bluuebunny/crossref_metadata_2025 huggingface dataset:
Influence of climate and reproductive timing on demography of little brown myotis Myotis lucifugus
Authors: Frick Winifred F. , Reynolds D. Scott , Kunz Thomas H.
Published: September 2009

1. Estimating variation in demographic rates, such as survival and fecundity, is important for testing life‐history theory and identifying conservation and management goals.

2. We used 16 years (1993–2008) of mark–recapture data to estimate age‐specific survival and breeding probabilities of the little brown myotis Myotis lucifugus LeConte in southern New Hampshire, USA. Using Kendall & Nichols' (1995) full‐likelihood approach of the robust design to account for temporary emigration, we tested whether survival and breeding propensity is influenced by regional weather patterns and timing of reproduction.

3. Our results demonstrate that adult female survival of M. lucifugus ranged from 0·63 (95% CL = 0·56, 0·68) to 0·90 (95% CL = 0·77, 0·94), and was highest in wet years with high cumulative summer precipitation. First‐year survival [range: 0·23 (95% CL = 0·14, 0·35) to 0·46 (95% CL = 0·34, 0·57)] was considerably lower than adult survival and depended on pup date of birth, such that young born earlier in the summer (c. late May) had a significantly higher probability of surviving their first year than young born later in the summer (c. mid‐July). Similarly, the probability of young females returning to the maternity colony to breed in the summer following their birth year was higher for individuals born earlier in the summer [range: 0·23 (95% CL = 0·08, 0·50) to 0·53 (95% CL = 0·30, 0·75)].

4. The positive influence of early parturition on 1st‐year survival and breeding propensity demonstrates significant fitness benefits to reproductive timing in this temperate insectivorous bat.

5. Climatic factors can have important consequences for population dynamics of temperate bats, which may be negatively affected by summer drying patterns associated with global climate change.

6. Understanding long‐term demographic trends will be important in the face of a novel disease phenomenon (White‐Nose Syndrome) that is associated with massive mortalities in hibernating bat species, including M. lucifugus, in the northeastern United States.
Structured review: evaluating the effectiveness of nurse case managers in improving health outcomes in three major chronic diseases
Authors: Sutherland Debbie , Hayter Mark
Published: September 2009

Aim.  This paper presents the findings of a review and appraisal of the evidence for the effectiveness of nurse case management in improving health outcomes for patients living either with Diabetes, Chronic Obstructive Pulmonary Disease or Coronary Heart Disease.

Background.  Long term chronic health conditions provide some of the greatest challenges to western health care systems. In the UK, three of the most significant chronic conditions are Diabetes, Chronic Obstructive Pulmonary Disease and Coronary Heart Disease. Patients with these long term conditions are high users of health services who often receive unplanned, poorly co‐ordinated, ad‐hoc care in response to an exacerbation or crisis. To counter this, the nurse case manager is identified as a central aspect of improving care for these patients. However, the evidence for the effectiveness of nurse case management in improving health outcomes for the chronically ill is scarce.

Design.  A structured review of the literature.

Method.  The review was undertaken focussing on studies that evaluated nurse case management with one or all of the three major long term chronic conditions. A total of 108 papers were initially reviewed and filtered to leave 75 citations that were appraised. About 18 papers were finally included in the review and subject to thematic analysis based on the health outcomes evaluated in the studies.

Results.  Significantly positive results were reported for nurse case management impact on five health outcomes; ‘objective clinical measurements’, ‘quality of life and functionality’, ‘patient satisfaction’, ‘adherence to treatment’ and ‘self care and service use’.

Relevance to clinical practice.  The evidence generated in this review suggests that nurse case managers have the potential to achieve improved health outcomes for patients with long term conditions. Further research is required to support role development and create a more targeted approach to the intervention.
Thermal expansion coefficient of titanium casting
Authors: Low D. , Sumii T. , Swain M.
Published: September 2009

A reliable measurement of the thermal expansion coefficient (α) value is required to achieve a positive thermal mismatch between metal and porcelain for porcelain‐fused to metal crowns. Heating rate and specimen conditions may significantly influence the α value and the effects of these factors were studied. Commercially pure cast titanium rods, ‘as cast’ and sandblasted, were heated at various conditions. According to this study, the discrepancy of α values between heating and cooling conditions was insignificant when the heating (cooling) rate was reduced to 1 °C min–1. It was revealed that α values obtained from 1 °C min–1 cooling rates should be utilized. Dental porcelain with an α value lower than 8·5 × 10–6 °C will be suitable for titanium‐ceramic applications.
Evaluation of pre‐fabricated root canal posts
Authors: Hew Y. S. , Purton D. G. , Love R. M.
Published: September 2009

In this in vitro study, properties of a titanium alloy post recently introduced to the market (IntegraPost), were compared with those of a clinically proven stainless steel post (ParaPost). The IntegraPost has a unique, perforated, spherical head and a microknurled shank surface. The posts were tested for rigidity, for retention within the root canals of extracted teeth and for ability to retain composite resin cores. The two post types exhibited similar properties in core and root canal retention, however, the IntegraPost was significantly less rigid than the ParaPost.
Cognitive function and number of teeth in a community‐dwelling elderly population without dementia
Authors: TAKATA Y. , ANSAI T. , SOH I. , SONOKI K. , AWANO S. , HAMASAKI T. , YOSHIDA A. , OHSUMI T. , TOYOSHIMA K. , NISHIHARA T. , TAKEHARA T.
Published: September 2009

Summary  Although the number of sound or decayed teeth has been reported to be associated with cognitive function in elderly populations with dementia, little is known about this association in elderly populations without dementia. We evaluated this relationship, with adjustment for confounding factors, in Japanese populations of 60‐year‐old (n = 270; 120 males and 150 females) and 65‐year‐old (n = 123; 57 males and 66 females) individuals residing in Fukuoka Prefecture of Japan. Dental examinations were performed in all subjects, along with the Mini‐mental state examination (MMSE) for assessing cognitive function. Among the total of 393 subjects, the mean MMSE score was 27·9 ± 1·9, and 391 subjects scored 24 or higher. The mean numbers of sound and decayed teeth were 12·0 ± 6·3 and 0·5 ± 1·2, respectively. Associations were found between the numbers of sound and decayed teeth and MMSE in total subjects and males, but not in females, by multiple regression analysis adjusted for gender, age, level of education, marital status, smoking, alcohol drinking, working status, systolic blood pressure and blood glucose. An association was also found between MMSE and the number of sound teeth in a logistic regression analysis. In conclusion, associations were found between normal‐range cognitive function and the numbers of sound and decayed teeth, after adjustment for various confounding factors, in an elderly Japanese population.
Birthweight and early neonatal health: Bangladesh perspective
Authors: Ullah Anayet , Barman Arunodaya , Haque Jawadul , Khanum Merina , Bari Iqbal
Published: September 2009

It has been suggested that a birthweight limit of 2.5 kg should not be regarded as valid for all populations as the cut‐off point of low‐weight births because of demographic, genetic and environmental differences. Countries often choose alternative cut‐off values for low birthweight for clinical purposes. Bangladesh also needs to choose a convenient cut‐off value for low birthweight. A total of 770 live singleton full‐term normal newborns were included in this study by stratified sampling; birthweight was measured using the Detecto‐type baby weight machine. Newborns were followed up to the end of their first week of life. For data collection a pretested structured questionnaire and an Apgar Score estimating checklist were used. Chi‐square test was applied to assess the association of different birthweight strata and neonatal health outcomes. Multiple logistic regression analyses were carried out to identify the independent effects of different levels of birthweight on early neonatal health.

The neonates having birthweight ≤2 kg had a significantly higher risk of early neonatal mortality and morbidity than the higher level birthweight group. Birth asphyxia was the commonest cause of early neonatal mortality and morbidity. Borderline birthweight (>2 to <2.5 kg) neonates experienced the same mortality and morbidity rates as the normal birthweight neonates during their early neonatal life. Birthweight ≤2 kg may be one of the criteria for admission to a neonatal intensive care unit whereas more than 2 kg may not require admission unless otherwise necessary.
Previous maternal oral contraception and the risk among subsequent offspring of asthma diagnosis in early childhood
Authors: Osman Mustafa F , Black Corri , Jick Susan , Hannaford Philip
Published: September 2009

Previous maternal use of the oral contraceptive pill (OCP) has been linked with asthma in subsequent offspring and has been implicated in the increased prevalence of childhood asthma in recent decades. We conducted a matched case–control study to test the hypothesis that maternal OCP used close to conception is associated with asthma in the offspring, particularly in children with coexistent eczema. We examined maternal OCP exposure in relation to asthma in the offspring (n = 6730) compared with offspring with no asthma (n = 6730) further stratifying by eczema, age group, treatment category and gender of the offspring. Maternal use of OCP was classified as: no OCP use in the 2 years prior to conception; past OCP use within 2 years but >6 months before conception; and recent OCP use within 6 months of conception.

The adjusted odds ratio (OR) for asthma in the offspring was 1.16 [95% confidence interval 1.06, 1.27] among mothers who were recent users of the OCP when compared with mothers who had not used the OCP. Past OCP use was not associated with asthma in the offspring. In the stratified analyses, we observed weak but statistically significant associations between recent maternal OCP use and asthma in the offspring among children: without a history of eczema (adjusted OR 1.22 [1.09, 1.36]), those aged ≤3 years (adjusted OR 1.24 [1.12, 1.37]), those not on treatment for their asthma (adjusted OR 1.33 [1.12, 1.58]) and among females (adjusted OR 1.34 [1.13, 1.51]). We did not find convincing evidence for a causal relationship between maternal OCP used close to conception and asthma in the offspring. The small statistically significant associations were not among children with characteristic features of asthma such as those with eczema and may be due to bias, uncontrolled confounding or chance.
Persistent fatigue in liver transplant recipients: a two‐year follow‐up study
Authors: Van Ginneken Berbke T.J. , Van Den Berg‐Emons Rita J.G. , Van Der Windt Anna , Tilanus Huug W. , Metselaar Herold J. , Stam Henk J. , Kazemier Geert
Published: September 2009

van Ginneken BTJ, van den Berg‐Emons RJG, van der Windt A, Tilanus HW, Metselaar HJ, Stam HJ, Kazemier G. Persistent fatigue in liver transplant recipients: a two‐year follow‐up study. Clin Transplant 2010: 24: E10–E16. © 2009 John Wiley & Sons A/S.

Background:  Fatigue after liver transplantation (LTx) is a major problem that is associated with lower daily functioning and health‐related quality of life (HRQoL). This study aimed to assess changes over time in fatigue following LTx. We also examined daily functioning and HRQoL changes over time and assessed the influence of fatigue and changes in fatigue on daily functioning and HRQoL. We determined whether sleep quality, anxiety, and depression were associated with fatigue.

Methods:  We identified 70 LTx recipients who had previously participated in a cross‐sectional study and reassessed them after two yr to determine changes in level of fatigue, daily functioning, and HRQoL. We also assessed sleep quality, anxiety, and depression after two yr.

Results:  Level of fatigue and level of daily functioning were unchanged at follow‐up. HRQoL domains remained stable or worsened. Fatigue was a significant predictor of daily functioning and all HRQoL domains (p < 0.01). Change in fatigue was a significant predictor of daily functioning and the HRQoL domains of “physical functioning,”“vitality,” and “pain” (p < 0.05). Sleep quality, anxiety, and depression were associated with fatigue severity (r = 0.35 to r = 0.60, p < 0.05).

Conclusion:  This longitudinal study shows that fatigue is a chronic problem after LTx and that daily functioning and HRQoL do not improve over time. This study supports the need for intervention programs to address fatigue after LTx.
Two‐year follow‐up of a prospective study of circulating regulatory T cells in renal transplant patients
Authors: Segundo David San , Fernández‐Fresnedo Gema , Ruiz Juan C. , Rodrigo Emilio , Benito María J. , Arias Manuel , López‐Hoyos Marcos
Published: September 2009

San Segundo D, Fernández‐Fresnedo G, Ruiz JC, Rodrigo E, Benito MJ, Arias M, López‐Hoyos M. Two‐year follow‐up of a prospective study of circulating regulatory T cells in renal transplant patients. Clin Transplant 2010: 24: 386–393. © 2009 John Wiley & Sons A/S.

Abstract:  CD4+CD25highFOXP3+ regulatory T cells (Tregs) are involved in alloreactivity and may be associated with protection from rejection. Their quantification in peripheral blood could guide clinicians in the management of renal transplant patients. Thus, we prospectively monitored the levels and in vitro suppression of circulating Tregs in 33 renal transplant patients from deceased donors within the first two yr of transplantation. Patients received maintenance immunosuppression with tacrolimus, mofetil mycophenolate and prednisolone. Results showed that peripheral blood Tregs were significantly lower six months after transplantation and recovered to almost basal levels at first post‐transplant year. The number of circulating Tregs increased significantly over basal levels afterwards. The decrease in circulating Tregs at six months may be explained by the high load of tacrolimus, as demonstrated by the inverse correlation between the blood concentration of Tregs and tacrolimus. Likewise, nine patients treated with anti‐CD25 antibodies showed higher numbers of Tregs at six months than those that did not, although differences were not observed later. In conclusion, circulating Tregs decrease in the first six months but recover thereafter up to two yr after kidney transplantation. Such a decrease is favored by high levels of tacrolimus but not by induction protocols with anti‐CD25.
Impact of RIFLE classification in liver transplantation
Authors: Ferreira Ana Carina , Nolasco Fernando , Carvalho Dulce , Sampaio Sandra , Baptista Alexandre , Pessegueiro Pedro , Monteiro Estela , Mourão Luís , Barroso Eduardo
Published: September 2009

Ferreira AC, Nolasco F, Carvalho D, Sampaio S, Baptista A, Pessegueiro P, Monteiro E, Mourão L, Barroso E. Impact of RIFLE classification in liver transplantation. Clin Transplant 2010: 24: 394–400. © 2009 John Wiley & Sons A/S.

Abstract:  Acute renal failure (ARF) is common after orthotopic liver transplantation (OLT). The aim of this study was to evaluate the prognostic value of RIFLE classification in the development of CKD, hemodialysis requirement, and mortality. Patients were categorized as risk (R), injury (I) or failure (F) according to renal function at day 1, 7 and 21. Final renal function was classified according to K/DIGO guidelines. We studied 708 OLT recipients, transplanted between September 1992 and March 2007; mean age 44 ± 12.6 yr, mean follow‐up 3.6 yr (28.8%≥5 yr). Renal dysfunction before OLT was known in 21.6%. According to the RIFLE classification, ARF occurred in 33.2%: 16.8% were R class, 8.5% I class and 7.9% F class. CKD developed in 45.6%, with stages 4 or 5d in 11.3%. Mortality for R, I and F classes were, respectively, 10.9%, 13.3% and 39.3%. Severity of ARF correlated with development of CKD: stage 3 was associated with all classes of ARF, stages 4 and 5d only with severe ARF. Hemodialysis requirement (23%) and mortality were only correlated with the most severe form of ARF (F class). In conclusion, RIFLE classification is a useful tool to stratify the severity of early ARF providing a prognostic indicator for the risk of CKD occurrence and death.
Simple sequence repeat‐based diversity in elite pigeonpea genotypes for developing mapping populations to map resistance to Fusarium wilt and sterility mosaic disease
Authors: Saxena R. K. , Saxena K. B. , Kumar R. V. , Hoisington D. A. , Varshney R. K.
Published: September 2009

With 1 figure and 3 tables

In order to maximize polymorphism in the mapping populations for mapping loci for Fusarium wilt (FW) and sterility mosaic disease (SMD) resistance in pigeonpea, a set of 32 pigeonpea lines were screened for polymorphism with 30 microsatellite or simple sequence repeat markers. A total of 23 marker loci showed polymorphism with 2–4 alleles and the polymorphism information content for these markers ranged from 0.12 to 0.65 with an average of 0.43 per marker. High number of polymorphic markers, higher genetic dissimilarity coefficient and contrasting phenotypic data taken into consideration and five parental combinations were identified and crosses initiated for developing five genetically diverse mapping populations. Of these crosses, one cross segregates for FW resistance, two for SMD resistance and the remaining two crosses segregate for resistance to both FW and SMD. Development of mapping populations is in progress for mapping loci for resistance to FW and SMD in pigeonpea.
Routine administration of the Canadian Occupational Performance Measure: Effect on functional outcome
Authors: Colquhoun Heather , Letts Lori , Law Mary , MacDermid Joy , Edwards Mary
Published: September 2009

Background/aim:  Routinely using outcome measures as an integral component of practice has been encouraged for decades yet has not been widely adopted. There are many reasons to measure outcomes yet any positive effect of measurement on our programs or clients has not been substantiated. If the time‐consuming nature of outcome measurement is to be encouraged, we need to begin addressing larger questions of the value of outcome measurement on care and outcomes. This cohort study evaluated the impact of routinely administering the Canadian Occupational Performance Measure on client outcomes on a geriatric rehabilitation unit.

Methods:  Changes in Functional Independence Measure™ scores between an experimental group (n = 45) that received the routine use of the Canadian Occupational Performance Measure for evaluation/planning versus a historical comparison group (n = 58) that received ‘usual’ care were analysed using generalised linear modeling.

Results:  Both groups had significant changes in Functional Independence Measure™ scores over time. Results for differences between groups were inconclusive with a significantly underpowered analysis; however, results suggest that a medium to large effect of this intervention cannot be expected.

Conclusions:  Results are significant for the field of routine outcome measurement, suggesting that when adding the Canadian Occupational Performance Measure to routine assessment within an inpatient rehabilitation setting, substantially improved Functional Independence Measure™ score outcomes should not be expected. The value of routine outcome measurement on client outcomes remains largely unexplored. Routinely, using outcome measures requires additional research to determine the specific benefits to our programs and client outcomes.
The structure of novice and expert occupational therapists’ clinical reasoning before and after exposure to a domain‐specific protocol
Authors: Kuipers Kathy , Grice James W.
Published: September 2009

Background/aim:  The research aimed to determine the influence of a protocol designed for use in the domain of upper limb hypertonia due to brain injury on novice and expert occupational therapy clinical reasoning.

Method:  Individual, structured repertory grid interviews were completed with 13 novice and eight expert occupational therapists prior to, and following, exposure to a domain‐specific clinical reasoning protocol. Data were subjected to quantitative analyses (Principal Components Analysis, Generalised Procrustes Analysis).

Results:  Novice participants demonstrated statistically significant change in the structure of their clinical reasoning following exposure to the protocol (P < 0.004). Prior to exposure, novices relied on therapy tasks, the problem‐solving process, environmental factors and standard practice to structure their reasoning. Following exposure, novices’ clinical reasoning changed to more closely reflect experts’ reasoning. Thus, a ‘structured approach’ and (theoretical) practice perspectives became evident. Prior to exposure to the protocol, experts structured reasoning in terms of (personal and theoretical) practice perspectives, therapy tasks and the scope of such tasks (either ‘general’ or ‘specific’). Following exposure, therapist/client collaboration and upper‐limb‐related constructs emerged as being used to structure experts’ reasoning, although these changes were not statistically significant.

Conclusion:  A protocol designed for guiding clinical reasoning in the context of upper limb hypertonia was perceived to be conceptually useful by novice and expert occupational therapists.
An evaluation of the construct validity of the Developmental Test of Visual‐Motor Integration using the Rasch Measurement Model
Authors: Brown Ted , Unsworth Carolyn , Lyons Carissa
Published: September 2009

Background:  One method of evaluating the construct validity of instruments is the Rasch Measurement Model (RMM), an increasingly popular method used for test construction and validation.

Aim:  The aim was to examine the construct validity of the Developmental Test of Visual‐Motor Integration 5th Edition (VMI) by applying the RMM to evaluate its scalability, dimensionality, differential item functioning and hierarchical ordering.

Method:  The participants were 400 children aged 5 to 12 years, recruited from six schools in Melbourne, Victoria, who completed the VMI under the supervision of an occupational therapist. VMI items 1, 2 and 3 were excluded from the Rasch analysis since all of the children achieved a perfect score on these items.

Results:  None of the items exhibited RMM misfit due to goodness‐of‐fit mean square (MnSq) infit statistics and standardised z (ZStd) scores being outside the specified acceptable range. VMI item 9 (copied circle) exhibited differential item functioning based on gender. In relation to hierarchical ordering of items, several were found to have similar logit difficulty values. For example, VMI items 26, 27 and 29; items 18, 22 and 24; and items 4, 5 and 11 were found to have the same level of challenge. As well, the VMI scale item logit measure order did not match that presented in the VMI test manual.

Conclusion:  Theoretically, the VMI items are developmentally ordered; however, this ordering was not mirrored by the item logit difficulty scores obtained. This has scoring implications, where scoring a respondent's VMI test booklet is terminated after three consecutive items are not passed. Clinicians should also be aware that item 9 may exhibit bias related to gender.
Advancing the metabolic theory of biodiversity
Authors: Stegen James C. , Enquist Brian J. , Ferriere Regis
Published: September 2009

A component of metabolic scaling theory has worked towards understanding the influence of metabolism over the generation and maintenance of biodiversity. Specific models within this ‘metabolic theory of biodiversity’ (MTB) have addressed temperature gradients in speciation rate and species richness, but the scope of MTB has been questioned because of empirical departures from model predictions. In this study, we first show that a generalized MTB is not inconsistent with empirical patterns and subsequently implement an eco‐evolutionary MTB which has thus far only been discussed qualitatively. More specifically, we combine a functional trait (body mass) approach and an environmental gradient (temperature) with a dynamic eco‐evolutionary model that builds on the current MTB. Our approach uniquely accounts for feedbacks between ecological interactions (size‐dependent competition and predation) and evolutionary rates (speciation and extinction). We investigate a simple example in which temperature influences mutation rate, and show that this single effect leads to dynamic temperature gradients in macroevolutionary rates and community structure. Early in community evolution, temperature strongly influences speciation and both speciation and extinction strongly influence species richness. Through time, niche structure evolves, speciation and extinction rates fall, and species richness becomes increasingly independent of temperature. However, significant temperature‐richness gradients may persist within emergent functional (trophic) groups, especially when niche breadths are wide. Thus, there is a strong signal of both history and ecological interactions on patterns of species richness across temperature gradients. More generally, the successful implementation of an eco‐evolutionary MTB opens the perspective that a process‐based MTB can continue to emerge through further development of metabolic models that are explicit in terms of functional traits and environmental gradients.
Changes in habitat specificity of species at their climatic range boundaries
Authors: Oliver Tom , Hill Jane K. , Thomas Chris D. , Brereton Tom , Roy David B.
Published: September 2009

Species are thought to have more restricted niches towards their range boundaries, although this has rarely been quantified systematically. We analysed transect data for 41 butterfly species along climatic gradients within Britain and show that 71% of species have broader niches at sites with milder winters. Shifts in habitat associations are considerable across most species’ ranges; averaged across all 41 species, we estimate that if 26% of individuals were associated with the favoured habitat on the species’ warmest transect, then 70% of individuals would be confined to this habitat on the species’ coldest transect. Species with more southerly distributions in Britain showed the greatest changes in their habitat associations. We conclude that geographic variation in realized niche breadth is common and relatively large, especially near range boundaries, and should be taken into account in conserving species under changing climates.
Discussion of Bloom
Authors: LONERGAN WAYNE
Published: September 2009

That the objective of financial reporting is to provide useful information for decision making is not only well known, it has long been the stated basic objective of accounting standard setters around the world. Similarly, there is broad agreement about what in financial terms is meant by the term ‘material’. It is therefore at least curious that, as Bloom (2009) notes, accounting standard setters devote only one accounting standard to goodwill. This standard has remained substantially unchanged in its simplistic discussion of both measurement and disclosure requirements for goodwill for some thirty years.
Control of negative emotions and its implication for illness perception among psoriasis and vitiligo patients
Authors: Kossakowska MM , Cieścińska C , Jaszewska J , Placek WJ
Published: September 2009

Background  The purpose of the study was to determine the intensity of control over negative emotions of anger, depressed mood, and anxiety in certain skin diseases such as psoriasis and vitiligo, and to define the predictors of this emotional control in terms of the illness perception in the following context: duration of illness, age at onset, subjective knowledge of the causes of illness, subjective sense of control over the disease.

Methods  The study included 60 patients with psoriasis (n = 30) and vitiligo (n = 30) as well as healthy persons (n = 60) matched to the experimental group in terms of gender, age, and level of education. Control of negative emotions was examined by means of Watson and Greer’s Courtauld Emotional Control Scale (Polish adaptation by Juczynski) and the illness perception by means of Kossakowska’s Chronic Patients Questionnaire.

Results  The research concludes that psoriasis patients control negative emotions more intensively than healthy people. Vitiligo patients on the other hand do not differ in the control of negative emotions compared with healthy subjects. There are no significant predictors of negative emotional control in vitiligo. In psoriasis gender and age are the main contributors to negative emotional control and anger control is predicted by the age at onset as well.

Conclusion  The specificity of the skin disease affects maladaptive negative emotional control and the suggestion is to use psychological treatment in hospitalised psoriasis in particular.
Unit cost of Mohs and Dermasurgery Unit
Authors: Wanitphakdeedecha R , Nguyen TH , Chen TM
Published: September 2009

Background  Appropriate pricing for medical services of not‐for‐profit hospital is necessary. The prices should be fair to the public and should be high enough to cover the operative costs of the organization.

Objective  The purpose of this study was to determine the cost and unit cost of medical services performed at the Mohs and Dermasurgery Unit (MDU), Department of Dermatology, The University of Texas – MD Anderson Cancer Center, Houston, TX from the healthcare provider’s perspective.

Methods  MDU costs were retrieved from the Financial Department for fiscal year 2006. The patients’ statistics were acquired from medical records for the same period. Unit cost calculation was based on the official method of hospital accounting.

Results  The overall unit cost for each patient visit was $673.99 United States dollar (USD). The detailed unit cost of nurse visit, new patient visit, follow‐up visit, consultation, Mohs and non‐Mohs procedure were, respectively, $368.27, $580.09, $477.82, $585.52, $1,086.12 and $858.23 USD. With respect to a Mohs visit, the unit cost per lesion and unit cost per stage were $867.89 and $242.30 USD respectively.

Conclusions  Results from this retrospective study provide information that may be used for pricing strategy and resource allocation by the administrative board of MDU.
Measuring mobility limitations in children with cerebral palsy: interrater and intrarater reliability of a mobility questionnaire (MobQues)
Authors: VAN RAVESTEYN NICOLIEN T , DALLMEIJER ANNET J , SCHOLTES VANESSA A , ROORDA LEO D , BECHER JULES G
Published: September 2009

Aim  The objective of this study was to assess the reliability of a mobility questionnaire (MobQues) that was developed to measure the mobility limitations of children with cerebral palsy (CP) as rated by their parents. A clinical version of the questionnaire, consisting of 47 items (MobQues47), is available, as well as a research version with 28 items for a specific population (MobQues28). Total scores are expressed on a scale of 0 to 100.

Method  We assessed the interrater reliability between both parents of 289 children with CP (168 males, 121 females, age range 2–13y, Gross Motor Function Classification System levels I–IV) and the intrarater reliability within a subgroup of 38 parents (of 23 children) who completed the MobQues twice.

Results  For the interrater reliability, high intraclass correlation coefficients (ICCs) were found for the MobQues47 (ICC 0.92) and MobQues28 (ICC 0.87). The standard error of measurement (SEM) was 7.8 and 8.9 respectively. As expected, the intrarater reliability was higher, as represented by higher ICCs (0.96–0.99) and lower SEMs (3.5–4.9) for both MobQues versions.

Interpretation  The results of this study indicate that the MobQues is a reliable instrument to measure the mobility limitations of children with CP.
Reading performance correlates with white‐matter properties in preterm and term children
Authors: ANDREWS JAMES S , BEN‐SHACHAR MICHAL , YEATMAN JASON D , FLOM LYNDA L , LUNA BEATRIZ , FELDMAN HEIDI M
Published: September 2009

Aim  We used diffusion tensor imaging to investigate the association between white‐matter integrity and reading ability in a cohort of 28 children. Nineteen preterm children (14 males, five females; mean age 11y 11mo [SD 1y 10mo], mean gestational age 30.5wks (SD 3.2), mean birthweight was 1455g [SD 625]); and nine term children (five males, four females; mean age 12y 8mo [SD 2y 5mo], mean gestational age 39.6wks (SD 1.2), and mean birthweight 3877g [SD 473]).

Method  We tested whether fractional anisotropy in a left hemisphere temporoparietal region and in the corpus callosum correlates with birthweight and scores on the following three subtests of the Woodcock‐Johnson III Tests of Achievement: word identification, word attack, and passage comprehension.

Results  Preterm children had lower reading scores than a comparison group for all reading subtests (p<0.05). We found significant correlations between birthweight and fractional anisotropy in the whole corpus callosum (p=0.001), and between fractional anisotropy and reading skill in the genu (p=0.001) and body (p=0.001) of the corpus callosum. The correlation between reading skill and fractional anisotropy in a left temporoparietal region previously associated with reading disability was not significant (p=0.095).

Interpretation  We conclude that perinatal white‐matter injury of the central corpus callosum may have long‐term developmental implications for reading performance.
A novel ARX phenotype: rapid neurodegeneration with Ohtahara syndrome and a dyskinetic movement disorder
Authors: ABSOUD MICHAEL , PARR JEREMY R , HALLIDAY DOROTHY , PRETORIUS PIETER , ZAIWALLA ZENOBIA , JAYAWANT SANDEEP
Published: September 2009

ARX mutations are associated with variable clinical phenotypes. We report a new neurodegenerative phenotype associated with a known ARX mutation and causing early abnormal neurodevelopment, a complex movement disorder, and early infantile epileptic encephalopathy with a suppression‐burst pattern (Ohtahara syndrome). A male infant presented at age 5 months with a dyskinetic movement disorder, which was initially diagnosed as infantile spasms. Clinical deterioration was accompanied by progressive cortical atrophy with a reduction in white matter volume and resulting in death in the first year of life; such a rapidly progressive and severe phenotype has not previously been described. ARX mutation testing should be undertaken in children aged less than 1 year with Ohtahara syndrome and a movement disorder, and in infants with unexplained neurodegeneration, progressive white matter loss, and cortical atrophy.
Dysfunction of the unfolded protein response increases neurodegeneration in aged rat hippocampus following proteasome inhibition
Authors: Paz Gavilán María , Pintado Cristina , Gavilán Elena , Jiménez Sebastián , Ríos Rosa M. , Vitorica Javier , Castaño Angélica , Ruano Diego
Published: September 2009

Dysfunctions of the ubiquitin proteasome system (UPS) have been proposed to be involved in the aetiology and/or progression of several age‐related neurodegenerative disorders. However, the mechanisms linking proteasome dysfunction to cell degeneration are poorly understood. We examined in young and aged rat hippocampus the activation of the unfolded protein response (UPR) under cellular stress induced by proteasome inhibition. Lactacystin injection blocked proteasome activity in young and aged animals in a similar extent and increased the amount of ubiquitinated proteins. Young animals activated the three UPR arms, IRE1α, ATF6α and PERK, whereas aged rats failed to induce the IRE1α and ATF6α pathways. In consequence, aged animals did not induce the expression of pro‐survival factors (chaperones, Bcl‐XL and Bcl‐2), displayed a more sustained expression of pro‐apoptotic markers (CHOP, Bax, Bak and JKN), an increased caspase‐3 processing. At the cellular level, proteasome inhibition induced neuronal damage in young and aged animals as assayed using Fluorojade‐B staining. However, degenerating neurons were evident as soon as 24 h postinjection in aged rats, but it was delayed up to 3 days in young animals. Our findings show evidence supporting age‐related dysfunctions in the UPR activation as a potential mechanism linking protein accumulation to cell degeneration. An imbalance between pro‐survival and pro‐apoptotic proteins, because of noncanonical activation of the UPR in aged rats, would increase the susceptibility to cell degeneration. These findings add a new molecular vision that might be relevant in the aetiology of several age‐related neurodegenerative disorders.
Methionine sulfoxide reductase A expression is regulated by the DAF‐16/FOXO pathway in Caenorhabditis elegans
Authors: Minniti Alicia N. , Cataldo Romina , Trigo Carla , Vasquez Luis , Mujica Patricio , Leighton Federico , Inestrosa Nibaldo C. , Aldunate Rebeca
Published: September 2009

The methionine sulfoxide reductase system has been implicated in aging and protection against oxidative stress. This conserved system reverses the oxidation of methionine residues within proteins. We analyzed one of the components of this system, the methionine sulfoxide reductase A gene, in Caenorhabditis elegans. We found that the msra‐1 gene is expressed in most tissues, particularly in the intestine and the nervous system. Worms carrying a deletion of the msra‐1 gene are more sensitive to oxidative stress, show chemotaxis and locomotory defects, and a 30% decrease in median survival. We established that msra‐1 expression decreases during aging and is regulated by the DAF‐16/FOXO3a transcription factor. The absence of this enzyme decreases median survival and affects oxidative stress resistance of long lived daf‐2 worms. A similar effect of MSRA‐1 absence in wild‐type and daf‐2 (where most antioxidant enzymes are activated) backgrounds, suggests that the lack of this member of the methionine repair system cannot be compensated by the general antioxidant response. Moreover, FOXO3a directly activates the human MsrA promoter in a cell culture system, implying that this could be a conserved mechanism of MsrA regulation. Our results suggest that repair of oxidative damage in proteins influences the rate at which tissues age. This repair mechanism, rather than the general decreased of radical oxygen species levels, could be one of the main determinants of organisms’ lifespan.
Ultrasound measures of muscle thickness: intra‐examiner reliability and influence of body position
Authors: Thoirs Kerry , English Coralie
Published: September 2009

Ultrasound is an inexpensive and practical alternative to gold standard measures of muscle mass. Changes in body position may lead to intra‐muscular fluid shifts that may affect the reliability of ultrasound measures. We assessed test–retest reliability of ultrasound measures of muscle thickness and the effect of position on these measures. Measures of muscle thickness were made from B‐mode ultrasound images in 18 healthy participants. Repeated measurements were made by one examiner from two participant positions; standing and recumbent, from 18 anatomical sites. Results demonstrated high test–retest reliability for measures taken in both participant positions [intra‐class coefficient (ICC) scores 0·65 to 0·94], except for the recumbent posterior lower leg measures (ICC 0·34). Recumbent measures were significantly smaller than those taken with participants standing. Length of time participants spent lying down did not significantly affect measures, indicating that any changes in intra‐muscular fluid related to the time spent recumbent are negligible.
Digital Inequality and Place: The Effects of Technological Diffusion on Internet Proficiency and Usage across Rural, Suburban, and Urban Counties*
Authors: Stern Michael J. , Adams Alison E. , Elsasser Shaun
Published: September 2009

Recently researchers have made efforts to reconceptualize digital inequality into discrete levels. These levels reflect access to and diffusion of technologies, proficiency in Internet usage, and propensity to take advantage of the opportunities afforded by information and communication technologies for assistance in daily life. We assess the utility of this approach for studying digital inequality across rural, suburban, and urban counties. Based on data from a 2005 nationally representative random sample telephone survey of 2,185 adults, the results provide mixed support for using this approach to studying digital inequality. In particular, we find that rural residents use Internet technologies less for assistance in helping with economics and other daily activities when compared with individuals from suburban and urban areas; however, our results suggest that this relationship is the product of the slow diffusion of advanced technologies to rural areas. The implications of these findings for understanding this under‐theorized form of inequality are discussed, and we make contributions to this literature through empirically addressing issues of digital capital.
Association of holidays, full moon, Friday the 13th, day of week, time of day, day of week, and time of year on case distribution in an urban referral small animal emergency clinic
Authors: Drobatz Kenneth J. , Syring Rebecca , Reineke Erica , Meadows Cheyney
Published: September 2009

Objective
–
To interrogate the association of variables: day of week, time of day, day of the year (major holidays, Friday the 13th, and the full moon), and month of year with the caseload of an urban academic emergency service.

Design
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Retrospective study.

Setting
–
Urban small animal teaching hospital emergency clinic.

Animals
–
Cats and dogs that were presented to the emergency clinic.

Interventions
–
None.

Measurements and Main Results
–
The hospital computer database was searched for all visits to the Emergency Service of the Mathew J. Ryan Veterinary Hospital of the University of Pennsylvania from January 1, 1987 through December 31, 2002. Variables included in the electronic data were date of admission, time of day of admission, species (dog or cat), hospital service the case was transferred to for ongoing care and whether the case was discharged directly from the emergency service. The association of caseload with day of week, time of day, day of the year (major holidays, Friday the 13th, and the full moon), and month of year was described and statistically evaluated. Saturdays and Sundays were the busiest days of the week and significantly increased caseload was noted for the majority of holidays (except Easter Day and Thanksgiving Day) with Memorial Day being the busiest. Midweek evenings as well as Saturday and Sunday afternoons were the busiest periods of the day. There was no association with caseload and Halloween, the full moon, or Friday the 13th.

Conclusions
–
The busiest times were midweek evenings, Saturday and Sunday afternoons, and most major holidays.
Noninvasive ventilation in cats
Authors: Brown Judy E. , Bersenas Alexa M.E. , Mathews Karol A. , Kerr Carolyn L.
Published: September 2009

Objective
–
The primary objective of this study was to assess the feasibility of noninvasive mechanical ventilation (NIV) in cats. The secondary objective was to determine whether cardiovascular parameters and anesthetic drug requirements associated with noninvasive ventilation differ from those associated with invasive ventilation.

Design
–
Randomized, cross‐over design.

Setting
–
A research laboratory in a veterinary teaching hospital.

Animals
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Eight healthy adult cats, 3 intact females and 5 intact males, weighing between 3 and 6 kg, were used.

Interventions
–
Each cat was randomly assigned to NIV via nasal mask, or invasive ventilation using an endotracheal tube. Mechanical ventilation was performed for 6 hours. Anesthesia was provided using continuous infusions of propofol and butorphanol. After a minimum 9‐day washout period, the procedure was repeated using the alternate ventilation interface.

Measurements and Main Results
–
Cardiovascular parameters (heart rate, rectal temperature, direct arterial blood pressure), arterial blood gases, drug requirements, sedation score, and ventilation parameters, were monitored throughout the procedures. These values were evaluated using ANCOVA for repeated measures. All cats were effectively ventilated using NIV. There were no significant differences in cardiovascular parameters, drug requirements, or sedation scores between groups. Although PaCO2 values did not differ, PaO2 values were significantly higher in the invasively ventilated group. Inspiratory tidal volumes were similar between groups, whereas expiratory tidal volumes were significantly lower in the NIV group. Inspiratory pressures were significantly higher in the NIV group. Respiratory frequency was significantly higher in the invasively ventilated group.

Conclusions
–
NIV of cats is possible. However, currently it does not confer any cardiovascular benefit over invasive ventilation and drug requirements are similar. Use of a correctly fitted mask is essential for successful NIV as air leaks account for the observed discrepancy between inspiratory and expiratory volumes. Further investigation into this modality is warranted.
Evaluation of an abdominal fluid scoring system determined using abdominal focused assessment with sonography for trauma in 101 dogs with motor vehicle trauma
Authors: Lisciandro Gregory R. , Lagutchik Michael S. , Mann Kelly A. , Fosgate Geoffrey T. , Tiller Elizabeth G. , Cabano Nicholas R. , Bauer Leslie D. , Book Bradley P. , Howard Philip K.
Published: September 2009

Objective –Evaluate an abdominal fluid scoring (AFS) system using an abdominal focused assessment with sonography for trauma (AFAST) protocol.

Design –Prospective study.

Setting –Private veterinary emergency center.

Animals –One hundred and one client‐owned dogs with motor vehicle trauma.

Interventions –AFAST performed on admission and 4 hours post‐admission.

Measurements and Main Results –An AFS was assigned to each dog based on the number of AFAST fluid‐positive quadrants identified using a 4‐point scale: AFS 0 (negative for fluid in all quadrants) to AFS 4 (positive for fluid in all quadrants). Free abdominal fluid was identified in 27 of 101 dogs (27%). Dogs with AFS scores of 3 or 4 (14/27 [52%] AFS‐positive dogs) experienced more marked decreases in packed cell volume and total plasma protein, increases in alanine aminotransferase, and needed more blood transfusions than dogs with lower AFS scores and AFS‐negative dogs. Serial AFAST was performed in 71% of dogs (71/101); 17% (12/71) of these cases changed AFS score, and 75% (9/12) of the changes were higher (worsened) AFS, correlating with increasing amounts of free abdominal fluid. Ninety‐eight percent of the study population was a primary presentation. Overall, median time from trauma to initial AFAST was 60 minutes, and median AFAST examination time was 3 minutes.

Conclusions –Initial and serial AFAST with applied AFS allowed rapid, semiquantitative measure of free abdominal fluid in traumatized patients, was clinically associated with severity of injury, and reliably guided clinical management. Where possible, AFAST and AFS should be applied to the management of blunt trauma cases.