bluuebunny/crossref_metadata_2025 huggingface dataset:
Spatial heterogeneity and rates of spread in experimental streams
Authors: Simpson Karilynn , McCauley Edward , Nelson William A.
Published: August 2008

Theoretical models predict that environmental heterogeneity can decrease or potentially increase rates of spread in biological populations depending on the relationship between the scale of dispersal and the scale of heterogeneity. These effects arise from the interaction between habitat quality and the processes of dispersal, colonization and growth. Flowing water environments provide a unique opportunity to test these predictions. If advection influences dispersal, flow can alter the relative scale of dispersal to environmental heterogeneity in the upstream versus downstream direction. We explored the influence of heterogeneity on the spatial spread of a species of diatom in experimental streams. Environmental heterogeneity was created by maintaining agar diffusing substrata at different nutrient levels. Diatoms were placed at the midpoint of each stream, and spatial spread rates were determined by monitoring algal abundance non‐destructively. Our results reveal that, relative to homogeneous streams, resource heterogeneity decreases spread rate in the upstream direction but increases spread rate in the downstream direction. Empirical estimates of growth rates and colonization times reveal that heterogeneity predominantly influenced colonization rates. Colonization rates estimate successful dispersal events, and thus relate to both colonization and dispersal. These results are one of the first empirical tests of general theories regarding the impact of heterogeneity on rates of spread and highlight the importance of understanding the impact of heterogeneity on colonization and dispersal in continuous habitats.
Molecules, morphology and fossils: a comprehensive approach to odonate phylogeny and the evolution of the odonate wing
Authors: Bybee Seth M. , Ogden T. Heath , Branham Marc A. , Whiting Michael F.
Published: August 2008

We undertook a comprehensive morphological and molecular phylogenetic analysis of dragonfly phylogeny, examining both extant and fossil lineages in simultaneous analyses. The legitimacy of higher‐level family groups and the phylogenetic relationship between families were tested. Thirteen families were supported as monophyletic (Aeshnidae, Calopterygidae, Chlorocyphidae, Euphaeidae, Gomphidae, Isostictidae, Lestidae, Libellulidae, Petaluridae, Platystictidae, Polythoridae, Pseudostigmatidae and Synthemistidae) and eight as non‐monophyletic (Amphipterygidae, Coenagrionidae, Corduliidae, Megapodagrionidae, Protoneuridae and Synlestidae), although Perilestidae and Platycnemididae were recovered as monophyletic under Bayesian analyses. Nine families were represented by one species, thus monophyly was not tested (Epiophlebiidae, Austropetaliidae, Chlorogomphidae, Cordulegastridae, Macromiidae, Chorismagrionidae, Diphlebiidae, Lestoideidae and Pseudolestidae). Epiprocta and Zygoptera were recovered as monophyletic. Ditaxinerua is supported as the sister lineage to Odonata, Epiophlebiidae and the lestid‐like damselflies are sister to the Epiprocta and Zygoptera, respectively. Austropetaliidae + Aeshnidae is the sister lineage to the remaining Anisoptera. Tarsophlebia's placement as sister to Epiprocta or as sister to Epiprocta + Zygoptera was not resolved. Refinements are made to the current classification. Fossil taxa did not seem to provide signals crucial to recovering a robust phylogeny, but were critical to understanding the evolution of key morphological features associated with flight. Characters associated with wing structure were optimized revealing two wing character complexes: the pterostigma–nodal brace complex and the costal wing base & costal–ScP junction complex. In turn, these two complexes appear to be associated; the pterostigma–nodal brace complex allowing for further modification of the wing characters comprised within the costal wing base & costal–ScP junction complex leading the modern odonate wing.

© The Willi Hennig Society 2008.
Prognostic factor of adult patients with atopic dermatitis
Authors: KATOH Norito , HIRANO Shinya , KISHIMOTO Saburo
Published: August 2008

The increased prevalence of atopic dermatitis (AD) in adults in recent decades suggests that dermatologists may be expected to estimate the prognosis of adult patients with AD when they visit as new patients. We therefore evaluated the change in the extent of involvement and analyzed the factors that contribute to the prognosis of adult AD. A retrospective chart review was performed for 65 adults patients (median age at first visit, 25 years) with AD who had been followed monthly for over 10 years. The median area of involvement at first visit was 19%. The area of the eruptions and peripheral eosinophil counts decreased significantly in the fifth and 10th years with standard treatment. The values of immunoglobulin (Ig)E were also reduced after 10 years. Patients with high values of serum total IgE and peripheral eosinophil count, and long duration of AD had wide areas of eruptions 10 years after the first visit. Total IgE had the highest correlation with area of involvement after 10 years. Although the prognosis of adult AD is not poor, patients with high IgE values are expected to have ongoing eczema with wide distribution after 10 years of follow up.
Pulsed dye laser treatment for viral warts: A study of 120 patients
Authors: PARK Hyun Su , CHOI Woo Seok
Published: August 2008

A prospective, non‐blinded, non‐randomized study on 120 wart patients treated with pulsed dye laser was performed to evaluate the efficacy and safety of pulsed dye laser treatment for viral warts and to demonstrate the proper application and effective technique of this method. The overall clearance rate was 49.5%. The clearance rates of flat warts, periungual warts, plantar warts and common warts were 67.6%, 51.1%, 47.6% and 44.3%, respectively. Overall, the response rates of pediatric warts, recalcitrant warts and old warts were superior to those of adult warts, simple warts and non‐old warts, respectively; however, those trends were not statistically significant. We concluded that pulsed dye laser treatment is a safe, tolerable and relatively effective treatment method for viral warts. Pulsed dye laser treatment may be a more efficacious method for flat warts and recalcitrant periungual warts, and it can be an effective modality for newly‐developed warts. The highest clearance rate was noted at a fluence of 9.5 J/cm2 (P ≤ 0.05) and it is recommended that practitioners perform pulsed dye laser treatments for viral warts at the fluences of 9.0–9.5 J/cm2. A replacement of pulsed dye laser treatment should be considered unless prominent improvement is observed after three treatment sessions.
Cutaneous and systemic plasmacytosis: A Chinese case
Authors: MA Hui‐Jun , LIU Wen , LI You , ZHAO Guang , MENG Ru‐Song , LI Dong‐Guang
Published: August 2008

Cutaneous and systemic plasmacytosis (CSP) is an exceedingly rare condition arising primarily in patients of Japanese descent. Herein, we describe a patient of mainland Chinese origin suffering CSP. A 49‐year‐old Chinese male had asymptomatic brownish‐red plaques and papules of the face and trunk for 6 years. Physical examination revealed innumerable symmetric red‐brownish macules on face and trunk with fewer red‐brownish papules scattered among the macules. Chemical analysis revealed hypergammaglobulinemia. Computerized tomography scan discovered some lymphadenopathy in the axillary, paratracheal and pulmonary regions. Histological examination showed focal perivascular and periadnexal infiltrate of mainly plasma cells in the superficial and deep dermis. Immunohistochemical study showed that a great number of the infiltrating cells were CD20‐positive. The infiltrated polyclonal plasma cells expressed both κ and λ light chains. Topical therapy with tacrolimus 0.1% ointment for 2 months reduced the thickness and pigmentation of the facial skin lesions. The lesions resumed the original appearance 3 weeks after discontinuing the therapy. To the best of our knowledge, this is the first case of CSP from mainland China.
Effect of add‐on gabapentin on opioid withdrawal symptoms in opium‐dependent patients
Authors: Kheirabadi Gholam R. , Ranjkesh Mansour , Maracy Mohamad R. , Salehi Mehrdad
Published: August 2008

Aims  Evaluation of the efficacy of gabapentin in patients undergoing out‐patient treatment for opiate withdrawal.

Design  A 3‐week double‐blind, randomized, placebo‐controlled trial of adjunctive gabapentin in methadone‐assisted detoxification (MAD).

Setting  Specialized Addictive Behaviors Unit, an out‐patient unit for the treatment of patients with an addictive disorder serving the city of Isfahan (Iran).

Participants  Forty out‐patients, 37 males and three females, aged 21–61 years, who met DSM‐IV criteria for opiate dependence.

Intervention  Random assignment of subjects to receive adjunctive treatment with either gabapentin (900 mg/day) or placebo under double‐blind conditions.

Measurements  Severity of subjective withdrawal symptoms using the Subjective Opiate Withdrawal Scale at six stages.

Findings  Despite the superiority of gabapentin on controlling some of withdrawal symptoms, no significant differences were reported between two groups.

Conclusions  Dosage of 900 mg/day of gabapentin is not significantly superior to placebo in controlling opiate withdrawal symptoms.
Do graphic health warning labels have an impact on adolescents’ smoking‐related beliefs and behaviours?
Authors: White Victoria , Webster Bernice , Wakefield Melanie
Published: August 2008

Aims To assess the impact of the introduction of graphic health warning labels on cigarette packets on adolescents at different smoking uptake stages.

Design School‐based surveys conducted in the year prior to (2005) and approximately 6 months after (2006) the introduction of the graphic health warnings. The 2006 survey was conducted after a TV advertising campaign promoting two new health warnings.

Setting Secondary schools in greater metropolitan Melbourne, Australia.

Participants Students in year levels 8–12: 2432 students in 2005, and 2050 in 2006, participated.

Measures Smoking uptake stage, intention to smoke, reported exposure to cigarette packs, knowledge of health effects of smoking, cognitive processing of warning labels and perceptions of cigarette pack image.

Findings At baseline, 72% of students had seen cigarette packs in the previous 6 months, while at follow‐up 77% had seen packs and 88% of these had seen the new warning labels. Cognitive processing of warning labels increased, with students more frequently reading, attending to, thinking and talking about warning labels at follow‐up. Experimental and established smokers thought about quitting and forgoing cigarettes more at follow‐up. At follow‐up intention to smoke was lower among those students who had talked about the warning labels and had forgone cigarettes.

Conclusions Graphic warning labels on cigarette packs are noticed by the majority of adolescents, increase adolescents’ cognitive processing of these messages and have the potential to lower smoking intentions. Our findings suggest that the introduction of graphic warning labels may help to reduce smoking among adolescents.
Assessing smoking status in children, adolescents and adults: cotinine cut‐points revisited
Authors: Jarvis Martin J. , Fidler Jennifer , Mindell Jennifer , Feyerabend Colin , West Robert
Published: August 2008

Aims  To reassess saliva cotinine cut‐points to discriminate smoking status. Cotinine cut‐points that are in use were derived from relatively small samples of smokers and non‐smokers 20 or more years ago. It is possible that optimal cut‐points may have changed as prevalence and exposure to passive smoking have declined.

Design  Cross‐sectional survey of the general population, with assessment of self‐reported smoking and saliva cotinine.

Participants  A total of 58 791 respondents aged 4 years and older in the Health Survey for England for the years 1996–2004 who provided valid saliva cotinine specimens.

Measures  Saliva cotinine concentrations, demographic variables, self‐reported smoking, presence or absence of smoking in the home, a composite index of social disadvantage derived from occupation, housing tenure and access to a car.

Findings  A cut‐point of 12 ng/ml performed best overall, with specificity of 96.9% and sensitivity of 96.7% in discriminating confirmed cigarette smokers from never regular smokers. This cut‐point also identified correctly 95.8% of children aged 8–15 years smoking six or more cigarettes a week. There was evidence of substantial misreport in claimed ex‐smokers, especially adolescents (specificity 72.3%) and young adults aged 16–24 years (77.5%). Optimal cut‐points varied by presence (18 ng/ml) or absence (5 ng/ml) of smoking in the home, and there was a gradient from 8 ng/ml to 18 ng/ml with increasing social disadvantage.

Conclusions  The extent of non‐smokers' exposure to other people's tobacco smoke is the principal factor driving optimal cotinine cut‐points. A cut‐point of 12 ng/ml can be recommended for general use across the whole age range, although different cut‐points may be appropriate for population subgroups and in societies with differing levels of exposure to secondhand smoke.
Old enough for a beer? Compliance with minimum legal age for alcohol purchases in monopoly and other off‐premise outlets in Finland and Norway
Authors: Rossow Ingeborg , Karlsson Thomas , Raitasalo Kirsimarja
Published: August 2008

Aim To assess whether government monopoly outlets comply better with minimum legal age for purchase of alcohol compared to other off‐premise outlets for alcohol sales.

Methods Under‐age‐appearing 18‐year‐olds attempted to purchase alcohol in off‐premise outlets applying identical procedures in Finland (n = 290) and Norway (n = 170). Outcomes were measured as whether or not the buyers were asked to present an identity (ID) card and whether or not they succeeded in purchasing alcohol.

Results The buyers were asked to present an ID card in slightly more than half the attempts, and they succeeded in purchasing alcohol in 48% of the cases. The buyers were more likely to be requested to present an ID card and less likely to succeed in purchasing alcohol in monopoly outlets compared to other types of outlets, and also when other outcome predictors, such as age and gender of salesperson and crowdedness in the outlet, were taken into account.

Conclusion Monopoly outlets may facilitate compliance with minimum legal age for purchase of alcohol.
Relationship between polypharmacy and underprescribing
Authors: Kuijpers Mascha A. J. , Van Marum Rob J. , Egberts Antoine C. G. , Jansen Paul A. F. ,   The OLDY (OLd people Drugs & dYsregulations) study group
Published: August 2008

WHAT IS ALREADY KNOWN ABOUT THIS SUBJECT

• Polypharmacy is common among the elderly.

• Underprescribing is also frequent.

• Optimizing polypharmacy includes avoiding underprescription.

WHAT THIS STUDY ADDS

• The probability of underprescription increases with the number of drugs used.

• Forty‐three % of patients who used five or more medicines are undertreated.

• In undertreated patients a mean of 1.4 medicines were lacking.

AIMS

Underprescribing is increasingly recognized as an important problem. The aim of this study was to determine the relationship between polypharmacy and underprescribing.

METHODS

Treatment of current medical problems in geriatric patients was compared with general practitioner and national guidelines. Underprescription was defined as lack of an indicated drug, while no reason could be found for not prescribing it. Polypharmacy was defined as five or more drugs.

RESULTS

Polypharmacy was present in 61% of 150 patients. Underprescription was found in 47 (31%). Of patients with polypharmacy 42.9% were undertreated, in contrast to 13.5% of patients using four medicines or less (OR 4.8, 95% CI 2.0, 11.2). The estimated probability of underprescription increased significantly with the number of drugs.

CONCLUSIONS

We found a clear relationship between polypharmacy and underprescribing.
Haemophilia A mutations in the UK: results of screening one‐third of the population
Authors: Green P. M. , Bagnall R. D. , Waseem N. H. , Giannelli F.
Published: August 2008

One‐third of the UK haemophilia A population was screened to establish a national database of mutations and pedigrees and advance knowledge of the disease. The following mutations were found: 131 intron 22‐ and 13 intron1‐breaking inversions; 11 gross deletions and an insertion; 65 frameshifts; three in‐frame deletions and one insertion; 46 nonsense; 30 intronic mutations affecting splice sites and four generating new sites; 469 non‐synonymous mutations due to 203 different base substitutions of which four affected, and nine were predicted to affect, splicing; three promoter mutations; two synonymous exon 14 mutations possibly affecting splicing; two VWF mutations. Of the above mutations, 176 are not listed in the Haemophilia A Mutation, Structure, Test and Resource Site (HAMSTeRS). Four gross deletions arose by non‐homologous end‐joining; we detected unexpected splicing in some mutations; substitution of amino acids conserved for less than 90 million years are rare; the risk of developing inhibitors for patients with nonsense mutations is greater when the stop codon is in the 3′ half of the mRNA; changes likely to generate splice sites causing frameshifts are over‐represented among non‐synonymous mutations associated with inhibitors; our data and those in HAMSTeRS enabled the size of the spectrum of specific mutations causing the disease to be estimated and to determine how much of it is known.
Cytotoxic T lymphocytes as immune‐therapy in haematological practice
Authors: Leen Ann M. , Heslop Helen E.
Published: August 2008

Viral infections are a significant cause of morbidity and mortality, particularly in pediatric allogeneic haematopoietic stem cell transplant recipients. Effective therapies are limited and often associated with significant side effects. Adoptive transfer of virus‐reactive T cells offers a means of reconstituting antiviral immunity and this approach has been successfully used to prevent and treat cytomegalovirus, Epstein‐Barr virus, and adenovirus infections in vivo. This review outlines the clinical trials that have been performed to date, and will describe future initiatives to (a) develop strategies that can increase the breadth of the viruses that can be targeted, and (b) simplify the process to extend this technology to more centers so that cellular therapy to reconstitute immunity can be more widely applied.
Clomiphene citrate, metformin or both as first‐step approach in treating anovulatory infertility in patients with polycystic ovary syndrome (PCOS): a systematic review of head‐to‐head randomized controlled studies and meta‐analysis
Authors: Palomba Stefano , Pasquali Renato , Orio Francesco , Nestler John E.
Published: August 2008

Background  To date, no systematic review or meta‐analysis has been published of direct head‐to‐head studies comparing clomiphene citrate (CC) vs. metformin, or the combination of both drugs as first‐line therapy in anovulatory polycystic ovary syndrome (PCOS) patients seeking pregnancy. The aim of the current paper was to define, if possible, the best evidence‐based recommendations regarding the use of CC and/or metformin as the initial treatment of PCOS women with anovulatory infertility.

Design  Systematic review and meta‐analysis of the head‐to‐head randomized controlled trials (RCTs) available in the literature.

Methods  A bibliographic search was performed using the following bibliographic databases: Medline, EMBASE, Biological Abstracts, Cochrane Controlled Trials Register and Cochrane Database of Systematic Reviews. Reference lists of included studies, other relevant review articles and textbooks were checked for additional citations of interest.

Results  Four head‐to‐head RCTs were identified and qualified for inclusion in the analysis. No difference in fertility improvement was observed comparing CC with metformin (OR = 1·22, 95% CI 0·23–6·55, P = 0·815), whereas a significant (P < 0·0001) heterogeneity was observed. Homogeneous data showed no difference in fertility improvement between the combination treatment and CC monotherapy (OR = 0·99, 95% CI 0·70–1·40, P = 0·982), but a significant difference in comparison with metformin monotherapy (OR = 0·23, 95% CI 0·14–0·37, P < 0·0001).

Conclusions  In PCOS patients with anovulatory infertility and not previously treated, the administration of metformin plus CC is not better than monotherapy (metformin alone or CC alone), whereas to date no specific recommendation can be given regarding the use of CC or metformin as first‐step drug.
Prevalence of low male testosterone levels in primary care in Germany: cross‐sectional results from the DETECT study
Authors: Schneider Harald Jörn , Sievers Caroline , Klotsche Jens , Böhler Steffen , Pittrow David , Lehnert Hendrik , Wittchen Hans‐Ulrich , Stalla Günter Karl
Published: August 2008

Objective  Low testosterone levels in men occur with increasing age and are associated with increased morbidity, particularly metabolic syndrome, and mortality. As the prevalence of hypogonadal testosterone levels has not been assessed in the primary care setting in Europe, we aimed to investigate the prevalence of low testosterone levels in this setting, and the patient characteristics and comorbidities associated with this finding.

Design  A cross‐sectional, epidemiological study (the Diabetes Cardiovascular Risk‐Evaluation: Targets and Essential Data for Commitment of Treatment (DETECT) study).

Patients  A total of 2719 male primary care patients (age 58·7 ± 13·4 years) were included.

Measurements  Testosterone was measured in all patients. Information on diseases, risk conditions and treatments was documented by the primary care physicians. A large set of laboratory parameters was measured in a central laboratory. We calculated univariate and multivariate logistic regression models to assess the associations of low testosterone levels with different health and life style factors.

Results  A total of 19·3% of all men had hypogonadism as defined by testosterone levels < 3·0 ng/ml. Stepwise logistic regression analysis revealed that obesity, metabolic syndrome, cancer, intake of six or more drugs, acute inflammation and nonsmoking were associated with hypogonadal testosterone levels. Higher age, liver diseases, and cancer were associated with very low testosterone levels (< 1·0 ng/ml).

Conclusions  Hypogonadal testosterone levels are common in primary care, particularly in patients with the above conditions.
Forest succession and prey availability influence the strength and scale of terrestrial‐aquatic linkages in a headwater salamander system
Authors: GREENE BRIAN T. , LOWE WINSOR H. , LIKENS GENE E.
Published: August 2008

1. Trophic linkages between terrestrial and aquatic ecosystems are common and sensitive to disruption. However, there is little information on what causes variation in the strength and spatial scale of these linkages.

2. In the highly aquatic adults of the headwater salamander Gyrinophilus porphyriticus (family Plethodontidae), use of terrestrial prey decreases along a gradient from early‐ to late‐successional riparian forests. To understand the cause of this relationship, we tested the predictions that (i) terrestrial prey abundance is lower in late‐successional forests, and (ii) G. porphyriticus adults cannot move as far from the stream to forage in late‐successional forests, thus limiting access to terrestrial prey.

3. We established 100‐m long study reaches on six headwater streams in the Hubbard Brook Experimental Forest, New Hampshire. Three reaches were in early‐successional forests and three were in late‐successional forests. We conducted pitfall trapping for invertebrate prey in June and July of 2005, with three traps at 0, 2, 5 and 10 m from the stream at each reach. In June, July and August of 2004 and 2005, nighttime salamander surveys were conducted at each reach along ten, 10‐m long by 2.5‐m wide transects perpendicular to the stream.

4. Abundance of terrestrial prey was consistently lower in late‐successional forests, suggesting that consumption of terrestrial prey by G. porphyriticus is affected by prey abundance. Contrary to our prediction, G. porphyriticus adults moved farther from the stream in late‐successional forests, suggesting that habitat conditions in late‐successional forests do not limit movement away from the stream, and that lower abundances of terrestrial prey in these forests may cause salamanders to move farther from streams.

5. Our results provide novel insight on the extent of terrestrial habitat use by G. porphyriticus. More broadly, these results indicate that major habitat gradients, such as forest succession, can affect the strength and scale of terrestrial‐aquatic linkages. Application of this insight to the design of vegetation buffers along headwater streams would have widespread benefits to freshwater ecosystems.
Nucleoredoxin regulates the Wnt/planar cell polarity pathway in Xenopus
Authors: Funato Yosuke , Michiue Tatsuo , Terabayashi Takeshi , Yukita Akira , Danno Hiroki , Asashima Makoto , Miki Hiroaki
Published: August 2008

The Wnt signaling pathway is conserved across species, and is essential for early development. We previously identified nucleoredoxin (NRX) as a protein that interacts with dishevelled (Dvl) in vivo to negatively regulate the Wnt/β‐catenin pathway. However, whether NRX affects another branch of the Wnt pathway, the Wnt/planar cell polarity (PCP) pathway, remains unclear. Here we show that NRX regulates the Wnt/PCP pathway. In Xenopus laevis, over‐expression or depletion of NRX by injection of NRX mRNA or antisense morpholino oligonucleotide, respectively, yields the bent‐axis phenotype that is typically observed in embryos with abnormal PCP pathway activity. In co‐injection experiments of Dvl and NRX mRNA, NRX suppresses the Dvl‐induced bent‐axis phenotype. Over‐expression or depletion of NRX also suppresses the convergent extension movements that are believed to underlie normal gastrulation. We also found that NRX can inhibit Dvl‐induced up‐regulation of c‐Jun phosphorylation. These results indicate that NRX plays crucial roles in the Wnt/PCP pathway through Dvl and regulates Xenopus gastrulation movements.
Inducible‐ and constitutive‐type transcript variants of kakusei, a novel non‐coding immediate early gene, in the honeybee brain
Authors: Kiya Taketoshi , Kunieda Takekazu , Kubo Takeo
Published: August 2008

We previously identified a novel non‐coding immediate early gene, termed kakusei, from the honeybee (Apis mellifera) and used it as a marker to detect neural activity in the brains of foraging workers (Kiya et al., 2007). Here, we investigated the detailed kakusei gene structure. Expression analysis revealed that, in addition to the neural activity‐inducible transcript variant, multiple neural activity‐independent transcript variants were constitutively expressed from the same kakusei locus. In situ hybridization revealed that constitutive‐type kakusei variants were detected in the whole brain and the RNA was localized predominantly in the neural nuclei, like the inducible‐type variant, suggesting the concerted action of inducible‐ and constitutive‐types of kakusei transcript variants on nuclear function.
Preconditions needed for establishing a trusting relationship during health counselling – an interview study
Authors: Eriksson Irene , Nilsson Kerstin
Published: August 2008

Aim. To examine the preconditions needed by district nurses to build a trusting relationship during health counselling of patients with hypertension.

Background. Trust has been found to be an important aspect of the patient–nurse relationship. Little research has focused on how trust is formed in patient–nurse relationships or the conditions the development process requires when working with health counselling; in particular not in relation to hypertension.

Design. Qualitative study.

Method. Qualitative data were collected through open‐ended interviews with all (10) district nurses from three primary health care districts of western Sweden. All interviewees work with the health counselling of patients with hypertension. A latent content analysis was performed with thematic coding of the content of the interviews.

Results. The first theme that emerged from the analysis, the nurses’ competence, describes the nurses’ consciousness of their method of expression, both oral and non‐verbal, as well as their pedagogical competence and their ability to be reliable in their profession. The second theme, the patient meeting, describes the continuity in the patient meeting and creating respectful communication.

Conclusion. The results show an awareness of preconditions influencing building a trusting relationship. When creating a trusting relationship the communication and pedagogical competences of district nurses have considerable importance. Despite this awareness they state that it is easy to fall into a routinised way of working.

Relevance to clinical practice. The implications of this study might be used as support and guidance for district nurses when developing their competence in health counselling in relations to patients with hypertension. This knowledge is also important when planning for nurse‐led clinics for this patient group.
Medium‐term post‐Katrina health sequelae among New Orleans residents: predictors of poor mental and physical health
Authors: Kim Son Chae , Plumb Ruth , Gredig Quynh‐Nga , Rankin Larry , Taylor Barbara
Published: August 2008

Aims.  To assess the medium‐term post‐Katrina mental and physical health of New Orleans residents and to determine demographic, social and environmental factors that predict poor mental and physical health.

Background.  Major disasters can have a negative impact on the health of survivors for prolonged periods. Although the initial and short‐term impacts of Hurricane Katrina have been well described, the medium‐term impacts have not been studied as thoroughly.

Design.  Cross‐sectional survey.

Methods.  A convenience sample (n = 222) of residents in Gentilly area of New Orleans completed questionnaires between 16 and 18 December 2006. Multivariate logistic regression and multiple regression models were employed to determine predictors of poor mental and physical health.

Results.  Poor mental health was reported by 52% of the respondents. Pre‐Katrina depression [odds ratio (OR) = 19·1], post‐Katrina depression (OR = 7·2), poor physical health (OR = 5·6), feeling unsafe from crime (OR = 4·3) and female gender (OR = 2·6) were significant predictor variables of poor mental health. Twenty‐four percent of the variance in number of days of poor mental health was explained by the independent variables (R2 = 0·24; p < 0·001). Poor physical health was reported by 48% of the respondents. Poor mental health (OR = 3·9), lack of money to buy food (OR = 2·7) and pre‐Katrina arthritis (OR = 2·6) were significant predictor variables of poor physical health. Twenty‐three percent of the variance in number of days of poor physical health was explained by the independent variables (R2 = 0·23; p < 0·001).

Conclusions.  Approximately half of the New Orleans residents continue to experience poor mental and physical health 15 months after Katrina. The results support focusing post‐Katrina efforts to protect residents from crime, improve mental health services to the depressed and improve food supply to the poor.

Relevance to clinical practice.  Identifying predictors of poor mental and physical health may help clinicians and policy makers to focus their efforts in ameliorating the post‐disaster health sequelae.
Existential aspects of living with addiction – Part II: caring needs. A hermeneutic expansion of qualitative findings
Authors: Wiklund Lena
Published: August 2008

Aim.  This paper aims to describe caring needs associated with existential aspects of living with addiction.

Background.  Spirituality is considered a driving force within and the concept relates to self, others and God and the relationships between them. The spiritual dimension is of great importance in both the addiction itself as well as in recovery and addressing caring needs relating to spirituality is important in nursing.

Design.  Hermeneutic inquiry was used to explore caring needs related to peoples experiences of living with addiction.

Method.  This paper is a hermeneutic expansion of findings presented in Part I. Existential themes in the form of spiritual challenges and caring needs are reflected upon as a process between figure and background.

Results.  The themes presented are: meaning – meaninglessness, connectedness – loneliness, life – death, freedom – adjustment, responsibility – guilt, control – chaos. Caring needs associated with them are identified as; the need to create a new frame of reference for interpreting of life, the need to experience coherence in life, a restored dignity as well as the need for a sense of community and attachment, confirmation and acceptance. The caring need for forgiveness and reconciliation is also identified as well as the need for continuity, comprehensibility and manageability.

Conclusions.  When caring for patients suffering from addiction nurses should address patients’ spirituality. The caring communion is vital, as it is the foundation for meeting the patients’ needs. Intervention by nurses should focus on aspects that will help patients feel alive and in communion with others.

Relevance to clinical practice.  Understanding and being able to identify patients’ caring needs associated with existential aspects of living with addiction will enable nurses to provide professional care and promote patient’s recovery.
A systematic review of nursing administration of medication via enteral tubes in adults
Authors: Phillips Nicole M , Nay Rhonda
Published: August 2008

Aim.  This systematic review aimed to determine the best available evidence regarding the effectiveness of nursing interventions in minimising the complications associated with administering medication via enteral tubes in adults.

Background.  Giving enteral medication is a fairly common nursing intervention entailing several skills: verifying tube position, preparing medication, flushing the tube and assessing for potential complications. If not carried out effectively harmful consequences may result leading to increased morbidity and even mortality. Until now, what was considered to be best practice in this area was unknown.

Design.  Systematic review.

Methods.  CINAHL, MEDLINE, The Cochrane Library, Current Contents/All Editions, EMBASE, Australasian Medical Index and PsychINFO databases were searched up to September 2005. Reference lists of included studies were appraised. Two reviewers independently assessed study eligibility for inclusion. There were no comparable randomised‐controlled trials; data were presented in a narrative summary.

Results.  Identified evidence included using 30 ml of water for irrigation when giving medication or flushing small‐diameter nasoenteral tubes may reduce tube occlusion. Using liquid medication should be considered as there may be less tube occlusions than with solid forms in nasoenteral tubes and silicone percutaneous endoscopic gastrostomy tubes. In addition, nurses may need to consider the sorbitol content of some liquid medications, for example elixirs, as diarrhoea has been attributed to the sorbitol content of the elixir, not the drug itself.

Conclusion.  The evidence was limited. There was a lack of high‐quality research on many important issues relating to giving enteral medication.

Relevance to clinical practice.  Nurses have the primary responsibility for giving medication through enteral tubes and need knowledge of the best available evidence. Some of the nursing considerations and interventions relating to this skill have been researched in the clinical area and have implications for practice. There is a need for further studies to strengthen these findings.
Brief report: Aggressive challenging behaviour in adults with intellectual disability following community resettlement
Authors: Bhaumik S. , Watson J. M. , Devapriam J. , Raju L. B. , Tin N. N. , Kiani R. , Talbott L. , Parker R. , Moore L. , Majumdar S. K. , Ganghadaran S. K. , Dixon K. , Das Gupta A. , Barrett M. , Tyrer F.
Published: August 2008

Background  Aggressive challenging behaviour is common in adults with intellectual disability (ID) in long‐term care facilities. The government's commitment to the closure of all facilities in England has led to concerns over how to manage this behaviour in the community. The aim of this study was to assess changes in aggressive challenging behaviour and psychotropic drug use in adults with ID following resettlement using a person‐centred approach.

Method  The Modified Overt Aggression Scale was administered to carers of 49 adults with ID prior to discharge from a long‐stay hospital and 6 months and 1 year after community resettlement.

Results  All areas of aggressive challenging behaviour reduced significantly between baseline and 6 months following resettlement (P < 0.001). This reduction remained (but did not decrease further) at 1‐year follow‐up.

Conclusions  Further work is needed to evaluate the role of environmental setting on aggressive challenging behaviour in adults with ID.
Inhibition of cytochrome P450 activity enhances the systemic availability of triclabendazole metabolites in sheep
Authors: VIRKEL G. , LIFSCHITZ A. , SALLOVITZ J. , BALLENT M. , SCARCELLA S. , LANUSSE C.
Published: August 2008

Understanding the disposition kinetics and the pattern of metabolism is critical to optimise the flukicidal activity of triclabendazole (TCBZ) in ruminants. TCBZ is metabolised by both flavin‐monooxygenase (FMO) and cytochrome P450 (P450) in the liver. Interference with these metabolic pathways may be useful to increase the systemic availabilities of TCBZ metabolites, which may improve the efficacy againstFasciola hepatica. The plasma disposition of TCBZ metabolites was evaluated following TCBZ co‐administration with FMO [methimazole (MTZ)] and P450 [piperonyl butoxyde (PB) and ketoconazole (KTZ)] inhibitors in sheep. Twenty (20) healthy Corriedale x Merino weaned female lambs were randomly allocated into four experimental groups. Animals of each group were treated as follow: Group A, TCBZ alone (5 mg/kg, IV route); Group B, TCBZ (5 mg/kg, IV) + MTZ (3 mg/kg, IV); Group C, TCBZ (5 mg/kg, IV) + PB (30 mg/kg, IV) and Group D, TCBZ (5 mg/kg, IV) + KTZ (10 mg/kg, orally). Blood samples were taken over 240 h post‐treatment and analysed by HPLC. TCBZ sulphoxide and sulphone were the main metabolites recovered in plasma. MTZ did not affect TCBZ disposition kinetics. TCBZ sulphoxide Cmax values were significantly increased (P < 0.05) after the TCBZ + PB (62%) and TCBZ + KTZ (37%) treatments compared to those measured in the TCBZ alone treatment. TCBZ sulphoxide plasma AUCs were higher (P < 0.05) in the presence of both PB (99%) and KTZ (41%). Inhibition of TCBZ P450‐mediated oxidation in the liver accounted for the increased systemic availability of its active metabolite TCBZ sulphoxide. This work contributes to the search of different strategies to improve the use of this flukicidal drug in ruminants.
Functional characterization of the muscarinic receptors involved in endothelium‐dependent relaxation in isolated canine uterine artery
Authors: PESIC S. , GRBOVIC L. , STOILJKOVIC M. , NIKOLIC V. , DJOKIC J.
Published: August 2008

Acetylcholine interacts with endothelial muscarinic receptors releasing nitric oxide and causing vasodilatation. To identify the receptor subtype responsible for acetylcholine‐induced relaxation in canine uterine artery, the usual organ bath method forin vitroinvestigation on isolated blood vessels was applied. Using a range of muscarinic receptor antagonists such as atropine (nonselective), pirenzepine (M1‐selective), methoctramine (M2‐selective) andp‐fluoro‐hexahydro‐sila‐difenidol (p‐FHHSiD) (M1/M3) and determining pA2 value of those antagonists through Shild analysis, we aimed at establishing a precise receptor mechanism underlying acetylcholine‐induced relaxation in isolated canine uterine artery. The relaxation of uterine arterial rings in response to acetylcholine in the presence or absence of selective muscarinic receptors antagonists was calculated using concentration response curves. Acetylcholine induced concentration‐dependent and endothelium‐dependent relaxation of arterial rings precontracted with phenylephrine (pEC50 = 6.90 ± 0.02). Muscarinic receptors antagonists atropine, pirenzepine, methoctramine andp‐FHHSiD competitively antagonized the response to acetylcholine and obtained pA2values were 9.91 ± 0.06, 6.60 ± 0.04, 6.21 ± 0.08 and 8.05 ± 0.1, respectively. This study showed that acetylcholine induced endothelium‐dependent relaxation of canine uterine artery by stimulation of muscarinic receptors localized on the endothelial cells. On the basis of differential antagonist affinity, we suggest that the muscarinic receptors involved in the acetylcholine‐induced relaxation of canine uterine artery are predominantly of M3subtype.
Genetically monomorphic invasive populations of the rapa whelk, Rapana venosa
Authors: CHANDLER E. A , McDOWELL J. R , GRAVES J. E
Published: August 2008

Rapana venosa is a predatory marine gastropod native to the coastal waters of China, Korea, and Japan. Since the 1940s, R. venosa has been transported around the globe and introduced populations now exist in the Black Sea, the Mediterranean Sea, the Adriatic and Aegean seas, off the coasts of France and the Netherlands, in Chesapeake Bay, Virginia, USA, and in the Rio de la Plata between Uruguay and Argentina. This study surveyed variation in two mitochondrial gene regions to investigate the invasion pathways of R. venosa, identify likely sources for introduced populations, and evaluate current hypotheses of potential transportation vectors. Sequence data were obtained for the mitochondrial cytochrome c oxidase I and NADH dehydrogenase subunit 2 gene regions of 178 individuals from eight native locations and 106 individuals from 12 introduced locations. Collections from within the native range displayed very high levels of genetic variation while collections from all introduced populations showed a complete lack of genetic diversity; a single haplotype was common to all introduced individuals. This finding is consistent with the hypothesis that R. venosa was initially introduced into the Black Sea, and this Black Sea population then served as a source for the other secondary invasions by various introduction vectors including ballast water transport. Although non‐native R. venosa populations currently appear to be thriving in their new environments, the lack of genetic variability raises questions regarding the evolutionary persistence of these populations.
Transcutaneous electroacupuncture improves dyspeptic symptoms and increases high frequency heart rate variability in patients with functional dyspepsia
Authors: Liu S. , Peng S. , Hou X. , Ke M. , Chen J. D. Z.
Published: August 2008

Abstract  The aim of the study was to evaluate the therapeutic value and possible mechanisms of transcutaneous electroacupuncture (TEA) in a double‐blind and cross‐over study in patients with functional dyspepsia (FD). Twenty‐seven patients with FD were enrolled and the study consisted of two parts: (i) acute effects of TEA at PC6 and ST36 on gastric slow waves and heart rate variability and (ii) chronic (2 weeks) effects of TEA at PC6 and ST36 on dyspepsia symptoms, gastric slow waves, heart rate variability and neuropeptide Y (NPY) and motilin. The results of this study are: (i) The dyspepsia symptom score was decreased by 55% at the end of chronic TEA and the improvement was significant (P < 0.01); (ii) the high frequency (HF) assessed from the spectral analysis of heart rate variability was markedly increased with both acute TEA (76% increase, P = 0.01) and chronic TEA (75% increase, P = 0.025); (iii) gastric slow waves were not altered by either acute or chronic TEA; and (iv) the plasma level of NPY but not motilin was increased after chronic TEA. Non‐invasive and needleless transcutaenous electroacupuncture at ST36 and PC6 markedly improves dyspepsia symptoms and the improvement may be associated with the increase in HF heart rate variability and the modulation of NPY.
The Arabidopsis transcription factor WRKY27 influences wilt disease symptom development caused by Ralstonia solanacearum
Authors: Mukhtar M. Shahid , Deslandes Laurent , Auriac Marie‐Christine , Marco Yves , Somssich Imre E.
Published: August 2008

WRKY transcription factors play a key role in modulating the plant defense transcriptome. Here we show that the Arabidopsis mutant wrky27‐1, which lacks a functional WRKY27 transcription factor, showed delayed symptom development in response to the bacterial wilt pathogen Ralstonia solanacearum. Additionally, wrky27‐1 plants did not express PR marker genes upon infection, as also observed in resistant Nd‐1 plants. Spatial expression of WRKY27 correlated well with the route of bacterial infection and propagation in planta. Complementation experiments restored both the early wilting phenotype of wild‐type Col‐1 plants and activation of PR genes, not only when the WRKY27 cDNA is expressed under the control of the native promoter, but also when the SUC2 promoter was used, suggesting that WRKY27 exerts its function in phloem companion cells. Expression studies identified genes involved in nitrogen metabolism and nitric oxide (NO) generation as potential targets of negative regulation by WRKY27. Our results show that WRKY27 negatively influences symptom development of a vascular pathogen, possibly by affecting signaling or trafficking between the phloem and the xylem.
Detoxification of the explosive 2,4,6‐trinitrotoluene in Arabidopsis: discovery of bifunctional O‐ and C‐glucosyltransferases
Authors: Gandia‐Herrero Fernando , Lorenz Astrid , Larson Tony , Graham Ian A. , Bowles Dianna J. , Rylott Elizabeth L. , Bruce Neil C.
Published: August 2008

Plants, as predominantly sessile organisms, have evolved complex detoxification pathways to deal with a diverse range of toxic chemicals. The elasticity of this stress response system additionally enables them to tackle relatively recently produced, novel, synthetic pollutants. One such compound is the explosive 2,4,6‐trinitrotoluene (TNT). Large areas of soil and groundwater are contaminated with TNT, which is both highly toxic and recalcitrant to degradation, and persists in the environment for decades. Although TNT is phytotoxic, plants are able to tolerate low levels of the compound. To identify the genes involved in this detoxification process, we used microarray analysis and then subsequently characterized seven uridine diphosphate (UDP) glycosyltransferases (UGTs) from Arabidopsis thaliana (Arabidopsis). Six of the recombinantly expressed UGTs conjugated the TNT‐transformation products 2‐ and 4‐hydroxylaminodinitrotoulene, exhibiting individual bias for either the 2‐ or the 4‐isomer. For both 2‐ and 4‐hydroxylaminodinitrotoulene substrates, two monoglucose conjugate products, confirmed by HPLC‐MS‐MS, were observed. Further analysis indicated that these were conjugated by either an O‐ or C‐glucosidic bond. The other major compounds in TNT metabolism, aminodinitrotoluenes, were also conjugated by the UGTs, but to a lesser extent. These conjugates were also identified in extracts and media from Arabidopsis plants grown in liquid culture containing TNT. Overexpression of two of these UGTs, 743B4 and 73C1, in Arabidopsis resulted in increases in conjugate production, and enhanced root growth in 74B4 overexpression seedlings. Our results show that UGTs play an integral role in the biochemical mechanism of TNT detoxification by plants.