bluuebunny/crossref_metadata_2025 huggingface dataset:
Antineuronal antibodies and electroneurophysiological studies in pediatric patients with neuropsychiatric systemic lupus erythematosus
Authors: Mostafa Gehan A. , Nazif Hayam K. , El‐Shahawi Heba H. , Abd El‐Aziz Manal M. , Hassan Magda A.
Published: April 2008

Neuropsychiatric systemic lupus erythematosus (NPSLE) is one of the most difficult manifestations of lupus to diagnose. Measurement of serum brain autoantibodies and assessment of cognitive function by electroneurophysiological studies (electroencephalogram (EEG) and P300) have contributed to an earlier and a more specific diagnosis of NPSLE. Thus, we were stimulated to assess the value of serum antineuronal antibodies and electroneurophysiological studies in diagnosis and early prediction of NPSLE. To investigate this, assessment of serum antineuronal antibodies and cognitive function (clinically and by electroneurophysiological studies) was done in 30 lupus patients [14 (46.7%) with and 16 (53.3%) without clinical evidence of NPSLE] in comparison with 30 healthy matched subjects. Patients without clinical evidence of NPSLE were followed‐up clinically by monthly neuropsychiatric evaluation for 18 months. Seropositivity for antineuronal antibodies and abnormalities of EEG and P300 (prolonged latency and/or low amplitude) were found in 60%, 50% and 70%, respectively of lupus patients. During follow‐up, 8 out of the 16 patients without clinical evidence of NPSLE developed such evidence [six (75%) had antineuronal seropositivity, five (62.5%) had abnormal EEG, six (75%) had P300 abnormalities and all had at least one abnormal result of these parameters at the time of initial evaluation before clinical presentation of NPSLE]. In conclusion, serum antineuronal antibodies and electroneurophysiological studies may be reliable parameters for diagnosis and early prediction of NPSLE, especially when combined together, before clinical manifestations ensue. Further studies on a large scale are warranted to evaluate the predictive value of these parameters in NPSLE.
Redox signal integration: from stimulus to networks and genes
Authors: Dietz Karl‐Josef
Published: April 2008

Recent research has established redox‐dependent thiol modification of proteins as a major regulatory layer superimposed on most cell functional categories in plants. Modern proteomics and forward as well as reverse genetics approaches have enabled the identification of a high number of novel targets of redox regulation. Redox‐controlled processes range from metabolism to transport, transcription and translation. Gene activity regulation by transcription factors such as TGA, Athb‐9 and RAP2 directly or indirectly is controlled by the redox state. Knowledge on putative redox sensors such as the peroxiredoxins, on redox transmitters including thioredoxins and glutaredoxins and biochemical mechanisms of their linkage to the metabolic redox environment has emerged as the framework of a functional redox regulatory network. Its basic principle is similar in eukaryotic cells and particularly complex in the photosynthesizing chloroplast. Methods and knowledge are now at hand to develop a quantitative understanding of redox signalling and the redox regulatory network in the eukaryotic cell.
Gravisensitivity and automorphogenesis of lentil seedling roots grown on board the International Space Station
Authors: Driss‐Ecole Dominique , Legué Valérie , Carnero‐Diaz Eugénie , Perbal Gérald
Published: April 2008

The GRAVI‐1 experiment was brought on board the International Space Station by Discovery (December 2006) and carried out in January 2007 in the European Modular Cultivation System facility. For the first run of this experiment, lentil seedlings were hydrated and grown in microgravity for 15 h and then subjected for 13 h 40 min to centrifugal accelerations ranging from 0.29 × 10−2 g to 0.99 × 10−2 g. During the second run, seedlings were grown either for 30 h 30 min in microgravity (this sample was the control) or for 21 h 30 min and then subjected to centrifugal accelerations ranging from 1.2 × 10−2 g to 2.0 × 10−2 g for 9 h. In both cases, root orientation and root curvature were followed by time‐lapse photography. Still images were downlinked in near real time to ground Norwegian User Support and Operations Center during the experiment. The position of the root tip and the root curvature were analyzed as a function of time. It has been shown that in microgravity, the embryonic root curved strongly away from the cotyledons (automorphogenesis) and then straightened out slowly from 17 to 30 h following hydration (autotropism). Because of the autotropic straightening of roots in microgravity, their tip was oriented at an angle close to the optimal angle of curvature (120°–135°) for a period of 2 h during centrifugation. Moreover, it has been demonstrated that lentil roots grown in microgravity before stimulation were more sensitive than roots grown in 1 g. In these conditions, the threshold acceleration perceived by these organs was found to be between 0 and 2.0 × 10−3 g and estimated punctually at 1.4 × 10−5 g by using the hyperbolic model for fitting the experimental data and by assuming that autotropism had no or little impact on the gravitropic response. Gravisensing by statoliths should be possible at such a low level of acceleration because the actomyosin system could provide the necessary work to overcome the activation energy for gravisensing.
Foliar susceptibility of eastern oak species to Phytophthora infection
Authors: Balci Y. , Balci S. , MacDonald W. L. , Gottschalk K. W.
Published: April 2008

Seven different Phytophthora species were used to test the foliar susceptibility of the common eastern US oak species and understory plants to Phytophthora infection. The Phytophthora species employed were Phytophthora cambivora, Phytophthora cinnamomi, Phytophthora citricola, Phytophthora europaea, Phytophthora quercetorum, Phytophthora quercina‐like and Phytophthora sp1. Inoculation of detached‐leaves with agar plugs containing mycelia of Phytophthora provided an estimate of their relative susceptibility. Lesions were always greater when foliage was wounded and young. On deciduous plants, lesion sizes were considerably reduced with the increasing foliar age, although with evergreen plants lesion sizes remained similar regardless of foliar age when more aggressive isolates were tested. Infections seldom resulted when foliage was not wounded. With young and mature foliage, P. citricola usually produced the largest lesions. Young foliage of Quercus rubra was the most susceptible to infection followed by Castanea dentata for both wounded and non‐wounded inoculations. Mature foliage of Hamamelis virginiana, Kalmia latifolia and Quercus alba were the most susceptible to wound and non‐wound inoculations.
Chitinase CHIT36 from Trichoderma harzianum Enhances Resistance of Transgenic Carrot to Fungal Pathogens
Authors: Baranski Rafal , Klocke Evelyn , Nothnagel Thomas
Published: April 2008

Microbial endochitinase CHIT36 is one of the lytic enzymes secreted by Trichoderma harzianum that exhibits antifungal activity in vitro. To evaluate its activity when expressed in planta, a plasmid containing chit36 gene under the control of CaMV 35S promoter and the nptII selection gene were introduced into polyethylene glycol (PEG)‐treated carrot (Daucus carota L.) protoplasts. The transgenic plants expressing CHIT36 were used in resistance assays to evaluate their susceptibility to fungal pathogens. Laboratory‐based assays on detached leaves and petioles showed that the transgenic carrots had less severe disease symptoms. The resistance response depended on the transgenic clone, but all clones had significantly enhanced tolerance to Alternaria radicina and Botrytis cinerea, on average by 50%. Slower disease progress caused by Alternaria dauci was observed for two transgenic clones while the remaining clone was more susceptible than the control. The most resistant transgenic clones were also more tolerant to the pathogens than ‘Bolero’ F1, which is a conventionally bred cultivar tolerant to A. dauci. This is the first report of the use of microbial chitinase to enhance carrot resistance. The results indicate that CHIT36 expressed in planta has the potential to reduce development of fungal diseases.
Monitoring of Epstein–Barr virus load and antibody in pediatric renal transplant patients
Authors: Sato Tetsuya , Fujieda Mikiya , Tanaka Eriko , Miyamura Masakazu , Chikamoto Hiroko , Hisano Masataka , Akioka Yuko , Ishiura Yoshihito , Dohno Sumitaka , Maeda Akihiko , Hattori Motoshi , Wakiguchi Hiroshi
Published: April 2008

Background: Epstein–Barr virus (EBV) infection can lead to life‐threatening post‐transplant lymphoproliferative disorder (PTLD). The aim of the present study was to establish EBV monitoring methods to prevent PTLD.

Methods: EBV‐DNA load was investigated, using real‐time polymerase chain reaction (PCR) and anti‐EBV antibody titers, in peripheral blood mononuclear cells of 21 renal transplant patients (seven recipients who were EBV‐seronegative, R[−]; 14 who were EBV‐seropositive, R[+]) before grafting. The mean age at entry and the mean follow‐up period was 7.8 years of age (range, 3.3–12.0 years) and 1.8 years (range, 0.4–4.0 years), respectively, in the R(−) group, and 12.5 years of age (range, 3.9–17.7 years) and 3.8 years (range, 0.8–8.2 years) in the R(+) group, respectively.

Results: The mean maximum load of the EBV genome was 1071 copies/μg DNA (range, 106–20700 copies/μg DNA) in the R(−) group, and 61 copies/μg DNA (range, <50–552 copies/μg DNA) in the R(+) group. During follow up no patient in the R(+) group had any noticeable symptoms that could be related to EBV, but three recipients in the R(−) group developed EBV‐related symptoms including adenoid hypertrophy, cervical lymphadenopathy, and PTLD (B cell lymphoma), in one patient each. In the R(−) group the first leukocyte‐associated viremia was detected at 30–180 days, and seroconversion at 43–266 days after transplantation.

Conclusions: Viral DNA detection using PCR is a useful tool for EBV surveillance, but the maximum EBV load was not markedly elevated (2474 copies/μg DNA) in a patient with PTLD. Therefore, EBV surveillance using only monitoring of EBV load in peripheral leukocyte may be insufficient. Histology may therefore be necessary to accurately diagnose PTLD.
Increased serum high‐sensitivity C‐reactive protein is related to hypoxia and brain natriuretic peptide in congenital heart disease
Authors: Tomita Hideshi , Takamuro Motoki , Soda Wataru , Hatakeyama Kinya , Tsutsumi Hiroyuki
Published: April 2008

Background: Studies of adults have shown a direct association between increased serum concentrations of high‐sensitivity C‐reactive protein (hs‐CRP) and atherosclerotic cardiovascular disease, diabetes, and chronic heart failure. Some studies have documented elevated hs‐CRP in obese children and adolescents, and in patients with a history of Kawasaki disease, but there are few data on its clinical significance in congenital heart disease.

Methods: Measurements of hs‐CRP, brain natriuretic peptide (BNP), hemoglobin, and percutaneous oxygen saturation (SpO2) were done in the following 70 patients: 18 controls; 11 with hypoxia (SpO2 ≤ 85% and BNP < 40 pg/mL); 31 with raised BNP (BNP ≥ 40 pg/mL and SpO2 > 85%); and 10 patients with hypoxia–BNP (SpO2 ≤ 85% and BNP ≥ 40 pg/mL). Correlations between hs‐CRP, and age, body mass index (BMI), hemoglobin, SpO2, and BNP were analyzed using single and multiple regression analysis.

Results: Hs‐CRP in the hypoxia–BNP group was higher than in the other three groups, while in the hypoxia and the BNP groups it tended to be higher than in the controls. Although single regression analysis showed significant correlations between hs‐CRP and, age, BNP, hemoglobin, and SpO2, multiple regression analysis showed that only BNP and SpO2 had a significant correlation with hs‐CRP.

Conclusions: In preoperative or postoperative congenital heart disease, patients who had hypoxia or increased BNP had a higher hs‐CRP level than controls. Serum concentration of hs‐CRP significantly correlated with SpO2 and plasma BNP levels, but not with age or BMI.
Risk factors for developing severe clinical course in HUS patients: a national survey in Japan
Authors: Kamioka Ichiro , Yoshiya Kunihiko , Satomura Kenichi , Kaito Hiroshi , Fujita Teruo , Iijima Kazumoto , Nakanishi Koichi , Yoshikawa Norishige , Nozu Kandai , Matsuo Masafumi ,   members of the Japanese Society for Pediatric Nephrology
Published: April 2008

Background: Hemolytic uremic syndrome (HUS) is characterized by acute renal failure, thrombocytopenia and hemolytic anemia. Cases accompanied by prodromal gastrointestinal tract symptoms are referred to as typical HUS. Some severe HUS patients require dialysis or develop central nervous system (CNS) disorders after the onset of HUS.

Methods: Patients who developed typical HUS in 2001 and 2002 in Japan, 127 in all, were the study subjects. To identify the risk factors for the development of a severe clinical course, clinical and laboratory data were analyzed on logistic regression.

Results: Two of the 127 patients died (1.6%): one from acute cardiac failure and the other from a CNS disorder. Thirty‐five patients required dialysis (28%) and 30 had CNS symptoms (24%). Multivariate analysis indicated that the risk factors for need for dialysis were serum sodium and alanine aminotransferase (ALT) levels of ≤130 mEq/L and ≥70 IU/L, respectively, at the onset of HUS and those for developing CNS disorders were dialysis and C‐reactive protein (CRP) ≥5.0 mg/dL at the onset of HUS.

Conclusions: Because patients with these risk factors, such as low serum sodium, high ALT or high CRP levels, may require dialysis or develop CNS disorders, they should be treated carefully in the early stage of HUS.
Elective cryopreservation of all day 5 blastocysts is more effective than using day 6 blastocysts for improving pregnancy outcome in stimulated cycles
Authors: YAMAMOTO SETSUKO , UMEKI MICHIKO , HAMANO TERUHIRO , MATSUSITA FUJIYO , KUWAHARA KIMIKO
Published: April 2008

Aim:  To evaluate the efficacy of cryopreservation of all blastocysts for future transfers in stimulated cycles.

Methods:  We carried out fresh blastocyst transfer cycles on day 5 (n = 290) or day 6 (n = 119) and thawed blastocyst transfer cycles that were frozen on day 5 (n = 136), day 6 (n = 71) or day 6 electively (n = 21). We retrospectively compared the clinical outcome of fresh blastocyst transfers with thawed blastocyst transfers according to the day of blastocyst transfer or freezing.

Results:  The clinical implantation rates in women with stimulated cycles were significantly higher after the transfer of thawed blastocysts compared with the transfer of fresh blastocysts (day 5, P < 0.0005; day 6, P < 0.00005). Although the implantation rate of fresh day 6 transfer cycles was lower than that of elective day 6 frozen–thawed cycles, this difference was not statistically significant (P = 0.17).

Conclusions:  Thawed blastocysts demonstrated a better potential for implantation when compared with fresh blastocysts in stimulated cycles. We concluded that elective cryopreservation of all blastocysts on day 5 is an effective option to improve the clinical outcome in stimulated cycles. Additionally, with cryopreservation of all day 6 blastocysts, the implantation rates of first embryo transfers may increase by allowing the best‐quality blastocysts to be transferred in thawed cycles. (Reprod Med Biol 2008; 7: 75–83)
Mild stimulation with clomiphene citrate in combination with recombinant follicle‐stimulating hormone and gonadotropin‐releasing hormone antagonist and its influence on serum estradiol level and pregnancy rate
Authors: YANAIHARA ATSUSHI , YORIMITSU TAKESHI , MOTOYAMA HIROSHI , OHARA MOTOHIRO , KAWAMURA TOSHIHIRO
Published: April 2008

Aim:  The mild ovarian stimulation protocol for in vitro fertilization (IVF) is carried out to minimize adverse side‐effects as well as cost. While performing mild ovarian stimulation with a gonadotropin‐releasing hormone (GnRH) antagonist, the pregnancy rate was examined in cases that exhibited a serum estradiol (E2) drop down.

Methods:  In this study, 174 patients who requested mild ovarian stimulation for IVF began clomiphene citrate on day 3 and recombinant follicle‐stimulating hormone (FSH) on day 5 of their menstrual cycles. A GnRH antagonist was administered when the dominant follicle reached a diameter of 14 mm. Serum luteinizing hormone and estradiol were measured at the time of GnRH antagonist administration and at the time of human chorionic gonadotropin (hCG) injection. Pregnancy rates and implantation rates were compared between 24 cycles in which the E2 level fell at the time of hCG injection and 150 cycles in which it did not fall.

Results:  The pregnancy rate in the cases in which the E2 level fell (25% decrease) at the time of hCG injection was significantly lower than it was in the cases in which it did not fall (16.7 vs 41.0%). The implantation rate for the cases in which the E2 level fell was also lower than that of the control group (7.0 vs 31.0%). There was no significant difference in the number of good‐quality embryos between the two groups.

Conclusion:  When performing the mild ovarian stimulation protocol, serum E2 should be followed. It is prudent to avoid embryo transfer in the same cycle in cases that exhibit E2 drop down. (Reprod Med Biol 2008; 7: 85–89)
Angiogenesis in the human corpus luteum
Authors: SUGINO NORIHIRO , MATSUOKA AKI , TANIGUCHI KEN , TAMURA HIROSHI
Published: April 2008

Angiogenesis is important for the formation and development of the corpus luteum and for maintenance of luteal function. Blood vessel regression is an important physiological phenomenon in the corpus luteum, which is associated with tissue involution during structural luteolysis. Angiogenesis actively occurs during the early luteal phase and is completed by the mid‐luteal phase. Perivascular cells (pericytes) increase in number from the early luteal phase to the mid‐luteal phase, suggesting that blood vessels are gradually stabilized until the mid‐luteal phase. In the corpus luteum undergoing luteolysis, blood vessels and pericytes decrease in number, which is related to structural involution. In the corpus luteum of early pregnancy, the number of blood vessels with pericytes increases, suggesting that angiogenesis occurs again, accompanied by blood vessel stabilization. These changes in vasculature of the corpus luteum are regulated by the collaboration with vascular endothelial growth factor, which is involved in proliferation of vascular endothelial cells, and angiopoietins, which are involved in stabilization of blood vessels. This review focuses on angiogenesis, blood vessel stabilization and blood vessel regression during the divergent phases of luteal formation, luteal regression and luteal rescue by pregnancy. (Reprod Med Biol 2008; 7: 91–103)
Social Capital as Social Relations: The Contribution of Normative Structures
Authors: Reimer Bill , Lyons Tara , Ferguson Nelson , Polanco Geraldina
Published: April 2008

This paper presents a framework for social capital that highlights the normative structures through which it is manifested. The primary focus is on the ways that norms structure the relationships in which social capital is embedded. To this end, we introduce four types of normative structures which condition social capital: market, bureaucratic, associative, and communal. A field site in Japan is used to illustrate how different aspects of social capital interact. This case analysis also serves to make an important distinction between the availability and use of social capital. The central arguments are that 1) social capital is organized in different ways by the normative structures in which it is embedded; 2) there are important interactions between these different aspects of social capital that are often overlooked by simpler frameworks; 3) a useful distinction can be made between available social capital and used social capital; 4) access to social capital can be used to analyze power relations; and 5) distinguishing different aspects of social capital makes areas visible that are overlooked by other understandings of social capital. We conclude by identifying the utility of our perspective for informing public policy and guiding future research.
The Japanese Hikikomori Phenomenon: Acute Social Withdrawal among Young People
Authors: Furlong Andy
Published: April 2008

Although rare in the west, in Japan and in some other advanced countries on the Asian-Pacific rim, there is a popular perception that there has been a significant increase in the numbers of young people who withdraw socially for protracted periods of time (referred to by the Japanese term ‘hikikomori’). This paper describes the hikikomori phenomenon in Japan, considers evidence relating to its prevalence and examines views about the causes. I argue that the tendency to think of hikikomori as a homogeneous group characterised by psychological malaise is misleading and that withdrawal and disengagement can also be linked to changing opportunity structures. The collapse of the primary labour market for young people and the growing prevalence of a precarious secondary sector has led to a situation in which traditional and deep-rooted norms are undermined and young people forced to find new ways of navigating transitions within a highly pressured and rigid system. Under these circumstances, acute withdrawal often represents an anomic response to a situation where tradition no longer provides adequate clues to appropriate behaviour rather than as a malaise reducible to individual psychologies.
Cocaine‐like neurochemical effects of antihistaminic medications
Authors: Tanda Gianluigi , Kopajtic Theresa A. , Katz Jonathan L.
Published: April 2008

The pattern of activation of dopamine (DA) neurotransmission in the nucleus accumbens (NAc) of rats produced by H1histamine antagonists which have behavioral effects like those of psychostimulant drugs was examined. Diphenhydramine and (+)‐chlorpheniramine were compared with triprolidine, a potent and selective H1antagonist and (−)‐chlorpheniramine which is less active than its enantiomer at H1receptors. Affinities of the drugs to DA, serotonin, and norepinephrine transporters at H1receptors and potencies for DA uptake inhibition in striatal synaptosomes were determined to assess mechanisms by which the compounds increased DA levels. Intravenous diphenhydramine (1.0–3.0 mg/kg) (+)‐ and (−)‐chlorpheniramine (1.0–5.6 mg/kg) but not triprolidine (1.0–3.0 mg/kg) elicited a cocaine‐like pattern of stimulation of DA transmission with larger effects in the NAc shell than core. The absence of stereospecific effects with chlorpheniramine enantiomers along with the lack of an effect with triprolidine suggest that the effects on DA transmission were not related to H1receptor antagonism. Althoughin vivopotencies were not directly related to DA transporter affinities, it is hypothesized that actions at that site modulated by other actions, possibly those at the serotonin transporter, are primarily responsible for the neurochemical actions of the drugs on DA neurotransmission and might underlie the occasional misuse of these medications.
Inattentional blindness and augmented‐vision displays: effects of cartoon‐like filtering and attended scene
Authors: Apfelbaum Henry L. , Apfelbaum Doris H. , Woods Russell L. , Peli Eli
Published: April 2008

Augmented‐vision devices that we are developing to aid people with low vision (impaired vision) employ vision multiplexing– the simultaneous presentation of two different views to one or both eyes. This approach enables compensation for vision deficits without depriving the wearers of their normal views of the scene. Ideally, wearers would make use of the simultaneous views to alert them to potential mobility hazards, without a need to divide attention consciously. Inattentional blindness, the frequent inability to notice otherwise‐obvious events in one scene while paying attention to another, overlapping, scene, works against that sort of augmentation, so we are investigating ways to mitigate it. In this study, we filtered the augmented view, creating cartoon‐like representations, to make it easier to detect significant features in that view and to minimise interference with the normal view. We reproduced a classic inattentional blindness experiment to evaluate the effect, and found that, surprisingly, edge filtering had no detectable effect – positive or negative – on the noticing of unexpected events in the unattended scene. We then modified the experiment to determine if the inattentional blindness was because of the confusion of overlaid views or simply a matter of attention, and found the latter to be the case.
What do kids think about kids in eyeglasses?
Authors: Walline Jeffrey J. , Sinnott Loraine , Johnson Erica D. , Ticak Anita , Jones Sylvia L. , Jones Lisa A.
Published: April 2008

Purpose:  Previous studies have examined how people feel about others who wear glasses, but no studies of children have been published on the subject. We conducted the Children’s Attitudes about Kids in Eyeglasses (CAKE) study to determine how children feel about other children who wear glasses.

Methods:  Subjects compared a series of 24 picture pairs and answered six questions regarding which child …he or she would rather play with, looks better at playing sports, appears smarter (more intelligent), appears nicer, looks more shy and looks more honest. The children in each pair of pictures differed by gender, ethnicity and spectacle wear. Logistic regression was performed to determine the probability and confidence interval that a subject would pick a particular child.

Results:  Eighty subjects between the ages of 6 and 10 years participated. The average (±SD) age of the subjects was 8.3 ± 1.3 years, 42 (53%) were females, 51 (64%) were whites, 21 (26%) were blacks, and 30 (38%) wore glasses. The spectacle wearer appeared smarter (0.66, CI = 0.60–0.71) and more honest (0.57, CI = 0.50–0.64), and children who wore glasses looked smarter regardless of whether the child picking wore glasses. Both boys (0.66, CI = 0.68–0.79) and girls (0.77, CI = 0.71–0.82) thought that boys looked better at playing sports.

Discussion:  The old adage ‘Boys never make passes at lasses who wear glasses’ may be outmoded, but glasses may tend to make children look smarter and slightly more honest to their peers.
Pass rates for the Farnsworth D15 colour vision test
Authors: Birch Jennifer
Published: April 2008

Introduction:  The Farnsworth D15 test (D15) is used worldwide to select applicants for employment in occupations which require good colour vision. People with slight colour deficiency are intended to pass the D15 and people with significant (moderate/severe) colour deficiency to fail.

Methods:  Pass rates were determined for 710 adult males with red–green colour deficiency using three different pass criteria in general use.

Results:  Forty‐six per cent of subjects were successful when the pass criterion was a circular results diagram (one single transformation of adjacent hues was accepted as a pass), 53% passed when one red‐green isochromatic error was allowed and 60% passed when two red–green isochromatic errors were permitted. The pass rate for 200 dichromats was 1.5% on a circular diagram, 3% on one red–green error and 6% on two red–green errors. Protans made fewer errors than deutans and more protans than deutans were successful when either one or two red–green crossings were permitted as a pass.

Conclusion:  A circular results diagram is the preferred pass criterion. This criterion most nearly fulfils the aim of the test to fail all dichromats and people with significant protanomalous and deuteranomalous trichromatism. A circular diagram is also easy to interpret consistently. Re‐examination is recommended if there are only one or two red–green isochromatic error lines across the results diagram. This gives individuals with borderline slight/moderate colour deficiency an opportunity to pass at the second attempt.
Evaluating evidence‐based practice within critical care
Authors: O’Neal Helen , Gray Alison , Thompson Angela
Published: April 2008

Background and Aims:  Between 2002‐2005 the Trust undertook an action research project to evaluate a corporate practice development strategy. During this period clinicians became practitioner‐researchers utilising a variety of methods to evaluate the influence of practice development. One aspect of this focused upon evaluation of evidence based guidelines. This article concentrates upon this process and the learning from this within critical care.

Method:  Within critical care it was recognised that the standard of guidelines and protocols varied in terms of the amount of evidence used to underpin decision making. A group was set up to evaluate and appraise these using a structured format such as the Appraisal of Guidelines for Research and Evaluation (AGREE) Instrument.

Findings:  The initial evaluation (cycle 1) highlighted learning associated with the process of using the instrument within critical care, as well as where the quality of the guidelines could be improved. The second cycle of evaluation demonstrated that implementation of the action plans as a consequence of cycle 1 resulted in an improvement in the quality of the guidelines. It also resulted in streamlining the process of undertaking guideline appraisal across a Trust.

Discussion and Conclusions:  Action resulting from analysis of the findings of cycle 1 led to a cultural change in which the structure of a tool such as the AGREE instrument could be beneficial in the development of future guidelines. This has been sustained both within critical care and Trust wide with various initiatives such as the establishment of critical care multidisciplinary guideline development groups and a Trust wide electronic library management system.
Therapeutic hypothermia following cardiac arrest: a review of the evidence
Authors: Collins Tim J. , Samworth Peter J.
Published: April 2008

Aims and objectives:  This paper aims to undertake a review on the current evidence available on therapeutic hypothermia (TH) following cardiac arrest.

Background:  The use of TH has been associated as a potential treatment for a number of medical conditions including head injury and cerebral vascular accidents. Within the past decade, there have been numerous studies focusing upon the use of hypothermia following cardiac arrest. This paper evaluates the research on the use of TH following cardiac arrest and provides recommendations for clinical practice. Evidence from randomized controlled trials that are reviewed in this paper found that neurological outcome and mortality were significantly improved following inducing hypothermia following cardiac arrest.

Search strategies:  The following databases were accessed: Bandolier, Embase, Medline, Science Direct, CINAHL, Blackwell Synergy, Nursing Collection, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews and the National Electronic Library for Health. The following key words were used to search the databases: ‘Therapeutic hypothermia’, ‘Induced hypothermia’, ‘cooling post cardiac arrest’ and ‘post cardiac arrest care’.

Inclusion and exclusion criteria:  Only evidences published within the past 10 years and written in English were included. Studies on TH for the treatment of raised intracranial pressure were excluded.

Conclusions:  All adult patients who have return of spontaneous circulation and remain unconscious following cardiac arrest should be considered for TH between 32°C and 34°C for at least 12–24 h as this will improve patient mortality and morbidity. Acute hospitals need to devise policies and guidelines on the use of TH following cardiac arrest that include methods on how to achieve effective cooling by cold i.v. infusions, ice packs or purchasing specific cooling mattresses.
A dedicated retrieval and transfer service: The QUARTS Project
Authors: Andrews Sue , Catlin Sue , Lamb Nikki , Christensen Martin
Published: April 2008

Background:  The transfer and/or retrieval of a critically patient is inherently dangerous not only for the patient but for staff as well. The quality and experience of unplanned transfers can influence patient mortality and morbidity. However, international evidence suggests that dedicated transfer/retrieval teams can improve mortality and morbidity outcomes.

Aims:  The initial aim of this paper is to describe an in‐house competency‐based training programme, which encompasses the STaR approach to develop members of our existing nursing team to be part of the dedicated transfer/retrieval service. The paper also presents audit data findings which examined the source of referrals, number of patients actually transferred and clinical status of those being transferred.

Results:  Audit data illustrate that the most frequent source of referrals comes from Accident and Emergency and the Surgical Directorate with the most common presenting condition being cardio‐respiratory failure or arrest. Audit data reveal that the number of patients actually transferred or retrieved is relatively small (33%) compared with the overall number of requests for assistance. However, 36% of those patients transferred had a level 2 or level 3 acuity status that necessitated the admission to a critical care area.

Conclusions:  A number of studies have concluded that the ill‐experienced and ill‐equipped transfer team can place patients’ at serious risk of harm. Whether planned or unplanned, dedicated critical care transfer/retrieval teams have been shown to reduce patient mortality and morbidity.
What factors influence arterial blood gas sampling patterns?
Authors: Andrews Tom , Waterman Heather
Published: April 2008

Study objective:  To investigate if patterns of arterial blood gas (ABG) sampling were influenced by values of fractional inspiratory oxygen (FiO2), partial pressure of carbon dioxide (PCO2), partial pressure of oxygen (PO2) and oxygen saturation (%SaO2).

Setting:  An intensive care unit (ICU) in a university teaching hospital located in the North of England, UK.

Design:  A retrospective, descriptive, correlation study based on patient records.

Participants:  All patients admitted to the ICU for 24 hours or greater and who had an arterial line in situ.

Measurements and results:  The study included the records of 65 patients consecutively admitted to the ICU. Patients in this study had more blood gases taken than reported elsewhere in the literature. While consistent correlation was found between values of FiO2, PCO2, PO2 and %SaO2, values of PO2 were the most consistent.

Conclusions:  Values of PO2 are associated with frequency of ABG sampling and to a lesser extent on FiO2. Nurses in this study opted to track changes in oxygenation using ABGs despite continuous monitoring of %SaO2.
Functional Recovery After Hip Fracture: The Combined Effects of Depressive Symptoms, Cognitive Impairment, and Delirium
Authors: Givens Jane L. , Sanft Tara B. , Marcantonio Edward R.
Published: April 2008

OBJECTIVES: To measure the prevalence of depressive symptoms, cognitive impairment, and delirium in patients with hip fracture and to estimate their effect on functional recovery, institutionalization, and death after surgical repair.

DESIGN: Prospective cohort.

SETTING: Hospital, follow‐up to community and nursing home.

PARTICIPANTS: One hundred twenty‐six patients aged 65 and older admitted for hip fracture repair.

MEASUREMENTS: Baseline measurements: Mini‐Mental State Examination, Blessed Dementia Rating Scale, Geriatric Depression Scale, prefracture activities of daily living (ADLs), ambulatory status. The Confusion Assessment Method was used to diagnose in‐hospital delirium. One‐ and 6‐month outcomes were ADL decline, loss of ambulation, and new nursing home placement or death.

RESULTS: Twenty‐two percent of patients had one cognitive or mood disorder, 30% had two, and 7% had three. At 1 month, each cognitive or mood disorder was independently associated with one or more adverse outcome. Considered together, each additional cognitive or mood disorder was associated with greater odds of 1 month outcomes (ADL decline: odds ratio (OR)=1.8, 95% confidence interval (CI)=1.1–2.9; decline in ambulation: OR=1.8, 95% CI=1.1–3.0; nursing home placement or death: OR=3.9, 95% CI=1.9–8.1).

CONCLUSION: Cognitive and mood disorders were common in elderly hip fracture patients and were associated with greater risk of poor outcomes, both independently and in combination. Recognition and treatment of these conditions may reduce adverse outcomes in this vulnerable population.
Genetic variation ofFUT2in Ovambos, Turks, and Mongolians
Authors: Soejima Mikiko , Nakajima Tamiko , Fujihara Junko , Takeshita Haruo , Koda Yoshiro
Published: April 2008

BACKGROUND:Many single‐nucleotide polymorphisms (SNPs) have been identified in the coding region of theFUT2locus, which encodes secretor type α(1,2)fucosyltransferase. These SNPs are highly population‐specific.

STUDY DESIGN AND METHODS:The 1121‐bp polymerase chain reaction (PCR) product containing the wholeFUT2coding region in three human populations, Ovambos (n = 74), Turks (n = 70), and Mongolians (n = 118), was sequenced. The haplotypes consisting of novel SNPs were determined by sequencing cloned inserts, and the haplotypes consisting of already reported SNPs were inferred by free computer software (PHASE). The functional significance of novel SNPs by transient expression study was also examined.

RESULTS:Twenty‐four SNPs were found including seven novel SNPs (i.e., 4G > A, 244G > A, 442C > A, 489G > A, 569G > A, 665G > A, and 950C > T). A transient expression study suggested that the 244G > A, 569G > A, and 950C > T SNPs are enzyme‐inactivating mutations.

CONCLUSION:This study identified 24 SNPs in theFUT2gene, of which 7 were novel. The frequencies of alleles and genotypes were determined in Ovambos, Turks, and Mongolians. The allelic composition of each population was similar to those of geographically closer populations.
Inactivation of Leishmania donovani infantum and Trypanosoma cruzi in red cell suspensions with thiazole orange
Authors: Wagner Stephen J. , Skripchenko Andrey , Salata Jeanne , O'Sullivan Anne Marie , Cardo Lisa J.
Published: April 2008

BACKGROUND: Methods for pathogen inactivation are currently available in some European countries for treatment of plasma and platelet (PLT) components; no approved method for treatment of red cells (RBCs) or whole blood is ready for implementation. In a previous study, thiazole orange (TO), a dye commonly used to count reticulated RBCs and PLTs, exhibited potent photoactivity against human immunodeficiency virus‐1 and several model viruses in RBC suspensions. The aim of this study is to further evaluate the ability of TO to inactivate pathogens by measuring its activity against the protozoa Leishmania donovani infantum and Trypanosoma cruzi.

STUDY DESIGN AND METHODS: RBC suspensions were deliberately contaminated with L. donovani infantum promastigotes or T. cruzi trypomastigotes and either maintained as an untreated control, incubated with 80 μmol per L TO in the dark, or treated with TO and light. Control and treated samples were inoculated into medium and subsequently microscopically examined for growth.

RESULTS: No growth was observed in samples treated with TO in the presence or absence of light, while matched control samples lacking TO and diluted up to 5 log consistently demonstrated Leishmania or T. cruzi growth (n = 3).

CONCLUSION: TO inactivated Leishmania or T. cruzi to the limit of detection in RBC suspensions without intentional illumination.
Particle Sizes from Sectional Data
Authors: Pawlas Zbyněk , Nyengaard Jens R. , Jensen Eva B. Vedel
Published: April 2008

Summary We propose a new statistical method for obtaining information about particle size distributions from sectional data without specific assumptions about particle shape. The method utilizes recent advances in local stereology. We show how to estimate separately from sectional data the variance due to the local stereological estimation procedure and the variance due to the variability of particle sizes in the population. Methods for judging the difference between the distribution of estimated particle sizes and the distribution of true particle sizes are also provided.
Bayesian Case Influence Diagnostics for Survival Models
Authors: Cho Hyunsoon , Ibrahim Joseph G. , Sinha Debajyoti , Zhu Hongtu
Published: April 2008

SummaryWe propose Bayesian case influence diagnostics for complex survival models. We develop case deletion influence diagnostics for both the joint and marginal posterior distributions based on the Kullback–Leibler divergence (K–L divergence). We present a simplified expression for computing the K–L divergence between the posterior with the full data and the posterior based on single case deletion, as well as investigate its relationships to the conditional predictive ordinate. All the computations for the proposed diagnostic measures can be easily done using Markov chain Monte Carlo samples from the full data posterior distribution. We consider the Cox model with a gamma process prior on the cumulative baseline hazard. We also present a theoretical relationship between our case‐deletion diagnostics and diagnostics based on Cox's partial likelihood. A simulated data example and two real data examples are given to demonstrate the methodology.
The Prognostic Value of T Wave Amplitude in Lead aVR in Males
Authors: Tan Swee Y. , Engel Gregory , Myers Jonathan , Sandri Marcus , Froelicher Victor F.
Published: April 2008

Background: Since there is an uncertainty regarding which of the 12 leads provides the most information, we investigated the association between repolarization phenomenon in all of the 12 leads and cardiovascular (CV) mortality.

Methods: Retrospective cohort study was performed at Palo Alto Veterans Affairs Medical Center, Palo Alto, California, which included 24,270 consecutive male veterans with ECGs obtained for clinical reasons from 1987 to 2000. Analysis of computerized 12‐lead resting ECGs was performed of all subjects excluding inpatients, patients with atrial fibrillation, WPW, QRS duration > 120 ms, and paced rhythms. Average follow‐up was 7.5 years during which time there were 1859 CV deaths.

Results: While ST segment measurements in aVR were univariately predictive of CV death, T wave amplitude superseded them in multivariate survival analysis. In addition, T wave amplitude in aVR outperformed repolarization measurements in all other leads as well as other ECG criteria (Q waves, damage scores, LVH) for predicting CV mortality. As T wave amplitude became less negative in aVR, there was a progressive increase in relative risk (RR). When the T waves in aVR had a positive deflection (i.e., upward pointing) the RR for CV death was 5.0.

Conclusions: T wave amplitude in lead aVR is a powerful prognostic marker for estimating risk of CV death. Upward pointing T waves (a simple visual criterion) was prevalent (7.3% of a clinical population) and was associated with an annual CV mortality of 3.4% and a risk of five times.
Effects of Cigarette Smoking on Heart Rate Variability and Plasma N‐Terminal Pro‐B‐Type Natriuretic Peptide in Healthy Subjects: Is There the Relationship between Both Markers?
Authors: Alyan Omer , Kacmaz Fehmi , Ozdemir Ozcan , Maden Orhan , Topaloglu Serkan , Ozbakir Cemal , Metin Fatma , Karadede Aziz , Ilkay Erdogan
Published: April 2008

Background: Cigarette smoking increased the risk of acute cardiac events related with endothelial dysfunction and increased sympathetic activity. Impaired autonomic nervous activity is recognized as a considerable symptom of cardiac dysfunction and is strongly associated with increased risk overall mortality.

Methods: A total of 75 healthy habitual smokers (40 female, 35 male, mean age 36.5 ± 8.5 years), and 73 non‐smokers subjects (45 female, 28 male, mean age 34.6 ± 7.2 years) were studied. LF and LF/HF ratio were significantly higher in smokers than in non‐smokers. On the contrary, SDNN, SDANN, RMSSD, and HF values were lower in smokers compared to those in non‐smokers. Not the duration of smoking but the number of cigarettes smoked per day was correlated with the HRV parameters and NT‐pro BNP. Furthermore, the average levels of NT‐pro BNP were found to be positively correlated with LF, LF/HF and inversely correlated with SDNN, SDANN, RMSSD and HF.

Results: As a result, smoking impaires sympathovagal balance and decreases the heart rate variability in healthy subjects. And even a one cigarette smoking leads to overt sympathetic excitation. Furthermore, smoking results in an increase in NT‐proBNP levels and the changes in adrenergic nervous system and NT‐proBNP levels are well correlated.

Conclusion: These findings could contribute to the higher rate of cardiovascular events in smokers.
Adelmidrol, a palmitoylethanolamide analogue, reduces chronic inflammation in a carrageenin‐granuloma model in rats
Authors: De Filippis Daniele , D’Amico Alessandra , Cinelli Maria Pia , Esposito Giuseppe , Di Marzo Vincenzo , Iuvone Teresa
Published: April 2008

Palmitoylethanolamide (PEA) and some of its analogues have shown great efficacy in the treatment of pain and inflammation. Adelmidrol – the International Nonproprietary Name (INN) of the di‐amide derivative of azelaic acid – is one of these analogues. The anti‐inflammatory and analgesic effects of PEA and adelmidrol are hypothesized to be mediated, at least in part, by mast cell down‐modulation. Mast cell mediators released at early stage of the inflammatory process drive the inflammatory reaction to chronicity as it happens in X‐carrageenin‐induced granulomatous tissue formation. In the present study, the choice of testing adelmidrol depends upon the physicochemical properties of the compound, i.e. the amphipatic feature, that make it more easily soluble than PEA. In this study, we investigated the effect of adelmidrol on granuloma formation induced by λ‐carrageenin‐soaked sponge implant in rats. Our results show that the local administration of the compound under study significantly decreases weight and neo‐angiogenesis in granulomatous tissue. The anti‐inflammatory effect was due to the modulation of mast cells degranulation, as shown by histological analysis and by the inhibition of the release of several pro‐inflammatory and pro‐angiogenic enzymes (e.g. iNOS, chymase and metalloproteinase MMP‐9), and mediators (e.g. nitric oxide and TNF‐α). The results indicate that adelmidrol, given locally, may represent a potential therapeutic tool in controlling chronic inflammation.
VEGF concentration from plasma‐activated platelets rich correlates with microvascular density and grading in canine mast cell tumour spontaneous model
Authors: Patruno R. , Arpaia N. , Gadaleta C.D. , Passantino L. , Zizzo N. , Misino A. , Lucarelli N.M. , Catino A. , Valerio P. , Ribatti D. , Ranieri G.
Published: April 2008

Canine cutaneous mast cell tumour (CMCT) is a common cutaneous tumour in dog, with a higher incidence than in human. CMCT is classified in three subgroups, well and intermediately differentiated (G1 and G2), corresponding to a benign disease, and poorly differentiated (G3), corresponding to a malignant disease, which metastasize to lymph nodes, liver, spleen and bone marrow. In this study, we have evaluated serum (S), platelet‐poor plasma (P‐PP), plasma‐activated platelet rich (P‐APR) and cytosol vascular endothelial growth factor (VEGF) concentrations, microvascular density (MVD) and mast cell density (MCD) in a series of 86 CMCTs and we have correlated these parameters with each other, by means of ELISA detection of VEGF and immunohistochemistry. Results show that VEGF level from cytosol P‐APR and MVD were significantly higher in G3 CMCTs as compared to G1 or G2 subgroups. Moreover, a significantly strong correlation among VEGF levels from P‐PAR and cytosol, MVD and MCD was found in G3 subgroup. Because VEGF levels from P‐APR well correlated with MVD and malignancy grade in CMCT, we suggest that VEGF might be secreted from MCs and it may be a suitable surrogate inter‐species angiogenetic markers of tumour progression in CMCT. Finally, CMCT seems to be a useful model to study the role of MCs in tumour angiogenesis and inhibition of MCs degranulation or activation might be a new anti‐angiogenic strategy worthy to further investigations.