform. While support for distributive reform in the direction of decreasing redistribution can solely be explained by economic interests and economic values, support for commodifying reform can also be explained culturally. It appears that one's cultural position and cultural ideological values are important for support for commodifying reform.
Is a Bird an Apple? The Effect of Speaker Labeling Accuracy on Infants' Word Learning, Imitation, and Helping Behaviors
Authors: Brooker Ivy , Poulin‐Dubois Diane
Published: May 2013

This study examined infants' sensitivity to a speaker's verbal accuracy and whether the reliability of the speaker had an effect on their selective trust. Forty‐nine 18‐month‐old infants were exposed to a speaker who either accurately or inaccurately labeled familiar objects. Subsequently, the speaker administered a series of tasks in which infants had an opportunity to: learn a novel word, imitate the speaker's “irrational” actions, and help the speaker obtain an out‐of‐reach object. In contrast to infants in the accurate (reliable) condition, those in the inaccurate (unreliable) condition performed more poorly on a word‐learning task and were less likely to imitate. All infants demonstrated high rates of instrumental helping behavior. These results are the first to demonstrate that infants as young as 18 months of age cannot only detect a speaker's verbal inaccuracy but also use this information to attenuate their word recognition and learning of novel actions.
Population dynamics of the spruce bark beetle: a long‐term study
Authors: Marini Lorenzo , Lindelöw Åke , Jönsson Anna Maria , Wulff Sören , Schroeder Leif Martin
Published: May 2013

Bark beetle population dynamics is thought to be primarily driven by bottom‐up forces affecting insect performance and host tree resistance. Although there are theoretical predictions and empirical evidences that predation and parasitism may play an important role in driving bark beetle population fluctuations, long‐term studies testing the role of both biotic and abiotic controls on population dynamics are still rare. The aim of the study was to quantify the relative importance of predation, negative density feedback and abiotic factors in driving Ips typographus population dynamics. We analyzed a unique time series of population density of I. typographus and its main predator Thanasimus formicarius over almost two decades in four regions across Sweden. We used a discrete population model and a multi‐model inference approach to evaluate the importance of both bottom up and top down factors. We found that availability of breeding substrates in the form of storm‐felled trees was the main outbreak trigger, while strong intra‐specific competition for host trees was the main endogenous regulating factor. Although temperature‐related metrics are known to have strong individual effect on I. typographus development and number of generations, they did not emerge as important drivers of population dynamics. A positive effect of low summer rainfall was evident only in the region located in the southernmost and warmest part of the spruce distribution range in Sweden. Predator density did not emerge as an important prey regulating factor. As the reported damage from storms seems to have increased across whole Europe, spruce forests are expected to be increasingly susceptible to large outbreaks of I. typographus with important economic and ecological consequences for boreal ecosystems. However, the observed negative density feedback seems to be a natural regulating mechanism that impedes a strong long‐term propagation of the outbreaks.
Trait‐mediated indirect interactions in a marine intertidal system as quantified by functional responses
Authors: Alexander Mhairi E. , Dick Jaimie T. A. , O’Connor Nessa E.
Published: May 2013

Studies of trait‐mediated indirect interactions (TMIIs) typically focus on effects higher predators have on per capita consumption by intermediate consumers of a third, basal prey resource. TMIIs are usually evidenced by changes in feeding rates of intermediate consumers and/or differences in densities of this third species. However, understanding and predicting effects of TMIIs on population stability of such basal species requires examination of the type and magnitude of the functional responses exhibited towards them. Here, in a marine intertidal system consisting of a higher‐order fish predator, the shanny Lipophrys pholis, an intermediate predator, the amphipod Echinogammarus marinus, and a basal prey resource, the isopod Jaera nordmanni, we detected TMIIs, demonstrating the importance of habitat complexity in such interactions, by deriving functional responses and exploring consequences for prey population stability. Echinogammarus marinus reacted to fish predator diet cues by reducing activity, a typical anti‐predator response, but did not alter habitat use. Basal prey, Jaera nordmanni, did not respond to fish diet cues with respect to activity, distribution or aggregation behaviour. Echinogammarus marinus exhibited type II functional responses towards J. nordmanni in simple habitat, but type III functional responses in complex habitat. However, while predator cue decreased the magnitude of the type II functional response in simple habitat, it increased the magnitude of the type III functional response in complex habitat. These findings indicate that, in simple habitats, TMIIs may drive down consumption rates within type II responses, however, this interaction may remain de‐stabilising for prey populations. Conversely, in complex habitats, TMIIs may strengthen regulatory influences of intermediate consumers on prey populations, whilst potentially maintaining prey population stability. We thus highlight that TMIIs can have unexpected and complex ramifications throughout communities, but can be unravelled by considering effects on intermediate predator functional response types and magnitudes.

Synthesis

Higher‐order predators and habitat complexity can influence behaviour of intermediate species, affecting their consumption of prey through trait‐mediated indirect interactions (TMIIs). However, it is not clear how these factors interact to determine prey population stability. Using functional responses (FRs), relating predator consumption to prey density, we detected TMIIs in a marine system. In simple habitats, TMIIs reduced consumption rates, but FRs remained de‐stabilising for prey populations. In complex habitats, TMIIs strengthened prey regulation with population stabilizing FRs. We thus demonstrate that FRs can assess interactions of environmental and biological cues that result in complex and unexpected outcomes for prey populations.
The impact of workplace relationships on engagement, well‐being, commitment and turnover for nurses in Australia and the USA
Authors: Brunetto Yvonne , Xerri Matthew , Shriberg Art , Farr‐Wharton Rod , Shacklock Kate , Newman Stefanie , Dienger Joy
Published: May 2013

Aims

We examined the impact of workplace relationships (perceived organizational support, supervisor–nurse relationships and teamwork) on the engagement, well‐being, organizational commitment and turnover intentions of nurses working in Australian and USA hospitals.

Background

In a global context of nurse shortages, knowledge about factors impacting nurse retention is urgently sought. We postulated, using the Social Exchange Theory, that nurses' turnover intentions would be affected by several factors and especially their relationships at work.

Design

Based on the literature review, data were collected via a self‐report survey to test the hypotheses.

Methods

A self‐report survey was used to gather data in 2010–2012 from 510 randomly chosen nurses from Australian hospitals and 718 nurses from US hospitals. A multi‐group structural equation modelling analysis identified significant paths and compared the impact between countries.

Results

The findings indicate that this model was more effective in predicting the correlations between variables for nurses in Australia compared with the USA. Most paths predicted were confirmed for Australia, except for the impact of teamwork on organizational commitment and turnover, plus the impact of engagement on turnover. In contrast, none of the paths related to supervisor–subordinate relationships was significant for the USA; neither were the paths from teamwork to organizational commitment or turnover.

Conclusion

Our findings suggest that well‐being is a predictor of turnover intentions, meaning that healthcare managers need to consider nurses' well‐being in everyday decision‐making, especially in the cost‐cutting paradigm that pervades healthcare provision in nearly every country. This is important because nurses are in short supply and this situation will continue to worsen, because many countries have an ageing population.
Expression of phospho‐Ca2+/calmodulin‐dependent protein kinase II in the pre‐Bötzinger complex of rats
Authors: Kang Jun‐Jun , Wei Xiao‐Yan , Liu Jin‐Ping , Wong‐Riley Margaret T. T. , Ju Gong , Liu Ying‐Ying
Published: May 2013

The pre‐Bötzinger complex (pre‐BötC) in the ventrolateral medulla oblongata is a presumed kernel of respiratory rhythmogenesis. Ca2+‐activated non‐selective cationic current is an essential cellular mechanism for shaping inspiratory drive potentials. Ca2+/calmodulin‐dependent protein kinase II (CaMKII), an ideal ‘interpreter’ of diverse Ca2+ signals, is highly expressed in neurons in mediating various physiological processes. Yet, less is known about CaMKII activity in the pre‐BötC. Using neurokinin‐1 receptor as a marker of the pre‐BötC, we examined phospho (P)‐CaMKII subcellular distribution, and found that P‐CaMKII was extensively expressed in the region. P‐CaMKII‐ir neurons were usually oval, fusiform, or pyramidal in shape. P‐CaMKII immunoreactivity was distributed within somas and dendrites, and specifically in association with the post‐synaptic density. In dendrites, most synapses (93.1%) examined with P‐CaMKII expression were of asymmetric type, occasionally with symmetric type (6.9%), whereas in somas, 38.1% were of symmetric type. P‐CaMKII asymmetric synaptic identification implicates that CaMKII may sense and monitor Ca2+ activity, and phosphorylate post‐synaptic proteins to modulate excitatory synaptic transmission, which may contribute to respiratory modulation and plasticity. In somas, CaMKII acts on both symmetric and asymmetric synapses, mediating excitatory and inhibitory synaptic transmission. P‐CaMKII was also localized to the perisynaptic and extrasynaptic regions in the pre‐BötC.
Nursing Workforce Policy and the Economic Crisis: A Global Overview
Authors: Buchan James , O'May Fiona , Dussault Gilles
Published: May 2013

Purpose

To assess the impact of the global financial crisis on the nursing workforce and identify appropriate policy responses.

Organizing Construct and Methods

This article draws from international data sources (Organisation for Economic Co‐operation and Development [OECD] and World Health Organization), from national data sources (nursing regulatory authorities), and the literature to provide a context in which to examine trends in labor market and health spending indicators, nurse employment, and nurse migration patterns.

Findings

A variable impact of the crisis at the country level was shown by different changes in unemployment rates and funding of the health sector. Some evidence was obtained of reductions in nurse staffing in a small number of countries. A significant and variable change in the patterns of nurse migration also was observed.

Conclusions

The crisis has had a variable impact; nursing shortages are likely to reappear in some OECD countries. Policy responses will have to take account of the changed economic reality in many countries.

Clinical Relevance

This article highlights key trends and issues for the global nursing workforce; it then identifies policy interventions appropriate to the new economic realities in many OECD countries.
Children's and parents’ perceptions of postoperative pain management: a mixed methods study
Authors: Twycross Alison , Finley G Allen
Published: May 2013

Aims and objectives

To explore children's and parents' perceptions about the quality of postoperative pain management.

Background

Children continue to experience moderate to severe pain postoperatively. Unrelieved pain has short‐ and long‐term undesirable consequences. Thus, it is important to ensure pain is managed effectively. Little research has explored children's and parents' perceptions of pain management.

Design

Exploratory study.

Methods

Children (n = 8) were interviewed about their perceptions of pain care using the draw‐and‐write technique or a semi‐structured format and asked to rate the worst pain experienced postoperatively on a numerical scale. Parents (n = 10) were asked to complete the Information About Pain questionnaire. Data were collected in 2011.

Results

Most children experienced moderate to severe pain postoperatively. Children reported being asked about their pain, receiving pain medication and using nonpharmacological methods of pain relief. A lack of preoperative preparation was evident for some children. Most parents indicated they had received information on their child's pain management. Generally, participants were satisfied with care.

Conclusion

Participants appeared satisfied with the care provided despite experiencing moderate to severe pain. This may be attributable to beliefs that nurses would do everything they could to relieve pain and that some pain is to be expected postsurgery.

Relevance to clinical practice

Children are still experiencing moderate to severe pain postoperatively. Given the possible short‐ and long‐term consequences of unrelieved pain, this is of concern. Knowledge translation models may support the use of evidence in practice, and setting a pain goal with parents and children may help improve care.
Perspectives of health personnel on how to preserve and promote the patients’ dignity in a rehabilitation context
Authors: Caspari Synnøve , Aasgaard Trygve , Lohne Vibeke , Slettebø Åshild , Nåden Dagfinn
Published: May 2013

Aims and objectives

To explore how healthcare personnel comprehend the term dignity and what they do to attend to, preserve and promote the dignity of patients in the rehabilitation context.

Background

Literature reveals that knowledge exists concerning the nature of dignity. Literature is scant on how health personnel think the reasons may be when patients do not maintain their dignity or how caregivers might improve and strengthen their concern in preserving and promoting the patients' dignity in a rehabilitation context.

Design

The study was explorative and descriptive, with content analysis of gathered empirical data.

Methods

Qualitative focus group interviews with representatives from the staff at three different rehabilitation centres were carried out. Professionals within different occupations were represented at the meeting: nurses, ergonomists, physiotherapists, psychologists, medical doctors, social workers, auxiliary nurses and speech therapists.

Results

Dignity is promoted when the patient himself becomes an active agent, when the patient's feelings and thoughts are respected, when the family of the patient is included and listened to, when the patient is free to make critical comment, when members of staff are able to cope with the patient's disabilities and when the aesthetic environment is attended to and enhanced. Dignity is not promoted when health personnel override or dominate patients, when health personnel focus merely on the patient's diagnosis and not the sick person and when health personnel and/or relatives try to impose their own values.

Conclusion

The staff working in institutions to rehabilitate patients with head injuries and multiple sclerosis must be aware and sensitive to the importance of maintaining and supporting the patient's dignity and self‐respect.

Relevance for clinical practice

The results from this project confirm the importance of acknowledging the patient's self‐worth as a human being, unconditionally. This might be essential in promoting and preserving the patients' dignity.