bluuebunny/crossref_metadata_2025 huggingface dataset:
Percutaneous Injury Analysis: Consistent Categorization, Effective Reduction Methods, and Future Strategies
Authors: Haiduven Donna J. , Phillips Esther S. , Clemons Karl V. , Stevens David A.
Published: September 2009

Objective:

To report the results of an 8-year analysis of percutaneous injuries (PI), to describe interventions to decrease these injuries, and to discuss future prevention strategies.

Design:

Using consistent methods, 881 percutaneous injury reports were reviewed, categorized, and analyzed from 1986 through 1993.

Setting:

A 620-bed acute-care county teaching hospital located in San Jose, California, that is affiliated with Stanford University Medical School, Palo Alto, California.

Participants:

Employees of Santa Clara Valley Medical Center who reported percutaneous injuries from 1986 through 1993.

Interventions:

Placement of needle disposal containers in all patient care areas, 1987; education, 1987 to present; communication of percutaneous injury analyses to all departments, 1988 to present; and safety product evaluation and purchases, 1991 to present.

Results:

The total number of PI decreased by 65% (P=.0007) from 1986 through 1993. Recapping injuries decreased from 1986 through 1993 by 88% (P<.0002); interventions that included convenient placement of needle disposal containers and consistent annual education may have contributed to this decrease. Injuries from manipulating intravenous lines or heparin locks decreased in 1992 (P<.03) after purchase of a needleless system for intravenous lines. Injuries from improper disposal or from abrupt patient movement did not decrease significantly over the 8-year period.

Conclusions:

This institution has conducted percutaneous injury analysis for 8 years, utilizing consistent reviewers and categorization methods. Successful interventions have reduced recapping injuries, injuries from manipulating intravenous lines/heparin locks, and the overall numbers of PI. The categories of “Improper Disposal” and “Patient Moved Abruptly” present challenges for future reductions, as well as the recently identified problem of staff not using available safety devices or using them improperly.
Molecular Heterogeneity of Acinetobacter baumanii Isolates During Seasonal Increase in Prevalence
Authors: Christie Celia , Mazon Dorothy , Hierholzer Walter , Patterson Jan Evans
Published: September 2009

Objective:

To study the epidemiology of Acinetobacter baumanii during a period of increased seasonal prevalence.

Design:

Descriptive molecular and clinical epidemiologic study of A baumanii isolates from 1990 through 1992.

Setting:

A 770-bed urban, acute, tertiary-care university hospital.

Results:

During 1990 through 1992, the rate of A baumanii isolations was 30.4 per 1,000 culture isolations during the summer, compared to 12.6 per 1,000 culture isolations during the fall, winter, and spring (P<.000001). There were 320 isolates identified among 260 patients during this time. Eighty-one patients with isolates available were identified for evaluation; they ranged in age from 2 months to 95 years. Pulsed-field gel electrophoresis (PFGE) typing showed that 59 (83%) of 71 typed isolates had distinct PFGE patterns. There were three small clusters of isolates with the same PFGE patterns, suggesting cross-transmission in those instances.

Conclusions:

A seasonally increased prevalence of A baumanii largely associated with device-related nosocomial infections in severely ill patients was noted over a 3-year period. Although there were isolated instances of cross-transmission, most isolates had distinct PFGE patterns. Clonal dissemination of a single strain was not responsible for the seasonal increased prevalence of A baumanii. PFGE typing was useful in directing control efforts.
Epidemiologic Investigation of an Outbreak of Coagulase-Negative Staphylococcus Primary Bacteremia in a Newborn Intensive Care Unit
Authors: Camargo Luis F.A. , Strabelli Tânia M.V. , Ribeiro Floracy G. , Iwahashi Eliza R. , Ebaid Munir , Filho Hélio H.H.C. , Sinto Sumiko I. , Mendes Caio M.F. , Uip David E.
Published: September 2009

Infections due to coagulase-negative Staphylococcus (CNS) are an ever-increasing nosocomial problem, particularly in the pediatric population. The authors describe a cluster of three primary bloodstream infections due to CNS in a newborn intensive care unit that occurred between November 23 and December 2, 1992. Two children died as a direct consequence of the bacteremia; at autopsy, one had a large bacteria-containing thrombus extending from the insertion site of a central catheter to the superior vena cava. The children were placed in isolation, and the nursing and medical staff were given topical nasal mupirocin. Plasmid analysis performed later disclosed three different blood isolates that also were different from any of the staff's nasal isolates.

The authors concluded that molecular methods such as plasmid analysis are important tools in identifying true outbreaks and can prevent needless interventions, such as those during this cluster.
Infections Caused by Staphylococcus aureus in a Veterans' Affairs Nursing Home Care Unit: A 5-Year Experience
Authors: Spindel Steven J. , Strausbaugh Larry J. , Jacobson Cleone
Published: September 2009

Objectives:

To describe the frequency and patterns of infection caused by methicillin-susceptible Staphylococcus aureus (MSSA) and methicillin-resistant S aureus (MRSA) infections in a single nursing home population and to determine the effect of MRSA's entry into the facility on subsequent experience with both MSSA and MRSA infections.

Design:

Observational and descriptive. Surveillance data on nursing home-acquired infections were reviewed to identify all patients with MSSA and MRSA infections occurring during the 5-year period from 1987 to 1991. The medical records of these patients were reviewed retrospectively to collect additional information about the patients and their infections.

Setting and Patients:

A 120-bed Veterans' Affairs nursing home care unit (NHCU) whose residents predominantly were elderly men with severe underlying diseases and functional impairments,

Results:

During the 5-year study period, 40 MSSA and 28 MRSA infections were acquired by NHCU residents. Twelve to 19 S aureus infections occurred each year. S aureus accounted for 13% to 17% of all NHCU-acquired infections during the years of study, occurring with a frequency of 0.29 to 0.47 infections per 1,000 resident-care days. MRSA infections, first detected in 1988, accounted for an increasing percentage of S aureus infections in subsequent years, but this increase had little effect on the facility's overall infection rates, the composite S aureus infection rates, or the types of infections observed. MSSA and MRSA infections acquired in the NHCU were comparable. Both affected patients with severe underlying diseases and functional impairments. Pneumonia, urinary tract infections, skin and soft tissue infections, and conjunctivitis were the types of infections observed most frequently, accounting for 28%, 25%, 22%, and 15% of all S aureus infections, respectively. Four bacteremic infections occurred in the MSSA group, and five in the MRSA group (P=.47). Four of the MSSA and three of the MRSA infections resulted in death (P= 1.0). Nine of the MSSA and 12 of the MRSA infections resulted in the patient's transfer to the associated acute care hospital for additional care (P= .13).

Conclusions:

In the NHCU setting, MSSA and MRSA infections were similar in terms of the types of residents affected, the sites involved, and the frequency of adverse outcomes. The entry of MRSA into the facility appeared to have no effect on the subsequent experience with NHCU-acquired infections caused by S aureus.
Preparing for and Surviving a JCAHO Inspection
Authors: Nettleman Mary D.
Published: September 2009

The Joint Commission on Accreditation of Healthcare Organizations (JCAHO) has been a major force in shaping the national approach to quality in the healthcare setting. In 1986, the JCAHO announced that it would establish an “Agenda for Change” designed to improve the measurement of quality. The result is that hospitals now are being held to a new set of standards, creating opportunity, uncertainty, and anxiety. This article is designed as a primer to help epidemiologists and infection control practitioners prepare for JCAHO visits.

The best advice is to start early and work continuously to prepare for a JCAHO visit. Most standards require that compliance be documented for at least 1 year prior to the survey. Several resources are available to assist the epidemiologist (Table).

The Comprehensive Accreditation Manual for Hospital, published annually by JCAHO, is an ideal place to begin preparing for a survey.' The accreditation manual contains standards that hospitals are expected to meet, as well as scoring guidelines and rules for accreditation. All sections that apply to the epidemiologist should be read. In some institutions, the epidemiologist's responsibilities are confined to infection control. In other institutions, the responsibilities have been broadened to include most of the functions described in the accreditation manual. It is helpful to go over each standard individually and consider how compliance will be documented.
Employee Health and Infection Control
Authors: Diekema Daniel J. , Doebbeling Bradley N.
Published: September 2009

Hospital employees are at risk for exposure to a variety of communicable diseases, which they may transmit to patients and other workers. The employee health service plays a critical role in an effective infection control program.

In this article, we outline the major responsibilities of the employee health service and summarize key current recom-endations for management of exposures.
Quantitative Antibiogram as a Typing Method for the Prospective Epidemiological Surveillance and Control of MRSA Comparison with Molecular Typing
Authors: Blanc Dominique S. , Petignat Christiane , Moreillon Philippe , Wenger Aline , Bille Jacques , Francioli Patrick
Published: September 2009

Objective:

Evaluation of the quantitative antibiogram as an epidemiological tool for the prospective typing of methicillin-resistant Staphylococcus aureus (MRSA), and comparison with ribotyping.

Methods:

The method is based on the multivariate analysis of inhibition zone diameters of antibiotics in disk diffusion tests. Five antibiotics were used (erythromycin, clindamycin, cotrimoxazole, gentamicin, and ciprofloxacin). Ribotyping was performed using seven restriction enzymes (EcoRV, HindIII, KpnI, PstI, EcoRI, SfuI, and BamHI).

Setting:

1,000-bed tertiary university medical center.

Results:

During a 1-year period, 31 patients were found to be infected or colonized with MRSA. Cluster analysis of antibiogram data showed nine distinct antibiotypes. Four antibiotypes were isolated from multiple patients (2, 4, 7, and 13, respectively). Five additional antibiotypes were isolated from the remaining five patients. When analyzed with respect to the epidemiological data, the method was found to be equivalent to ribotyping.

Among 206 staff members who were screened, six were carriers of MRSA. Both typing methods identified concordant of MRSA types in staff members and in the patients under their care.

Conclusions:

The quantitative antibiogram was found to be equivalent to ribotyping as an epidemiological tool for typing of MRSA in our setting. Thus, this simple, rapid, and readily available method appears to be suitable for the prospective surveillance and control of MRSA for hospitals that do not have molecular typing facilities and in which MRSA isolates are not uniformly resistant or susceptible to the antibiotics tested.
Occupational Hazards of Operating Opportunities for Improvement
Authors: Davis Mark S.
Published: September 2009

The emergence of hepatitis C virus compels us to refocus on protecting ourselves, our coworkers, and our families from potential illness, disability, or death. As bloodborne pathogens continue to evolve and mutate, the best option available is to prevent exposure. Surgeons have the opportunity to prevent the majority of exposures by utilizing currently available technology and knowledge. Surgeons should see, use, and evaluate a variety of safety-engineered devices, because their feedback can lead to improvements in technology. Education, communication, and access to safer technology will motivate surgeons to adopt safer behavior patterns. Provided with information and tools, we can change through self-motivation.
Infection Control Practices in the Home: A Survey of Households of HIV-Infected Persons with Hemophilia
Authors: Lobato Mark N. , Oxtoby Margaret J. , Augustyniak Linda , Caldwell M. Blake , Wiley Sarah D. , Simonds R.J.
Published: September 2009

Objective:

To assess infection control practices and risk for human immunodeficiency virus (HIV) transmission in households where home infusion for hemophilia is used.

Design:

Cross-sectional prospective survey from 1992 through 1994.

Setting:

Hemophilia treatment centers.

Participants:

Human immunodeficiency virus (HIV)-infected persons with hemophilia who receive home infusions of clotting factor concentrate and their household members.

Main Outcome Measures:

Frequency of specific infection control practices in the home and the risk of HIV transmission to household members.

Results:

We surveyed 235 persons from 75 families (79 HIV-infected persons with hemophilia and 156 household members) about infection control practices in the home. Forty-eight percent of household members surveyed helped with the infusion process. Of 74 members who assisted with infusion, 13 (18%) had sustained a needlestick injury, 11 of whom were injured during the past year. One hundred fifty household members tested for antibody to HIV were antibody negative. These household members had a total of 903 person-years of contact after HIV was diagnosed in the index case. Household members' adherence to recommended infection control measures was highest for washing hands after cleaning up infusion equipment and waste, and for using sharps disposal containers. Adherence was lowest for wearing gloves when helping with infusions and proper disposal of bloody waste from the infusion.

Conclusions:

No HIV transmission was found among persons living with HIV-infected persons with hemophilia, although there was a high rate of needlestick injuries during home infusion. Because persons who assisted with infusions often did not wear gloves and many households did not dispose of bloody waste properly, hemophilia treatment center personnel should emphasize these areas when training for home infusion. Adherence to appropriate infection control practices should help to keep the risk of HIV transmission in households extremely low.
Investigation of an Apparent Cluster of Klebsiella pneumoniae Bacteremias Using Random Amplified Polymorphic DNA Analysis
Authors: Hurley James C. , Russell Edward G. , Harrington Glenys , Spicer W. John
Published: September 2009

A cluster of bacteremia episodes with Klebsiella pneumoniae was noted in patients in a hematology-oncology ward during a 3-week period. Random amplified polymorphic DNA (RAPD) analysis, a novel technique for generating chromosomal fingerprints from bacterial isolates, was used as an aid to the epidemiological investigation of this cluster. For each of the two patients from whom multiple isolates had been obtained, identical RAPD patterns were observed in the serial isolates, even for a patient where the isolates had different biotypes. Isolates from different patients gave distinct patterns. Random amplified polymorphic DNA was found to be a useful typing technique for this cluster of K pneumonia bacteremias.
An Outbreak of Multiresistant Acinetobacter baumanii in a University Hospital in São Paulo, Brazil
Authors: Levin Anna S.S. , Mendes Caio M.F. , Sinto Sumiko I. , Sader Helio S. , Scarpitta Candida R.M. , Rodrigues Edna , Sauaia Naim , Boulos Marcos
Published: September 2009

A case-control (46 cases, 23 controls) study was done to determine risk factors for an outbreak of a multiresistant Acinetobacter baumanii (only susceptible to colistin) in a university hospital. The use of antecedent antibacterials and intubation were independent risk factors. No common source was found. With control measures, the outbreak resolved gradually.
Exploratory Data Analysis: Data Visualization or Torture?
Authors: Shelly Mark A.
Published: September 2009

Exploratory Data Analysis offers a set of graphical and statistical tools to find the full meaning from data sets. The user visualizes, analyzes, and transforms data distributions with these tools. Graphs reveal relationships between variables; the residuals left after fitting data show the adequacy of the model. Without this careful examination and understanding of the data, rote data analysis using standard statistical tests can give misleading results. Exploratory Data Analysis has its own set of pitfalls and must be used with confirmatory statistics and studies. Increasing power and resolution in personal computers enables modern statistical software to make these methods widely accessible. By easily moving between data and their graphic representation, analysis can be comprehensive without being tedious. Exploratory Data Analysis can add an exciting and useful tool to the epidemiologist's repertoire. This article illustrates several tools from an evolving list.
Noncompliance With Universal Precautions and the Associated Risk of Mucocutaneous Blood Exposure Among Danish Physicians
Authors: Nelsing Suzanne , Nielsen Thyge Lynghøj , Nielsen Jens Ole
Published: September 2009

Objective:

To study the compliance, and reasons for noncompliance, with Universal Precautions and the associated circumstances of mucocutaneous blood exposure (MCE) among Danish physicians.

Design:

A nationwide questionnaire survey.

Setting:

All Danish hospitals.

Participants:

All hospital-employed physicians.

Results:

Of 9,384 questionnaires, 6,256 (67%) were returned, and 6,005 were eligible for analysis. Only 35% of respondents were compliant with the basic principle of Universal Precautions. Compliance with specific barriers in the preceding week among “surgeons and pathologists” and “other physicians” was as follows: gloves, 63.0% and 23.4%; masks, 55.2% and 17.6%; and protective eyewear, 11.5% and 4.0%, respectively. Common arguments for non-compliance were “interferes with working skills,” “forget,” “wear spectacles,” “not available,” “too much trouble to get,” or “gloves do not fit.”

Detailed descriptions of 741 MCEs were obtained. Blood splashes in the eyes (n=320) was the most common MCE in surgical specialties and pathology, whereas blood on the hands (n=290) was most common in other specialties. In 20% of MCEs of the eyes, the exposure occurred despite the use of spectacles. An estimated 84% to 98% of MCEs potentially would have been preventable had appropriate barriers been worn. More than one half of MCEs were preventable by two interventions only: compulsory use of protective eyewear during operations and use of gloves during insertion of peripheral intravenous catheters.

Conclusion:

Compliance with Universal Precautions is unacceptably low, as reflected by the circumstances of MCE. Increased efforts to ensure education in Universal Precautions, easy accessibility of protective barriers, and improved design of the barriers are necessary to improve compliance and reduce the risk of MCE.
Nosocomial Acquisition of Pertussis Diagnosed by Polymerase Chain Reaction
Authors: Matlow Anne G. , Nelson Sue , Wray Rick , Cox Peter
Published: September 2009

Awareness is growing of the role of pertussis infection among adolescents and adults, and of the possibility of nosocomial transmission. However, pertussis remains difficult to diagnose. We report a case of nosocomially acquired pertussis in a healthcare worker, diagnosed by polymerase chain reaction. The high sensitivity and rapid turnaround time for this test is useful to confirm the diagnosis when advising a healthcare worker to refrain from working.
Occupational Blood Exposures in Dentistry: A Decade in Review
Authors: Cleveland Jennifer L. , Gooch Barbara F. , Lockwood Stuart A.
Published: September 2009

This review summarizes data from self-reported and observational studies describing the nature, frequency, and circumstances of occupational blood exposures among US dental workers between 1986 and 1995. These studies suggest that, among US dentists, percutaneous injuries have declined steadily over the 10-year period. Data also suggest that, in 1995, most dental workers (dentists, hygienists, assistants, and oral surgeons) experienced approximately three injuries per year. Work practices (eg, using an instrument instead of fingers to retract tissue), safer instrumentation or design (eg, self-sheathing needles, changes in dental-unit design), and continued worker education may reduce occupational blood exposures in dentistry further.
Product Evaluation
Authors: Valenti William M. , Herwaldt Loreen A.
Published: September 2009

As healthcare budgets shrink, infection control personnel must become more involved in the process by which their institutions choose products and equipment. This article suggests an approach that individuals or programs can use to assess products in a consistent and thorough manner
Disinfection of Hospital Rooms Contaminated With Vancomycin-Resistant Entemcocms faecium
Authors: Byers Karin E. , Durbin Lisa J. , Simonton Barbara M. , Anglim Anne M. , Adal Karim A. , Farr Barry M.
Published: September 2009

Sixteen percent of hospital room surfaces remained colonized by vancomycin-resistant enterococci (VRE) after routine terminal disinfection. Disinfection with a new "bucket method" resulted in uniformly negative cultures. Conventional cleaning took an average of 2.8 disinfections to eradicate VRE from a hospital room, while only one cleaning was required with the bucket method.
Antimicrobial Use and Resistance in Eight US Hospitals: Complexities of Analysis and Modeling
Authors: Monnet Dominique L. , Archibald Lennox K. , Phillips Lisa , Tenover Fred C. , McGowan John E. , Gaynes Robert P. ,   Intensive Care Antimicrobial Resistance Epidemiology Project and the National Nosocomial Infections Surveillance System Hospitals
Published: September 2009

OBJECTIVE:

To evaluate the relation between antimicrobial use and resistance in intensive-care unit (ICU) and non-ICU inpatient areas in eight US hospitals.

METHODS:

We determined antimicrobial use in terms of defined daily doses, antimicrobial-use density (defined daily doses/1,000 patient days), and percentage resistance for five antimicrobial-organism combinations in the ICU and non-ICU inpatient areas of eight US hospitals participating in project Intensive Care Antimicrobial Resistance Epidemiology.

RESULTS:

Antimicrobial resistance and use varied tremendously among the eight hospitals. Antimicrobial resistance among these five nosocomial pathogens was significantly higher within the inpatient setting of these hospitals, compared with the outpatient setting. One hospital consistently ranked highest for use of all classes of antimicrobials examined. High antimicrobial use was not associated necessarily with high resistance for a particular antimicrobial-organism pair.

CONCLUSION:

Antimicrobial use varied significantly across these hospitals, but generally was higher in ICUs. These results suggest that concomitant surveillance of both antimicrobial resistance and antimicrobial use is helpful in interpreting antimicrobial resistance in a hospital or ICU and that further analysis is required to determine the role of variables other than antimicrobial use in a statistical model for predicting antimicrobial resistance.
Guideline for Infection Control in Healthcare Personnel, 1998
Authors: Bolyard Elizabeth A. , Tablan Ofelia C. , Williams Walter W. , Pearson Michele L. , Shapiro Craig N. , Deitchman Scott D. ,   Hospital Infection Control Practices Advisory Committee
Published: September 2009

This guideline updates and replaces the previous edition of the Centers for Disease Control and Prevention (CDC) “Guideline for Infection Control in Hospital Personnel,” published in 1983. The revised guideline, designed to provide methods for reducing the transmission of infections from patients to healthcare personnel and from personnel to patients, also provides an overview of the evidence for recommendations considered prudent by consensus of the Hospital Infection Control Practices Advisory Committee members. A working draft of this guideline was also reviewed by experts in infection control, occupational health, and infectious diseases; however, all recommendations contained in the guideline may not reflect the opinion of all reviewers.
Remarks on Springer’s representations
Authors: Lusztig G.
Published: September 2009

We give an explicit description of a set of irreducible representations of a Weyl group which parametrizes the nilpotent orbits in the Lie algebra of a connected reductive group in arbitrary characteristic. We also answer a question of Serre concerning the conjugacy class of a power of a unipotent element in a connected reductive group.
First Report of “Candidatus Liberibacter solanacearum” in Pepper Plants in México
Authors: Munyaneza J. E. , Sengoda V. G. , Crosslin J. M. , Garzón-Tiznado J. A. , Cardenas-Valenzuela O. G.
Published: September 2009

Bell pepper (Capsicum annuum) plants exhibiting symptoms that resembled those of potato psyllid (Bactericera cockerelli Sulc) damage and “Candidatus Liberibacter solanacearum” infection (2) were observed in a pepper field in La Cruz de Elota, Sinaloa, México in March 2009, with an infection rate of 1.5%. Plants exhibited chlorotic or pale green apical growth and leaf cupping, sharp tapering of the leaf apex, shortened internodes, and an overall stunting (2). Total DNA was extracted from the top whole leaf tissue of nine symptomatic and five asymptomatic pepper plants with cetyltrimethylammoniumbromide (CTAB) buffer (3,4). Seven and eight of the nine selected symptomatic pepper plants yielded the expected 1,168-bp 16S rDNA and the expected 669-bp rplJ/rplL ribosomal protein gene amplicons with the “Ca. L. solanacearum” specific OA2/OI2c and CL514F/CL514R primer pairs, respectively, indicating the presence of liberibacter (2,4). Nucleic acid from asymptomatic pepper plants yielded no products with these primers. Three amplicons generated from symptomatic pepper plants with each primer pair were cloned into pCRII-TOPO plasmid vectors (Invitrogen, Carlsbad, CA) and three clones of each amplicon were sequenced in both directions (ACGT, Inc., Wheeling, IL). BLAST analysis of the 16S rDNA consensus sequence (GenBank Accession No. FJ957896) showed 100% identity to 16S rDNA sequences of “Ca. L. solanacearum” amplified from Solanum betaceum (EU935004) and S. lycopersicum (EU834130) from New Zealand (2), and “Ca. L. psyllaurous” from potato psyllids (EU812559) (1). The ribosomal protein gene consensus sequence (GenBank Accession No. FJ957894) was 100% identical to the analogous rplJ and rplL “Ca. L. solanacearum” ribosomal protein gene sequence amplified from S. lycopersicum (EU834131) from New Zealand (2) and to ‘Ca. Liberibacter’ sp. sequence amplified from zebra chip-infected potato tubers from Lancaster, CA (FJ498803). To our knowledge, this is the first report of “Ca. L. solanacearum” associated with bell pepper in México. “Ca. L. solanacearum” was first reported in tomato and pepper plants in 2008 in New Zealand, where it has resulted in plant decline and significant yield loss, resulting in millions of dollars in losses to the commercial glasshouse tomato and pepper industry (2). Zebra chip, a new and emerging potato disease associated with ‘Ca. Liberibacter’ sp., was first identified in México in 1994, where it has caused significant economic damage, often leading to abandonment of entire potato fields (3,4).

References: (1) A. K. Hansen et al. Appl. Environ. Microbiol. 74:5862, 2008. (2) L. W. Liefting et al. Plant Dis. 93:208, 2009. (3) J. E. Munyaneza et al. J. Econ. Entomol. 100:656, 2007. (4) J. E. Munyaneza et al. Plant Dis. 93:552, 2009.
Structural and mechanical design of tissue interfaces in the giant reedArundo donax
Authors: Rüggeberg Markus , Burgert Ingo , Speck Thomas
Published: September 2009

The culms of the giant reedArundo donaxrepresent slender tube-like structures. Several nodes along the culm, a ring of sclerenchymatous fibres in the periphery of the culm wall and numerous isolated vascular bundles enclosed by fibre rings in the culm wall function as stiffening elements. The bundles are embedded in lignified parenchyma. Micromechanical analysis indicated differences in stiffness between the individual tissues of more than one order of magnitude. In case of abrupt transitions in stiffness at the interfaces, stress discontinuities arise under dynamic loads. This eventually leads to critical shear stresses at cell ends, and culm failure may be initiated at these points. Pronounced mechanical differences between individual tissues can be compromised by gradual transitions at their interfaces. Ultrastructural and spectroscopic investigations with high spatial resolution revealed a gradual transition of cell parameters (cell wall area fraction and cell length). However, cell wall parameters (cellulose microfibril angle and lignin content) showed abrupt transitions or remained almost constant across the interfaces between various tissues. The design principles found at the interfaces between tissues in the culm walls ofA. donaxare discussed as an adaptation strategy to mechanical loads at different levels of hierarchy.
Marginal conditions for thermoacoustic oscillations in resonators
Authors: Sugimoto Nobumasa , Takeuchi Ryota
Published: September 2009

This paper examines marginal conditions for the onset of thermoacoustic oscillations in resonators of a Sondhauss tube and a gas-filled, dumbbell-shaped tube. An analysis is performed using a linear acoustic theory based on the first-order boundary-layer approximation. When a parabolic temperature distribution is assumed along the tube’s neck, a frequency equation is available analytically, whose complex solutions are examined numerically. In the case of the dumbbell-shaped tube, two modes of oscillations exist, one being an antisymmetric mode and the other a symmetric one for pressure variations in the neck, while in the case of the Sondhauss tube, only a mode corresponding to the antisymmetric one exists due to the boundary condition at the open end. Marginal conditions are sought numerically, not only for the lowest branches of both modes, but also for second higher branches, but they are available only for the lowest branch of the antisymmetric mode. For the Sondhauss tube, marginal conditions are obtained by taking account of radiation into free space. Some discussions are provided in comparison with experiments.
Flights of fear: a mechanical wing whistle sounds the alarm in a flocking bird
Authors: Hingee Mae , Magrath Robert D.
Published: September 2009

Animals often form groups to increase collective vigilance and allow early detection of predators, but this benefit of sociality relies on rapid transfer of information. Among birds, alarm calls are not present in all species, while other proposed mechanisms of information transfer are inefficient. We tested whether wing sounds can encode reliable information on danger. Individuals taking off in alarm fly more quickly or ascend more steeply, so may produce different sounds in alarmed than in routine flight, which then act as reliable cues of alarm, or honest ‘index’ signals in which a signal's meaning is associated with its method of production. We show that crested pigeons,Ocyphaps lophotes, which have modified flight feathers, produce distinct wing ‘whistles’ in alarmed flight, and that individuals take off in alarm only after playback of alarmed whistles. Furthermore, amplitude-manipulated playbacks showed that response depends on whistle structure, such as tempo, not simply amplitude. We believe this is the first demonstration that flight noise can send information about alarm, and suggest that take-off noise could provide a cue of alarm in many flocking species, with feather modification evolving specifically to signal alarm in some. Similar reliable cues or index signals could occur in other animals.
Living on the wedge: female control of paternity in a cooperatively polyandrous cichlid
Authors: Kohda Masanori , Heg Dik , Makino Yoshimi , Takeyama Tomohiro , Shibata Jun-ya , Watanabe Katsutoshi , Munehara Hiroyuki , Hori Michio , Awata Satoshi
Published: September 2009

Theories suggest that, in cooperatively breeding species, female control over paternity and reproductive output may affect male reproductive skew and group stability. Female paternity control may come about through cryptic female choice or female reproductive behaviour, but experimental studies are scarce. Here, we show a new form of female paternity control in a cooperatively polyandrous cichlid fish (
Julidochromis transcriptus
), in which females prefer wedge-shaped nesting sites. Wedge-shaped sites allowed females to manipulate the siring success of the group member males by spawning the clutch at the spot where the large males were just able to enter and fertilize the outer part of the clutch. Small males fertilized the inner part of the clutch, protected from the large aggressive males, leading to low male reproductive skew. Small males provided more brood care than large males. Multiple paternity induced both males to provide brood care and reduced female brood care accordingly. This is, to our knowledge, the first documented case in a species with external fertilization showing female mating behaviour leading to multiple male paternity and increased male brood care as a result.
Variation and covariation in infectivity, virulence and immunodepression in the host–parasite associationGammarus pulex–Pomphorhynchus laevis
Authors: Cornet Stéphane , Franceschi Nathalie , Bollache Loïc , Rigaud Thierry , Sorci Gabriele
Published: September 2009

Parasites often manipulate host immunity for their own benefit, either by exacerbating or suppressing the immune response and this may directly affect the expression of parasite virulence. However, genetic variation in immunodepression, which is a prerequisite to its evolution, and the relationship between immunodepression and virulence, have rarely been studied. Here, we investigated the variation among sibships of the acanthocephalan parasite,Pomphorhynchus laevis, in infecting and in immunodepressing its amphipod host,Gammarus pulex. We also assessed the covariation between infectivity, parasite-induced immune depression and host mortality (parasite virulence). We found that infectivity, the intensity of immunodepression and virulence were variable among parasite sibships. Infectivity and the level of immunodepression were not correlated across parasite sibships. Whereas infectivity was unrelated to host mortality, we found that gammarids that were exposed to the parasite sibships that immunodepressed their hosts the most survived better. This positive covariation between host survival and immunodepression suggests that gammarids exposed to the less immunodepressive parasites could suffer from damage imposed by a higher activity of the phenoloxidase.
Aneuploidy and DNA fragmentation in morphologically abnormal sperm
Authors: Tang S. S. , Gao H. , Zhao Y. , Ma S.
Published: September 2009

In light of the relative success of ICSI in the treatment of male infertility, much importance has been made to the selection of morphologically viable sperm. However, correlation between specific sperm morphology and chromosomal abnormalities is still relatively limited and less is known about the connection between sperm morphology and DNA integrity. Sperm obtained from isolated teratozoospermic men (n = 10) and control men (n = 9) were analysed using FISH (for chromosomes 13, 18, 21, X and Y) and TUNEL assays to determine the level of aneuploidy and DNA fragmentation. Sperm morphology was evaluated on its ability to identify the level of chromosomal abnormalities or fragmented DNA in sperm. Sperm from teratozoospermic men, compared with fertile men, had higher rates of total chromosomal abnormality (p < 0.05), total aneuploidy (p < 0.01) and chromosome 13 disomy (p < 0.01). Associations between particular types of sperm morphology and chromosomal abnormalities were observed in both control (tapered heads) and teratozoospermic (amorphous heads and tail abnormalities) samples. Levels of DNA fragmented sperm were higher in teratozoospermic men than in the control men (60.28 ± 21.40% vs. 32.40 ± 17.20%, p < 0.05) and positively correlated to sperm with bent necks in control samples and round heads in teratozoospermic samples (p < 0.05). Sperm of isolated teratozoospermic men have higher rates of chromosomal abnormalities and DNA fragmentation than that of the fertile controls. Specific abnormal sperm morphology can be correlated to chromosomal abnormalities and level of DNA fragmentation in sperm.
Random Forest characterization of upland vegetation and management burning from aerial imagery
Authors: Chapman Daniel S. , Bonn Aletta , Kunin William E. , Cornell Stephen J.
Published: September 2009

Aim The upland moorlands of Great Britain form distinctive landscapes of international conservation importance, comprising mosaics of heathland, acid grassland, blanket bog and bracken. Much of this landscape is managed by rotational burning to create gamebird habitat and there is concern over whether this is driving long‐term changes in upland vegetation communities. However, the inaccessibility and scale of uplands means that monitoring changes in vegetation and burning practices is difficult. We aim to overcome this problem by developing methods to classify aerial imagery into high‐resolution maps of dominant vegetation cover, including the distribution of burns on managed grouse moors.

Location Peak District National Park, England, UK.

Methods Colour and infrared aerial photographs were classified into seven dominant land‐cover classes using the Random Forest ensemble machine learning algorithm. In addition, heather (Calluna vulgaris) was further differentiated into growth phases, including sites that were newly burnt. We then analysed the distributions of the vegetation classes and managed burning using detrended correspondence analysis.

Results Classification accuracy wasc. 95% and produced a 5‐m resolution map for 514 km2of moorland. Cover classes were highly aggregated and strong nonlinear effects of elevation and slope and weaker effects of aspect and bedrock type were evident in structuring moorland vegetation communities. The classification revealed the spatial distribution of managed burning and suggested that relatively steep areas may be disproportionately burnt.

Main conclusions Random Forest classification of aerial imagery is an efficient method for producing high‐resolution maps of upland vegetation. These may be used to monitor long‐term changes in vegetation and management burning and infer species–environment relationships and can therefore provide an important tool for effective conservation at the landscape scale.
Prevalence of vision, hearing, and combined vision and hearing impairments in patients with hip fractures
Authors: Grue Else Vengnes , Kirkevold Marit , Ranhoff Anette Hylen
Published: September 2009

Aims and objectives. To examine the prevalence of hearing and vision impairments in 65+ year‐old patients with hip fractures.

Background. Many older people believe sensory problems are inevitable and thus avoid medical assessment and assistance. Furthermore, health professionals often overlook sensory problems, though it is known that sensory impairments can increase the risk of falling and sustaining hip fractures.

Design. A prospective, observational study.

Methods. We admitted 544 consecutive patients to an orthogeriatric ward from October 2004–July 2006; 332 were screened for study inclusion with the Resident Assessment Instrument for Acute Care (InterRAI‐AC) and a questionnaire (KAS‐Screen). We conducted patient interviews, objective assessments, explored hospital records and interviewed the family and staff. Impairments were defined as problems with seeing, reading regular print or hearing normal speech.

Results. Sixteen per cent of the patients had no sensory impairments, 15·4% had vision impairments, 38·6% had hearing impairments and 30·1% had combined sensory impairments. Among the impaired, 80·6% were female, the mean age was 84·3 years (SD 6·8), 79·9% were living alone, 48·0% had cognitive impairments, 89·6% had impaired activities of daily living, 70·6% had impaired instrument activities in daily living, 51·0% had bladder incontinence and 26·.8% were underweight. Comorbidity and polypharmacy were common. Delirium was detected in 17·9% on day three after surgery. Results showed the prevalence of combined sensory impairments was: 32·8% none; 52·2% moderate/severe; and 15·1% severe.

Conclusion. Patients with hip fractures frequently have hearing, vision and combined impairments.

Relevance to clinical practice. We recommend routine screening for sensory impairments in patients with hip fractures. Most sensory problems can be treated or relieved with environmental adjustments. Patients should be encouraged to seek treatment and training for adapting to sensory deficiencies. This approach may reduce the number of falls and improve the ability to sustain independent living.
Sense of coherence—a determinant of quality of life over time in older female acute myocardial infarction survivors
Authors: Norekvål Tone M , Fridlund Bengt , Moons Philip , Nordrehaug Jan E , Sævareid Hans I , Wentzel‐Larsen Tore , Hanestad Berit R
Published: September 2009

Aims. To determine the relationships between different sense of coherence levels and quality of life, and in older female myocardial infarction survivors; to investigate how socio‐demographic, clinical characteristics, sense of coherence self‐reported symptoms and function affect quality of life; and to determine whether sense of coherence and quality of life are stable during a six‐month follow‐up.

Background. Myocardinal infraction confers new physical and mental challenges. However, research on sense of coherence and other factors involved in maintaining physical, psychosocial and environmental aspects of quality of life in older female myocardinal infraction survivors is scant.

Design. Survey.

Methods. A postal survey was conducted of 145 women, aged 62–80 years, three months to five years after myocardial infarction (T1), with a follow‐up after six months (T2). Self‐reported socio‐demographic and clinical data and hospital medical records data were collected. The sense of coherence scale (SOC‐29) and the World Health Organization Quality of Life Instrument Abbreviated (WHOQOL‐BREF) were used.

Results. We found a significant difference in quality of life between weak, moderate, and strong sense of coherence groups (p<0·001). Sense of coherence contributed to the level of all quality of life domains (p<0·001). Several clinical characteristics contributed to quality of life: (1) physical domain: comorbidities (p<0·001), previous myocardial infarction (p = 0·013), ejection fraction (p<0·011), length of hospital stay (p = 0·005) symptoms and function (p<0·001); (2) psychological domain: previous myocardial infarction (p = 0·031) and symptoms and function (p<0·001); and (3) environmental domain: education (p = 0·033) and symptoms and function (p = 0·003). On group level, both sense of coherence and quality of life were stable. Experiencing specific health changes (p<0·001), not major life events, influenced quality of life during the six‐month follow‐up.

Conclusion. Sense of coherence was an important stable determinant of quality of life domains in female myocardial infarction survivors. Although other factors were identified, further research is needed to elucidate additional determinants of quality of life.

Relevance to clinical practice. These specific factors could guide clinicians in making treatment decisions that optimize the quality of life of their patients. Applying a salutogenic perspective through patient education may be important.
Development and implementation of a noise reduction intervention programme: a pre‐ and postaudit of three hospital wards
Authors: Richardson Annette , Thompson Abigail , Coghill Elaine , Chambers Iain , Turnock Chris
Published: September 2009

Aims.  By developing, implementing and delivering a noise reduction intervention programme, we aimed to attempt to reduce the high noise levels on inpatient wards.

Background.  Sleep is essential for human survival and sleep deprivation is detrimental to health and well being. Exposure to noise has been found to disrupt sleep in hospitalised patients which is to be expected as noise levels have been measured and reported as high.

Design.  A primarily nursing focused, multi‐method approach, involving development of clinical guidelines, ward environment review and a staff noise awareness and education programme, was used to target mainly nursing staff plus other healthcare staff on three wards within one hospital.

Methods.  This practice development initiative was carried out in three key phases (1) Preaudit of ward noise levels, (2) The development, implementation and delivery of a noise reduction intervention programme, (3) Postaudit of ward noise levels.

Results.  Preintervention average peak decibel levels over 24 hours were found to be 96·48 dB(A) and postintervention average peak decibel levels were measured at 77·52 dB(A), representing an overall significant reduction in noise levels (p < 0·001).

Conclusions.  This study describes one way to reduce peak noise levels on inpatient hospital wards.

Relevance to clinical practice.  Sleep deprivation is detrimental to patients with acute illness, so any developments to improve patients’ sleep are important. Nurses have a key role in leading, developing and implementing changes to reduce peak noise levels on inpatient wards in hospitals. This nurse‐led practice development programme has demonstrated how improvements can be achieved by significantly reducing peak noise levels using simple multi‐method change strategies.