bluuebunny/crossref_metadata_2025 huggingface dataset:
A review of educational strategies to improve nurses' roles in recognizing and responding to deteriorating patients
Authors: Liaw S.Y. , Scherpbier A. , Klainin‐Yobas P. , Rethans J.‐J.
Published: July 2011

LIAW S.Y., SCHERPBIER A., YOBAS P. & RETHANS J.‐J. (2011) A review of educational strategies to improve nurses' roles in recognizing and responding to deteriorating patients. International Nursing Review58, 296–303

Background:  Physiological instability leading to clinical deterioration often precedes cardiopulmonary arrest. Nurses, who have the most frequent patient contact and responsibility for ongoing monitoring of patients, play a crucial role in recognizing and responding to clinical deterioration. The importance of education in supporting such a role has been addressed in numerous studies.

Aim:  This study aimed to identify nurses' educational needs and explore educational strategies to enhance their ability in recognizing and managing wards with deteriorating patients.

Methods:  A literature search from databases (2000–2010) was undertaken to include papers that identified the educational needs of ward nurses and existing educational programmes related to the care of deteriorating patients.

Findings:  Twenty‐six papers were included in this review. Findings identified the educational need to empower nurses with the appropriate knowledge and skills in recognizing, reporting and responding to patient deterioration. The review of existing educational programmes and their outcomes identified valuable teaching information and strategies, and areas that could be improved in meeting nurses' educational needs.

Conclusion:  The review has highlighted important aspects of patient safety in clinical deterioration that could be further addressed by educational strategies targeting the role of ward nurses. These strategies include: utilizing clinical decision‐making models to develop nurses' decision making skills; developing a standardized tool for systematic nursing assessment and management of clinical deterioration; incorporating training in clinical deterioration as a core competence of pre‐registered nursing education; providing vital signs training to nursing assistants; and conducting more rigorous studies to evaluate the effectiveness of the educational programmes.
Introducing traditional Chinese nursing: a review of concepts, theories and practices
Authors: Hao Y. , Liu H. , Yue S. , Liu X.
Published: July 2011

HAO Y., LIU H., YUE S. & LIU X. (2011) Introducing traditional Chinese nursing: a review of concepts, theories and practices. International Nursing Review58, 319–327

Aim:  This paper discussed the basic concepts, theories and practices of traditional Chinese nursing (TCN) to enrich our understanding of relevant concepts and ways to contribute to human health.

Background:  Advantages of TCN include health education based on theories and techniques of traditional Chinese medicine. It focuses mainly on mobilizing humans' capacity for self‐adjustment and self‐rehabilitation to make a dynamic balance between yin and yang, qi and blood and zang and fu. It has played a significant role in the fields of primary nursing, geriatric nursing, hospice, family nursing, etc., in China.

Method:  PubMed, CINAHL, Ovid Medline (English) and the Wang Fang (Chinese) databases were searched for literature on a range of keywords relating to traditional Chinese medicine and nursing. Forty references (13 English and 27 Chinese) were finally selected for review.

Conclusion:  Practices of nursing care in traditional Chinese medicine are based mainly on the theories of yin–yang and the five elements. There are two prime characteristics in the theoretical system of TCN: holism and nursing determination based on syndrome differentiation. The distinctive content include prevention, daily care of patients, dietary nursing, etc. TCN, with its characteristics of little damage, little pain, ease of operation and low cost, is appropriately used in primary health care in China. By combining Western and Eastern philosophies and approaches to nursing, life phenomena can be better understood, and more ways to promote health can be exploited. Scientists are beginning to use Western research methods to establish effectiveness. Many common interventions would not, however, be considered safe in Western nursing practice without more evidence and consideration of health and safety issues.
FINANCIAL LITERACY AND PENSION INVESTMENT DECISIONS
Authors: Gallery Natalie , Gallery Gerry , Brown Kerry , Furneaux Craig , Palm Chrisann
Published: July 2011

The call for enhanced financial literacy amongst consumers is a global phenomenon, driven by the growing complexity of financial markets and products, and government concerns about the affordability of supporting an ageing population. Worldwide, defined benefit pensions are giving way to the risk and uncertainty of defined contribution superannuation/pension funds where fund members now make choices and decisions that were once made on their behalf. An important prerequisite for informed financial decision‐making is adequate financial knowledge and skills to make competent investment decisions. This paper reports the findings of an online survey of the members of a large Australian public sector‐based superannuation fund and shows that although respondents generally understand basic financial matters, on average, their understanding of investments concepts, such as the relationship between risk and returns, is inadequate. These results highlight the need for education programs focusing specifically on developing fund members’ investment knowledge and skills to facilitate informed retirement savings decisions.
Evaluating information literacy educators’ practices before and after the course facilitating information literacy education: from tutor to learner‐centred
Authors: Andretta Susie
Published: July 2011

Objective:  The article gives an account of a study on the impact of facilitating information literacy education (FILE) on its participants, health librarians who have attended this course between 2007 and 2010.

Methods:  The analysis presented here is based on the first stage of the research, funded by the Higher Education Academy Information and Computer Sciences and consisting of an online survey. This survey was conducted in Autumn 2010 and examined the respondents’ examples of information literacy practice before and after FILE.

Results and conclusion:  Two main outcomes can be drawn from the data. First, that overall the respondents’ provision of information literacy education has shifted from a tutor‐centred approach (where the trainer decides what the learner needs) to a learner‐centred approach (where the learner decides what he/she needs). And secondly, that the impact of FILE should be seen in terms of a self‐perpetuating professional development, rather than measured in terms of specific changes that occur at set times (e.g., at the end of the course or 6 months after completion). As one FILE participant puts it: ‘When FILE ends your career as an information literacy professional starts.’
Malignancies and mortality in 200 patients with primary sclerosering cholangitis: a long‐term single‐centre study
Authors: Fevery Johan , Henckaerts Liesbet , Van Oirbeek Robin , Vermeire Séverine , Rutgeerts Paul , Nevens Frederik , Van Steenbergen Werner
Published: July 2011

Background: The outcome of primary sclerosing cholangitis (PSC) has improved by liver transplantation (LT), but patients often develop malignancies. We analysed morbidity and mortality patterns to define strategies to prevent complications.

Methods: Two hundred consecutive patients diagnosed before October 2005 were studied.

Results: Malignancies developed in 40 (20%) and led to death in 28 patients (45.9% of the 61 mortalities). Cholangiocarcinoma (CCa) developed in 13 patients, and was detected shortly after the diagnosis of PSC in 31%. Colorectal carcinomas were documented in 10 and dysplastic adenomas in four patients; eight had ulcerative colitis, two Crohn's colitis, one unclassified inflammatory bowel disease (IBDu), three had no IBD. Five died of colorectal cancer. Three carcinomas and two adenomas were localized in the caecum or ascending colon, but most (n=10) in the recto‐sigmoidal region. Hepatocellular carcinoma developed in three patients with advanced fibrosis/cirrhosis, and pancreatic cancer in five. LT has been carried out in 42 patients, 6.1 years (median, 0.5–25) after the diagnosis of PSC. Mortality was due to hepatic complications in 13 patients. Within 5 years of the diagnosis, deaths were because of malignancy in 12 patients and to hepatobiliary decompensation in only three, whereas 18 had been transplanted.

Conclusions: Since the use of transplantation, malignancies are the major cause of death. CCa has to be searched for in any new symptomatic patient. Colorectal malignancy occurs frequently. Colonoscopy at the diagnosis of PSC is obligatory and should be repeated at 1–2 years interval in the patients with IBD and every 5 years in those without IBD.
Endothelial dysfunction in the regulation of cirrhosis and portal hypertension
Authors: Iwakiri Yasuko
Published: July 2011

Portal hypertension is caused by an increased intrahepatic resistance, a major consequence of cirrhosis. Endothelial dysfunction in liver sinusoidal endothelial cells (LSECs) decreases the production of vasodilators, such as nitric oxide, and favours vasoconstriction. This contributes to an increased vascular resistance in the intrahepatic/sinusoidal microcirculation and develops portal hypertension. Portal hypertension, in turn, causes endothelial dysfunction in the extrahepatic, i.e. splanchnic and systemic, circulation. Unlike dysfunction in LSECs, endothelial dysfunction in the splanchnic and systemic circulation causes overproduction of vasodilator molecules, leading to arterial vasodilation. In addition, portal hypertension leads to the formation of portosystemic collateral vessels. Both arterial vasodilation and portosystemic collateral vessel formation exacerbate portal hypertension by increasing the blood flow through the portal vein. Pathological consequences, such as oesophageal varices and ascites, result. While the sequence of pathological vascular events in cirrhosis and portal hypertension has been elucidated, the underlying cellular and molecular mechanisms causing endothelial dysfunctions are not yet fully understood. This review article summarizes the current cellular and molecular studies on endothelial dysfunctions found during the development of cirrhosis and portal hypertension with a focus on the intra‐ and extrahepatic circulations. The article ends by discussing the future directions of the study for endothelial dysfunction.
MRI‐negative epilepsy: Protocols to optimize lesion detection
Authors: Vézina Louis‐Gilbert
Published: July 2011

Identification of the structural lesions that underlie pediatric epilepsy can be challenging. Careful evaluation of the gray–white matter interface is crucial, and necessitates multiplanar thin images of high resolution that can differentiate focal lesions from partial volume averaging artifacts created by the innate gyral configuration. Careful evaluation of the hippocampus and of the myelination patterns can further increase the diagnostic yield of the study. Magnetization transfer imaging can call attention to a lesion that is either very subtle or not evident on conventional sequences. Detection of cortical anomalies is best performed early in infancy, preferably before 6 months of age. If the initial magnetic resonance imaging (MRI) scan is performed between 9 and 18 months of age and is negative, a repeat scan after 2 years of age may be necessary.
Diffusion tensor imaging in temporal lobe epilepsy
Authors: Gross Donald W.
Published: July 2011

Although mesial temporal sclerosis (MTS) has long been recognized in association with temporal lobe epilepsy (TLE), there is a growing body of literature suggesting structural abnormalities extending beyond the temporal lobe in patients with TLE. Diffusion tensor imaging (DTI) is a novel imaging technique that provides insight into the structural integrity of cerebral white matter. DTI studies have demonstrated extensive bilateral white matter abnormalities in TLE that extend far beyond the temporal lobe, even in patients with unilateral MTS. The relationship between white matter abnormalities, seizures, and comorbidity in TLE remains unclear.
Gender and drug effects on neuroimaging in epilepsy
Authors: Koepp Matthias J.
Published: July 2011

Men are different from women, and patients with epilepsy are different in many aspects from healthy control subjects. Quantitative or semiquantitative analysis of neuroimaging data depends on the comparison between either a single patient against a group of healthy or unaffected controls, or comparisons between groups of patients and controls. Matching for gender is desired, but is sometimes not possible, for example, in the case of nuclear medicine with women in childbearing age usually not being recruited as healthy controls. Antiepileptic drug treatment is the other major confounder for comparisons of cognitive functioning between patients and healthy control subjects. Whether these two covariates, gender and drug effects, are of interest or nuisance variables depends on the question and design of the neuroimaging study.
Combining EEG and fMRI in the study of epileptic discharges
Authors: Gotman Jean , Pittau Francesca
Published: July 2011

The combining of electroencephalography (EEG) and functional magnetic resonance imaging (fMRI) is a unique noninvasive method for investigating the brain regions involved at the time of epileptic discharges. The neuronal discharges taking place during an interictal spike or spike‐wave burst result in an increase in metabolism and blood flow, which is reflected in the blood oxygen–level dependent (BOLD) signal measured by fMRI. This increase is most intense in the region generating the discharge but is also present in regions affected by the discharge. On occasion, epileptic discharges result in decreased metabolism, the origin of which is only partially understood. EEG‐fMRI applied to focal epilepsy results in maxima of the BOLD signal most often concordant with other methods of localization and has been shown to help in localizing epileptic foci in nonlesional frontal lobe epilepsy. It has also demonstrated the involvement of the thalamus in generalized epileptic discharges. In patients with new‐onset epilepsy it could be used to evaluate the source and extent of the brain structures involved during discharges and their evolution as the disease progresses.
Tracking cognitive changes in new‐onset epilepsy: Functional imaging challenges
Authors: D’Arcy Ryan C. N. , Gawryluk Jodie R. , Beyea Steven D. , Hajra Sujoy Ghosh , Feindel Kirk W. , Clarke David B.
Published: July 2011

Functional imaging has potential for tracking changes in cognition during the onset and evolution of epilepsy. Although the concept of imaging such changes over time is an exciting new direction, feasibility remains an open question. The current article outlines a case example in which functional magnetic resonance imaging (fMRI) and event‐related potentials (ERPs) were used to monitor memory changes before and after selective temporal lobe resection. From this example, three key methodologic challenges for new‐onset epilepsy are identified and discussed. The first challenge relates to the interpretation of results in regions near epileptogenic tissue. We argue that this is best addressed by collecting information from multiple modalities to test for convergent evidence. The second challenge relates to optimizing the methods for sensitivity to detecting changes. In this case, enhanced imaging methods and a region‐of‐interest approach provide necessary focus. The third and final challenge relates to the practical difficulties of conducting research in new‐onset epilepsy cases. We suggest that greater integration of imaging research within the clinical setting is needed.
High positive antibody titers and adverse pregnancy outcome in women with antiphospholipid syndrome
Authors: SIMCHEN MICHAL J. , DULITZKI MORDECHAI , ROFE GUY , SHANI HAGIT , LANGEVITZ PNINA , SCHIFF EYAL , PAUZNER RACHEL
Published: July 2011

Objective. To investigate whether in patients with antiphospholipid syndrome (APS), high positive antibody titers are associated with adverse pregnancy outcome. Design. A retrospective cohort study of prospectively collected data. Setting. Sheba Medical Center, Israel, a tertiary referral center. Population sample. Pregnant women with APS. Methods. Anticardiolipin, a‐β2‐glycoprotein I antibodies, and lupus anticoagulant were measured before pregnancy. Women were divided into those with antibody titers >four times the upper limit of normal (high positive titer, HPT group), and the rest, into the positive titer (PT) group. All women were treated with daily enoxaparin and aspirin. Main outcome measures. Composite adverse fetal/neonatal outcome, defined as one or more of the following: fetal/neonatal loss, preterm birth ≤32 weeks, and birthweight below than 10th percentile. Composite adverse fetal/neonatal outcome was compared between the HPT and PT groups. Maternal adverse outcomes were also compared. Results. 51 women with APS were followed during 55 pregnancies, 20 in the HPT and 35 in the PT groups. The two groups were similar with regard to previous obstetric and clinical characteristics. Among HPT women, only 7/20 (35%) pregnancies culminated in appropriately grown, live‐born infants >32 weeks’ gestation, compared with 27/35 (77%) PT pregnancies. The risk of adverse fetal/neonatal outcome was 5.7 times higher (95%CI 1.9–17.7) for HPT than for PT women. Conclusions. Pregnant women with APS and high positive antiphospholipid antibody titers are a unique and extremely high risk group for adverse fetal/neonatal outcome. Stricter surveillance and possibly additional therapy options should be explored for this patient population.
Successful treatment of generalized childhood Schamberg's disease with narrowband ultraviolet B therapy
Authors: Can Burce , Turkoglu Zafer , Kavala Mukaddes , Zindancι Ilkin , Kural Esra
Published: July 2011

Pigmented purpuric dermatoses are a group of dermatoses characterized by petechia and hyperpigmented macules that occur predominantly on the lower extremities. Although it is most commonly seen in adults, this disease can also affect children. Phototherapy has been shown to be effective in some cases in the literature. Here, we present two cases of Schamberg's disease that improved rapidly with narrowband ultraviolet B (UVB) therapy. To our knowledge, they were the first pediatric cases of successful narrowband UVB therapy in this disease.
Chronic actinic dermatitis in Asian skin: a Singaporean experience
Authors: Tan Aaron Wei‐Min , Lim Kar‐Seng , Theng Colin , Chong Wei‐Sheng
Published: July 2011

Background/purpose: To study the characteristics of chronic actinic dermatitis (CAD) in a heterogeneous group of Singaporean patients.

Methods: The photobiologicial features of all patients phototested and diagnosed with CAD from January 2005 to December 2009 were examined retrospectively.

Results: Fifty‐eight patients were diagnosed as having CAD. The mean age at diagnosis was 62 years (range 35–83). Forty‐one were (70.7%) Chinese, six (10.3%) Indians, eight (13.8%) Malays, and three (5.2%) Others. Forty‐seven were (81.0%) male and 11 (19.0%) were female. Forty‐nine (84.5%) had Fitzpatrick skin phototype IV and nine (15.5%) had phototype V. Three of 26 (11.5%) tested for human immunodeficiency virus were positive. The face, neck, and forearms were most commonly affected. Thirty‐two patients (55.2%) had reduced minimal erythema dose (MED) to both ultraviolet B (UVB)and ultraviolet A (UVA), 23 patients (39.7%) had lowered MED to UVB only, while three (5.1%) had reduced MED to UVA only. Patients were followed up for a mean of 16.8 months. All were treated with photoprotection and topical steroids; however, a few required oral immunosuppression with partial improvement.

Conclusion: In Singapore, CAD was seen more commonly in elderly Chinese males of Fitzpatrick skin phototype IV. Reduced MED to both UVB and UVA was the most common phototest finding.
A randomized clinical comparative study of cryotherapy plus photodynamic therapy vs. cryotherapy in the treatment of multiple condylomata acuminata
Authors: Mi Xia , Chai Wangxing , Zheng Heyi , Zuo Ya‐Gang , Li Jun
Published: July 2011

Background: Cryotherapy cannot destroy subclinical human papillomavirus‐infected cells of condylomata acuminata (CA). The topical application of aminolevulinic acid (ALA) results in a shallow penetration depth in CA lesions (1).

Objectives: To compare the efficacy and safety of cryotherapy plus ALA‐photodynamic therapy (PDT) with cryotherapy in the treatment of multiple CA.

Methods: Eighty patients with multiple CA received cryotherapy plus ALA‐PDT (n=40) or cryotherapy plus placebo‐PDT (n=40). After cryotherapy, a 20% ALA or a placebo solution was applied to the CA area 3 h before illumination with red light (635 nm, 100 mW/cm2, 100 J/cm2). The treatment was repeated 7 days after the first treatment if the lesions were not completely resolved. The complete response rate, recurrence rate and adverse effects in the two groups were analyzed.

Results: After two treatments, the complete response rates in the combined group (cryotherapy plus ALA‐PDT) and cryotherapy group were 32.4% (36/111) and 32.6% (43/132) in the anal area (P>0.05), 100% (32/32) and 54.5% (18/33) in the urethral meatus (P<0.05), and 94.2% (129/137) and 50.5% (56/111) in the external genitals (P<0.05), respectively. The recurrence rates in the combined group and cryotherapy group were 24.3% (27/111) and 31.1% (41/132) in the anal area (P>0.05), 9.4% (3/32) and 39.4% (13/33) in the urethral meatus (P<0.05), and 3.6% (5/137) and 31.5% (35/111) in the external genitals (P<0.05), respectively. The adverse effects in each group included mild to moderate pain, edema, erosion and hypopigmentation, without any infection, ulcers, scarring or urethral malformations.

Conclusion: Cryotherapy plus ALA‐PDT is a more effective regimen for the treatment of multiple CA compared with cryotherapy alone.
311 nm ultraviolet B‐accelerated response of psoriatic lesions in adalimumab‐treated patients
Authors: Wolf Peter , Hofer Angelika , Weger Wolfgang , Posch‐Fabian Timea , Gruber‐Wackernagel Alexandra , Legat Franz J.
Published: July 2011

Background: Treatment with the tumor necrosis factor‐alpha antibody adalimumab for 12–16 weeks produces a satisfactory response [i.e., 75% reduction in psoriasis area and severity index (PASI)] in a majority (70–80%) of patients with psoriasis. We asked whether 311 nm ultraviolet B (UVB) can improve therapeutic response of psoriatic lesions to adalimumab.

Methods: Four patients (age range, 49–67 years) with moderate to severe plaque‐type psoriasis were treated with standard dosage of adalimumab. During adalimumab therapy, a randomly selected body half (left or right, excluding the head) was irradiated with 311 nm UVB three times weekly for 6 weeks. Treatment response was monitored weekly in terms of half‐body PASI.

Results: 311 nm UVB significantly accelerated the therapeutic response during adalimumab treatment. At the start of 311 nm UVB therapy, the mean PASI was 14.8. After 6 weeks of 311 nm UVB therapy, the mean PASI was 2.0 on UV‐irradiated body halves and 6.9 on non‐irradiated body halves (difference, 4.9; 95% confidence interval, 0.4–9.4; P=0.041; 2‐tailed paired t‐test). This corresponded to an overall mean PASI reduction from baseline (i.e., adalimumab start) of 86% on UV‐irradiated body halves vs. 53% on non‐irradiated body halves.

Conclusion: 311 nm UVB may accelerate and improve the clearance of psoriatic lesions in adalimumab‐treated patients.
Parental perspective on sun protection for young children in Bavaria
Authors: Li Jiang , Uter Wolfgang , Pfahlberg Annette , Gefeller Olaf
Published: July 2011

Background: Exposure to ultraviolet (UV) radiation is the most important modifiable risk factor for skin cancer. Parents are responsible for sun protection of their young children and thus their knowledge and attitudes should be assessed.

Methods: A survey that included 2619 children aged 3–6 years (response: 64.7%) was performed in Erlangen during 2001/2002. Parents' attitude, knowledge and behavior regarding sun protection were ascertained by using a self‐administered questionnaire. Demographic and photosensitivity data of the children were recorded, along with the UV radiation‐related outcomes.

Results: Most parents correctly recognized the risk factors of skin cancer, except the intermittent and intensive sun exposure. Nevertheless, most parents also agreed with statements regarding sun‐ and tanning related beauty and well‐being. The overwhelming majority of parents stressed the necessity of sun protection for their children; however, 50% of the children experienced some form of solar radiation injury during the preceding summer. Children eagerly pursued outdoor activities, especially boys compared with girls (P<0.01). A gender difference was also apparent, with boys showing more willingness to wear hats than girls (P<0.01).

Conclusion: The relatively high level of knowledge was in contrast to a prevalent attitude of regarding sunlight as enhancing health and well‐being. This may hamper UV radiation avoidance strategies. Thus, future campaigns should not only address preventive knowledge but also focus on associated attitudes to effectively modify the behavior.
Ginsenoside Rb1, Rg1 and three extracts of traditional Chinese medicine attenuate ultraviolet B‐induced G1 growth arrest in HaCaT cells and dermal fibroblasts involve down‐regulating the expression of p16, p21 and p53
Authors: Wang Xiao‐Yong , Wang Yun‐Gui , Wang Yan‐Fei
Published: July 2011

Objective: The aims of this study were to confirm whether traditional Chinese medicine ginsenoside Rb1 (Rb1), ginsenoside Rg1 (Rg1), polygonum multiflorum (PM), ginkgo extract (GE) and lycium barbarum polysaccharide (LBP) can attenuate G1 growth arrest of HaCaT cells and dermal fibroblasts induced by 10 subcytotoxic ultraviolet B (UVB) exposures, and to explore the possible mechanism in terms of the expression of cell‐cycle regulatory proteins p16, p21 and p53.

Methods: Ten subcytotoxic exposures to UVB induced G1 growth arrest of HaCaT cells and dermal fibroblasts. Cell‐cycle analysis was performed using flow cytometry, and mRNA levels of p16, p21 and p53 were detected by a reverse transcription‐polymerase chain reaction (RT‐PCR), and protein levels were detected using Western blot analysis.

Results: Five types of traditional Chinese medicine attenuated UVB‐induced G1 growth arrest. The mRNA and protein levels of p16, p21 and p53 in HaCaT cells and dermal fibroblasts increased after UVB irradiation, but pretreatment with five types of traditional Chinese medicine decreased the expression of p16, p21 and p53.

Conclusions: These results indicated that five types of traditional Chinese medicine can attenuate G1 growth arrest of HaCaT cells and dermal fibroblasts induced by UVB exposures, which was caused by down‐regulating the expression of cell‐cycle regulatory proteins p16, p21 and p53.
Time of initiation of skin‐to‐skin contact in extremely preterm infants in Sweden
Authors: Mörelius Evalotte , Angelhoff Charlotte , Eriksson Jennie , Olhager Elisabeth
Published: July 2011

Aim:  To describe the time of first skin‐to‐skin contact in extremely preterm infants in a national perspective and to investigate possible factors affecting the time of first skin‐to‐skin contact.

Methods:  A population‐based prospective descriptive study of extremely preterm infants (n = 520) in seven regional hospitals in Sweden.

Results:  Extremely preterm infants in Sweden experience first skin‐to‐skin contact with the parent at a median of six postnatal days (range 0–44). Low gestational age, a high score on the clinical risk index for babies, and the number of days on a ventilator tended to delay first skin‐to‐skin contact. A statistically significant difference was also found between regional hospitals.

Conclusion:  There is a difference in the time of first skin‐to‐skin contact based on the infant’s medical condition and the tradition in the neonatal intensive care unit at the regional hospital where the infant is born.
The effect of olfactory stimulation on energy expenditure in growing preterm infants
Authors: Marom Ronella , Shedlisker‐Kening Tamar , Mimouni Francis B. , Lubetzky Ronit , Dollberg Shaul , Berger Irit , Mandel Dror
Published: July 2011

Aim:  To test the hypothesis that olfactory stimulation in growing healthy preterm infants leads to an increase in resting energy expenditure (REE).

Design:  A prospective, randomized clinical trial with crossover was conducted in 20 healthy, appropriate weights for gestational age, gavage‐fed preterm infants. Infants were studied while asleep and cared for in a skin servo‐controlled convective incubator. Using a pipette, 15 drops of saturated solution of vanillin (Aldrich, Fallavier, France) were dripped to a cloth diaper that was placed on the opposite side of the incubator. REE was measured by indirect calorimetry (DeltaTrac II, Helsinki, Finland) exactly 1 h after feeding. Each infant was studied twice by randomization: after a period of 20 min of vanillin odour or after 20 min without vanillin odour.

Results:  We found no statistically significant difference in REE of preterm infants when exposed to vanillin odour (74.5 ± 10.1 kcal/kg/day) in comparison with their REE when not exposed to vanillin odour (79.0 ± 11.3 kcal/kg/day).

Conclusions:  Vanillin odour does not significantly influence REE in metabolically and thermally stable preterm infants.
Course and prognostic factors of disability in community‐dwelling older people with mild disability: The Rotterdam Study
Authors: Taş Ümit , Verhagen Arianne P , Bierma‐Zeinstra Sita MA , Hofman Albert , Pols Huib AP , Koes Bart W
Published: July 2011

Aim:  To study the prognosis of disability of community‐dwelling older people with mild disability at baseline.

Methods:  We used data from the Rotterdam Study: a community‐based prospective cohort study of community‐dwelling older people. We evaluated sociodemographic factors, lifestyle variables, health conditions and disability status at baseline and follow‐up after 6 years. Disability was defined as a score on the Health Assessment Questionnaire.

Results:  At baseline the population consisted of 1166 older people with mild disability with a mean age of 69.7 (55–93) years. At follow‐up 18% of the study population recovered from mild disability, 20% stayed mildly disabled, 31% became severely disabled, while 32% were deceased. At follow‐up relatively more men died while more women had a worsened disability. Age and income were predictors of disability decrease. Alcohol use seemed to be significantly protective against death.

Conclusion:  Just a few prognostic factors appeared to be related to disability 6 years later.
The shocking transit of WASP-12b: modelling the observed early ingress in the near-ultraviolet
Authors: Llama J. , Wood K. , Jardine M. , Vidotto A. A. , Helling Ch. , Fossati L. , Haswell C. A.
Published: July 2011

Near-ultraviolet (near-UV) observations of WASP-12b have revealed an early ingress compared to the optical transit light curve. This has been interpreted as due to the presence of a magnetospheric bow shock which forms when the relative velocity of the planetary and stellar material is supersonic. We aim to reproduce this observed early ingress by modelling the stellar wind (or coronal plasma) in order to derive the speed and density of the material at the planetary orbital radius. From this, we determine the orientation of the shock and the density of compressed plasma behind it. With this model for the density structure surrounding the planet we perform Monte Carlo radiation transfer simulations of the near-UV transits of WASP-12b with or without bow shock. We find that we can reproduce the transit light curves with a wide range of plasma temperatures, shock geometries and optical depths. Our results support the hypothesis that a bow shock could explain the observed early ingress.
Ex situ gibbon conservation: status, management and birth sex ratios
Authors: MELFI V. A.
Published: July 2011

Many zoos take part in captive‐management programmes for gibbon species, which contribute to the conservation of this highly threatened taxon. Eight gibbon species are represented in captive‐management programmes globally, although the numbers held are highly biased towards only two species, which fill most of the space available in zoos. The other gibbon species are held in small populations that are difficult to manage and, thus, are unlikely in their current form to be self‐sustaining. Effort and, more importantly, space are required to grow these small gibbon populations. In addition, the space that is available needs to be used wisely. This may require that only animals that can actively contribute, whether genetically or socially, to the goal of achieving a self‐sustaining captive population are maintained. There is also a need to investigate the impact of environmental factors in captivity as they relate to birth and death rates, which would enable evidence‐based captive management of gibbons with the aim of stimulating breeding and mitigating the potential deleterious impacts associated with managing small populations.
Is impedance pH monitoring superior to the conventional 24‐h pH meter in the evaluation of patients with laryngorespiratory symptoms suspected to be due to gastroesophageal reflux disease?
Authors: ANG Daphne , ANG Tiing Leong , TEO Eng Kiong , HSU Pon Poh , TEE Augustine , POH Choo Hean , TAN Jessica , ONG Jeannie , FOCK Kwong Ming
Published: July 2011

OBJECTIVE:  Cough and laryngo‐pharyngeal symptoms (LPS) are associated with gastroesophageal reflux disease (GERD). The role of acid reflux (AR) and non‐acid reflux (NAR) in atypical GERD pathogenesis is controversial. The aims of the study were to determine the prevalence of high esophageal acid exposure time (AET) in patients presenting with cough or LPS and determine the incremental yield of multichannel intraluminal impedance–pH (MII‐pH) monitoring.

METHODS:  We undertook a prospective study of patients with cough or LPS referred for GERD evaluation between January 2009 and May 2011. All patients underwent esophageal manometry, gastroscopy and MII‐pH. Patients' characteristics, gastroscopy findings, distal esophageal AET, bolus exposure (BE) time and numbers of AR and NAR episodes in the proximal and distal esophagus were studied.

RESULTS:  Overall 50 patients (22 male, mean age 47.5 ± 14.2 years) were evaluated for unexplained chronic cough (n = 23, 46.0%), and LPS symptoms including globus (n = 10, 20.0%), sore throat (n = 12, 24.0%) and hoarse voice (n = 5, 10.0%). A normal gastroscopy, Los Angeles grade A and B esophagitis occurred in 44 (88.0%), 5 (10.0%) and 1 (2.0%) patient, respectively. Seven (14.0%) recorded elevated AET (chronic cough, 4; sore throat, 2; and hoarse voice, 1). Nine patients recorded abnormal impedance characteristics (raised BE time and/or increased reflux numbers) despite a normal AET leading to an incremental diagnostic yield of 18%.

CONCLUSION:  An isolated high AET is uncommon in patients with cough or LPS. Combined MII‐pH improves the diagnostic yield in patients with atypical GERD manifestations.
UBE3A regulates MC1R expression: a link to hypopigmentation in Angelman syndrome
Authors: Low Daren , Chen Ken‐Shiung
Published: July 2011

Angelman syndrome (AS) is a neurogenetic disorder caused by the lack of functional ubiquitin‐protein ligase E3A (UBE3A) that acts as an E3 ligase in the ubiquitin‐proteosomal degradation pathway and/or as a transcriptional coactivator. Besides neurological deficit, hypopigmentation is another phenotype associated with AS patients currently attributed to the hemizygosity of the type II oculocutaneous albinism (OCA2) gene. Here we show that the melanocortin‐1‐receptor (MC1R) is down‐regulated in the skin of the Ube3a(−/−) mice. Luciferase‐reporter assay shows that UBE3A is able to induce MC1R promoter activity. Using chromatin immunoprecipitation assay, Ube3a was observed to be physically associated with the Mc1r promoter. Deletion of the E box/SP1 element in the MC1R minimal promoter abolishes the ability of UBE3A to elevate MC1R promoter‐luciferase reporter activity. Ube3a(−/−) mice also show relative skin hypopigmentation. These results demonstrate that UBE3A plays a role in MC1R transcriptional regulation which can contribute to the development of hypopigmentation in AS patients.
Recent advances in bacteriophage therapy: how delivery routes, formulation, concentration and timing influence the success of phage therapy
Authors: Ryan Elizabeth M , Gorman Sean P , Donnelly Ryan F , Gilmore Brendan F
Published: July 2011

Objectives

Bacteriophages are bacteria-specific viruses that infect and, in the case of obligately lytic phages, destroy their host bacteria. Phage therapy has been used therapeutically to combat bacterial infections since their discovery. This paper reviewed recent in-vivo phage therapy studies, with a distinct focus on the effect of delivery routes, phage concentration and timing of administration on the success of the therapy.

Key findings

It was found that the most successful route of administration for the treatment of systemic infections was via the parenteral route. Oral delivery is mainly used to treat gastrointestinal infections. However, in some cases phages can also reach the systemic circulation. Local delivery (skin, ears, teeth) has proved extremely successful in the treatment of topical infections, as has the inhalation of phages for the treatment of lung infections. The ability of phages to prevent biofilm formation on medical devices has received much attention, mainly in the area of catheter coatings. This review also highlights areas in which phage therapy needs substantial development. Many papers were lacking in formulation details, with crude phage stocks being used in most cases. No phage stability data were included in any of the papers.

The review concluded that although phage therapy is an excellent alternative for the treatment of bacterial infections, optimisation of formulations and long-term stability data is required before it can be widely used within a clinical setting.
Pharmacokinetics of caffeine in plasma and saliva, and the influence of caffeine abstinence on CYP1A2 metrics
Authors: Perera Vidya , Gross Annette S , Xu Hongmei , McLachlan Andrew J
Published: July 2011

Objectives

To investigate the utility of metrics of CYP1A2 activity using caffeine as a probe, and saliva and plasma sampling with or without a 24-h caffeine abstinence.

Methods

This was a cross-over pharmacokinetic study in 30 healthy male subjects who received a single oral 100 mg caffeine dose after 24-h caffeine abstinence or after maintaining their regular caffeine intake (no caffeine abstinence). Serial blood and saliva samples were collected simultaneously over 24 h. Caffeine and paraxanthine concentrations were measured using a validated HPLC assay.

Key findings

There was a strong correlation between the paraxanthine/caffeine AUC0–24 ratio (reference metric) and the paraxanthine/caffeine concentration (Ct) ratio at 4 h (C4) in both saliva and plasma (r ≥ 0.75). The paraxanthine/caffeine AUC0–24 ratio in plasma and saliva did not differ between the 24-h caffeine abstinence and the no abstinence period (P > 0.05). The optimal paraxanthine/caffeine Ct that correlated with the plasma paraxanthine/caffeine AUC0–24 ratio in the 24-h abstinence period was 2 and 4 h (r = 0.88) in plasma, and 4 and 6 h in saliva (r = 0.70), while it was the saliva 4 h time-point in the no abstinence period (r = 0.78).

Conclusions

The saliva paraxanthine/caffeine concentration ratio at 4 h was a suitable metric to assess CYP1A2 activity after oral administration of caffeine without the need for 24-h caffeine abstinence.
New empirical evidence of the validity of the Chronic Pain Acceptance Questionnaire: The differential influence of activity engagement and pain willingness on adjustment to chronic pain
Authors: Bendayan Rebecca , Esteve Rosa , Blanca María J.
Published: July 2011

Objective. The aims of this study were to examine the internal structure of the Spanish version of the Chronic Pain Acceptance Questionnaire and present new empirical evidence regarding its validity.

Design and Methods. A sample of 315 chronic pain patients attending a pain clinic completed a battery of instruments to assess pain acceptance, general psychological acceptance, depression, anxiety, pain intensity, functional impairment, and current functioning.

Results. Confirmatory factor analysis supported the validity of a 20‐item version with two subscales corresponding to two independent factors: Activity Engagement and Pain Willingness. Structural Equation Modelling showed that the association between pain intensity and anxiety and depression was fully mediated by Activity Engagement which partially mediated the association between pain intensity and functioning. Pain Willingness partially mediated the influence of pain intensity on functional impairment.

Conclusions. These findings indicate the differential influence of both components on adjustment to chronic pain.
Children's emotion regulation across and within nations: A comparison of Ghanaian, Kenyan, and American youth
Authors: Morelen Diana , Zeman Janice , Perry‐Parrish Carisa , Anderson Ellen
Published: July 2011

This research examined national, regional, developmental, and gender differences in children's reported management of anger and sadness. Participants (8–15 years) were 103 Ghanaian children from a village setting, 142 Ghanaian children from a middle‐class urban context, 106 Kenyan children from an impoverished urban context, and 170 children from the United States in lower to middle‐class urban areas (58.8% Caucasian). Children completed the Children's Anger and Sadness Management Scales (Zeman, Shipman, & Penza‐Clyve, 2001) to assess emotion management (i.e., effortful control, over control, under control). Comparisons across nations indicated that Ghanaian youth reported more overt anger expression than youth from Kenya and the United States and less anger inhibition than Kenyan youth. U.S. children reported less overt expression and more constraint over sadness than Kenyan and Ghanaian children, although Kenyans reported being calmer when experiencing sadness than Ghanaian and American youth. Comparing Ghanaian regional contexts, village children reported more anger control than urban children. Regardless of nationality, boys reported more control over sadness than girls who reported more under control of sadness and more over control of anger than boys. Future research is needed to build on these descriptive, preliminary findings examining under‐studied cross‐national contexts.
Numerical Analysis of Three Types of Cavitation Surge in Cascade
Authors: Iga Yuka , Hashizume Kei , Yoshida Yoshiki
Published: July 2011

In the present study, numerical analysis of a cavitating three-blade cyclic flat-plate cascade was performed considering cavitation surge, which is a type of cavitation instability in pumping machinery. A numerical method employing a uniquely developed gas-liquid two-phase model was applied to solve the unsteady cavitating flow field, where compressibility is considered in the liquid phase of the model. From the numerical results, the surging oscillations by cavitation represented in the present cascade system can be classified into three types of cavitation surge based on the oscillation characteristics and the flow fields. In the first type, oscillation is composed of small-vortex cavitation and large scale pulsation, which correspond to “surge mode oscillation” whose frequency is not affected by cavity volume. The second type of oscillation is composed of sheet cavitation with a re-entrant jet, which corresponds to so-called “cavitation surge.” The final type of oscillation is subsynchronous rotating cavitation accompanied by pulsation, which is considered as superposition of system and local instability. In addition, the locking phenomenon of break-off frequency of cavitation in the surging oscillations and the mechanism of the pulsation phenomenon accompanied by re-entrant jet in the present cascade were investigated.
Sintering Characteristics and Electrical Conductivity of (Sr1−xLax)TiO3 Synthesized by the Citric Acid Method
Authors: Wang Zhenwei , Mori Masashi
Published: July 2011

The air-sintering characteristics and electrical conductivity of (Sr1−xLax)TiO3 perovskites (0 ≤ x ≤ 0.3) synthesized by the citric acid method were evaluated in terms of their use as interconnect materials in solid oxide fuel cells. A single perovskite phase of (Sr0.8La0.2)TiO3 powder was formed at 800 °C. In this powder, a Ruddlesden–Popper Sr2TiO4 layer appeared in the temperature range of 1100–1500 °C, and disappeared at 1600 °C. (Sr0.8La0.2)TiO3 powders which were calcined at 1000–1100 °C showed the best sintering characteristics. The relative density of the samples reached 94% at 1400 °C, although the Ruddlesden–Popper layer remained in this dense sample. Electrical conductivities of (Sr1−xLax)TiO3 bars at 1000 °C were approximately 0.10–1.1 S cm−1 in air and 7.1–12 S cm−1 in a reducing atmosphere. For a (Sr0.9La0.1)TiO3 pellet placed between both air and reducing atmospheres, the conductivity at 850 °C was 0.033 S cm−1, which is close to that in air. No compositional dependency on electrical conductivity was observed for the (Sr1−xLax)TiO3 pellets.
The Instability of Flow Through a Slowly Diverging Pipe With Viscous Heating
Authors: Chandra Sahu Kirti
Published: July 2011

The nonparallel linear stability analysis of flow through a slowly diverging pipe undergoing viscous heating is considered. The pipe wall is maintained at constant temperatures and Nahme’s law is applied to model the temperature dependence of the fluid viscosity. A one-parameter family of velocity profiles for the basic state is obtained for small angles of divergence. The nonparallel stability equations for the disturbance velocity coupled to a linearized energy equation are derived and solved using a spectral collocation method. Our results indicate that increasing viscous heating, characterized by increasing Nahme number, is destabilizing. The Prandtl number has a negligible effect on the linear stability characteristics. The Grashof number stablizes the flow for Gr>106, below which it has a negligible effect.
Transition to Turbulence in Accelerating Pipe Flow
Authors: Annus Ivar , Koppel Tiit
Published: July 2011

A uniformly accelerated laminar flow in a pipe, initially at rest, is analyzed. The acceleration increases the critical Reynolds number remarkably. New experimental findings are used to describe the transitional process in accelerating pipe flow. The results are shown to validate the previously suggested transition parameters obtained on the basis of results on small diameter pipes. The influence of the transition process on mean values is studied. The relationships between flow parameters and transition time were derived from the experimental results for data available. The time from the start of the flow to the initiation of turbulence can be predicted by an empirical formula.
Observation of Transient Structural-Transformation Dynamics in a Cu
2
S Nanorod
Authors: Zheng Haimei , Rivest Jessy B. , Miller Timothy A. , Sadtler Bryce , Lindenberg Aaron , Toney Michael F. , Wang Lin-Wang , Kisielowski Christian , Alivisatos A. Paul
Published: July 2011

Structural fluctuations between two equilibrium phases are observed in copper sulfide nanoparticles.
Waste Panel Expected to Back Interim Storage
Authors: Kintisch Eli
Published: July 2011

A blue-ribbon commission signals that spent nuclear fuel should cool above ground while the United States figures out long-term disposal.
The Autistic Brain: Out of Synch?
Authors: Mashour George A.
Published: July 2011

Autism in toddlers is associated with decreased synchronization of brain regions involved in language.
Inkjet Pharmacy
Authors: Rytting Erik
Published: July 2011

Inkjet printer technology can accurately dispense individualized drug doses on demand.