bluuebunny/crossref_metadata_2025 huggingface dataset:
Low abundance and probable decline of the critically endangered Maui's dolphin estimated by genotype capture–recapture
Authors: Baker C. S. , Hamner R. M. , Cooke J. , Heimeier D. , Vant M. , Steel D. , Constantine R.
Published: August 2012

The New Zealand endemic Maui's dolphin (Cephalorhynchus hectori maui) is considered ‘critically endangered’ by the International Union for the Conservation of Nature as a result of decline due, in part, to fisheries‐related mortalities. To estimate the abundance and trends of this subspecies, we used open‐population capture–recapture models based on microsatellite genotyping of living and beachcast (dead) dolphins sampled between January 2001 and November 2007. A total of 82 genetic samples were available: 70 biopsy samples collected from living Maui's dolphins and 12 necropsy samples collected from beachcast or floating carcasses, of which five showed evidence of fisheries entanglement. Microsatellite genotyping of up to 14 loci identified 54 individuals; 42 sampled alive on one or more occasions, one sampled alive, then found beachcast 2 years later, and 11 sampled only as carcasses, including two neonates. The sex ratio of the sample did not differ significantly from unity (25 males: 29 females). Using a POPAN model for live capture records, the abundance of the super population available during the multiyear study was estimated to be N = 87 [95% (confidence limits) CL, 59–158]. Using a Pradel‐like model modified to include both live capture and beachcast records, the abundance of the population was estimated to be N = 69 (95% CL, 38–125) for the midpoint of the study in 2003. The results of both models suggested that the population was likely to be declining across the study period, although this trend could not be confirmed with 95% confidence. As the genotypes provide permanent marks of individual identity, continued genetic monitoring could provide improved confidence in the abundance and trends of this subspecies.
Gene expression indicates a zone of heterocyst differentiation within the thallus of the cyanolichen Pseudocyphellaria crocata
Authors: Chua Jocelyn P. S. , Wallace Emma J. S. , Yardley Jessica A. , Duncan Elizabeth J. , Dearden Peter K. , Summerfield Tina C.
Published: August 2012

Development of the symbiotic association in the bipartite lichen Pseudocyphellaria crocata was investigated by characterizing two regions of the thallus.

Thallus organization was examined using microscopy. A HIP1‐based differential display technique was modified for use on Nostoc strains, including lichenized strains. Northern hybridization and quantitative real‐time polymerase chain reaction were used to confirm differential display results, and determine expression levels of key cyanobacterial genes. Photosystem II yield across the thallus was measured using pulse‐amplitude modulated fluorescence.

Microscopy revealed structural differences in the thallus margins compared with the centre and identified putative heterocysts in both regions. Differential display identified altered transcript levels in both Nostoc punctiforme and a lichenized Nostoc strain. Transcript abundance of cox2, atpA, and ribA was increased in the thallus margin compared with the centre. Expression of cox2 is heterocyst specific and expression of other heterocyst‐specific genes (hetR and nifK) was elevated in the margin, whereas, expression of psbB and PSII yield were not.

Structural organization of the thallus margin differed from the centre. Both regions contained putative heterocysts but gene expression data indicated increased heterocyst differentiation in the margins where photosystem II yield was decreased. This is consistent with a zone of heterocyst differentiation within the thallus margin.
Significant genetic and phenotypic changes arising from clonal growth of a single spore of an arbuscular mycorrhizal fungus over multiple generations
Authors: Ehinger Martine O. , Croll Daniel , Koch Alexander M. , Sanders Ian R.
Published: August 2012

Arbuscular mycorrhizal fungi (AMF) are highly successful plant symbionts. They reproduce clonally producing multinucleate spores. It has been suggested that some AMF harbor genetically different nuclei. However, recent advances in sequencing the Glomus irregulare genome have indicated very low within‐fungus polymorphism.

We tested the null hypothesis that, with no genetic differences among nuclei, no significant genetic or phenotypic variation would occur among clonal single spore lines generated from one initial AMF spore. Furthermore, no additional variation would be expected in the following generations of single spore lines.

Genetic diversity contained in one initial spore repeatedly gave rise to genetically different variants of the fungus with novel phenotypes. The genetic changes represented quantitative changes in allele frequencies, most probably as a result of changes in the frequency of genetic variation partitioned on different nuclei.

The genetic and phenotypic variation is remarkable, given that it arose repeatedly from one clonal individual. Our results highlight the dynamic nature of AMF genetics. Even though within‐fungus genetic variation is low, some is probably partitioned among nuclei and potentially causes changes in the phenotype. Our results are important for understanding AMF genetics, as well as for researchers and biotechnologists hoping to use AMF genetic diversity for the improvement of AMF inoculum.
The human being’s spiritual experiences in a mental healthcare context; their positive and negative meaning and impact on health – a hermeneutic approach
Authors: Koslander Tiburtius , Lindström Unni Å. , Barbosa da Silva António
Published: August 2012

The study aims at describing different meanings of patients’ spiritual experiences and their impact on patients’ health in mental healthcare. The different contents of patients’ spiritual experiences are often understood by caregivers as the expressions of patients’ religious speculation. The study has a hermeneutic approach, inspired by Gadamer. Its theoretical pre‐understanding is Caring Science perspective, according to which the human being is a unity of body, psyche and spirit. The sources are 32 stories selected from William James’ book (1956) The Varieties of Religious Experience. They are hermeneutically interpreted and discussed in the light of international research on patients’ spirituality to gain a deeper understanding. The results are three main themes: (i) the positive meanings of spirituality, (ii) the negative meanings of spirituality and (iii) the both negative and positive meaning of spirituality. Therefore, it is a very important task for mental caregivers to address patients’ spiritual dimension to help them adequately.
Emotional geographies of enthusiasm: belonging to the Telecommunications Heritage Group
Authors: Geoghegan Hilary
Published: August 2012

Enthusiasm has long been associated with notions of impassioned mood, intensity of feeling and passionate dedication. Despite this burgeoning field of ‘enthusiastic geographies’, the conceptualisation of enthusiasm has until now remained largely untouched by geographers. This article develops recent work on emotional geographies in order to shed light on the emergence, experience and spatial implications of enthusiasm in group settings. It draws upon interview material with members of the UK’s Telecommunications Heritage Group in order to examine enthusiasm as an emotional affiliation. It is argued in this article that enthusiasm influences passions, performances and actions in space, revealing the mutual ‘closeness’, exclusivity of knowledgeability and sociability among participants.
Nation, ‘migration’ and critical practice
Authors: Bauder Harald
Published: August 2012

Scholarship on human mobility typically references ‘migration’ uncritically in the concept of the territorial nation‐state. This scholarly practice is problematic because it understates human mobility and ‘migrant’ identities at non‐national scales, reproduces the nation‐state as an ontological category vis‐à‐vis human mobility, and stifles the imagination of mobility in ways that are de‐linked from the territorial nation‐state. In this article, I build on the existing literature in geography and other disciplines to first elaborate on the link between ‘migration’ and the nation‐state in research on human mobility. Then, I destabilise this link by exploring the contradictions of the role of ‘migration’ in contemporary settler societies and ethnic nations, and by discussing the examples of No Border politics and recent feminist writing on the global intimate. Finally, I illustrate how critical practice can engage in the formation of new subject identities and facilitate transformative action.
Early nutritional support is associated with decreased length of hospitalization in dogs with septic peritonitis: A retrospective study of 45 cases (2000–2009)
Authors: Liu Debra T. , Brown Dorothy C. , Silverstein Deborah C.
Published: August 2012

Objective

To determine whether the timing and route of nutritional support strategy affect length of hospitalization in dogs with naturally occurring septic peritonitis.

Design

Retrospective study encompassing cases from 2000 to 2009.

Setting

University teaching hospital.

Animals

Forty‐five dogs that survived septic peritonitis.

Interventions

None.

Measurements and Main Results

Nutritional strategy for each dog was categorized as either enteral nutrition (EN: free choice voluntary eating or assisted tube feeding) or central parenteral nutrition (CPN). Early nutritional support was defined as consistent caloric intake initiated within 24 hours postoperatively. Consistent caloric intake occurring after 24 hours was defined as delayed nutritional support. Data reflective of nutritional status included body condition score, serum albumin concentration, and duration of inappetence before and during hospitalization. Body weight change from the beginning to the end of hospitalization was calculated. A modified Survival Prediction Index 2 score was calculated for each dog at admission. Additional clinical data recorded for comparison of illness severity included indicators of severe inflammation (eg, presence of toxic changes in neutrophils and immature neutrophils), coagulopathy (eg, prolonged prothrombin time and activated partial thromboplastin time), the use of vasopressors and blood transfusions, and presence of concurrent illnesses. Nutrition‐related complications were classified as mechanical, metabolic, or septic complications. Multivariate linear regression analyses were used to determine the relationship of nutritional strategy with hospitalization length, while considering the presence of nutrition‐related complications, the nutritional status‐ and illness severity‐related variables. While controlling for other variables, dogs that received early nutrition had significantly shorter hospitalization length (by 1.6 days). No statistically significant association was found between route of nutrition and hospitalization length. The presence of concurrent illnesses and nutrition‐related metabolic complications were also associated with longer hospitalization length (by 2.1 and 2.4 days, respectively).

Conclusion

Early nutritional support in dogs with septic peritonitis is associated with a shorter hospitalization length.
Assessment of acute moderate hyperglycemia on traditional and thromboelastometry coagulation parameters in healthy adult horses
Authors: McGovern Kate F. , Lascola Kara M. , Smith Stephanie A. , Clark‐Price Stuart C. , McMichael Maureen , Wilkins Pamela A.
Published: August 2012

Objective

To determine whether experimentally induced acute moderate hyperglycemia is associated with coagulation activation in healthy adult horses.

Design

Prospective experimental study.

Setting

University veterinary teaching hospital.

Animals

Six healthy adult horses.

Interventions

Hyperglycemia (10.0–13.3 mmol/L [180–240 mg/dL]) was induced and maintained for 6 hours using a hyperglycemic clamp technique. Blood glucose concentrations were assessed using a point of care (POC) glucometer at 10‐ and 20‐minute intervals throughout the hyperglycemic clamp procedure. Platelet count, fibrinogen concentration, prothrombin time (PT), activated partial thromboplastin time (aPTT), thrombin antithrombin complex level (TAT), and thromboelastometry (TEM) were determined before and after jugular catheter placement, prior to glucose administration, and at 3 and 6 hours of sustained hyperglycemia. Data were analyzed by repeated measures analysis of variance with significance defined as P < 0.05.

Measurements and Main Results

All horses maintained blood glucose concentration >10.0 mmol/L (>180 mg/dL) throughout the duration of the hyperglycemic clamp with a mean concentration of 11.9 ± 0.3 mmol/L [216 ± 6 mg/dL] as measured by the POC glucometer. No significant difference was found for any evaluated parameter associated with sustained hyperglycemia. Intravenous catheter placement resulted in a significant increase in mean TAT (0.8 ± 0.3 μg/L pre‐catheter, 2.3 ± 0.8 μg/L post‐catheter; P = 0.008).

Conclusions

Acute, moderate hyperglycemia in healthy adult horses does not have a detectable effect on coagulation based on evaluated parameters. Jugular catheter placement results in a transient increase in thrombin generation as determined by increased TAT concentrations.
4α‐phorbol 12,13‐didecanoate activates cultured mouse dorsal root ganglia neurons independently of TRPV4
Authors: Alexander R , Kerby A , Aubdool AA , Power AR , Grover S , Gentry C , Grant AD
Published: August 2012

Background and Purpose

The Ca2+‐permeable cation channel TRPV4 is activated by mechanical disturbance of the cell membrane and is implicated in mechanical hyperalgesia. Nerve growth factor (NGF) is increased during inflammation and causes mechanical hyperalgesia. 4α‐phorbol 12,13‐didecanoate (4αPDD) has been described as a selective TRPV4 agonist. We investigated NGF‐induced hyperalgesia in TRPV4 wild‐type (+/+) and knockout (–/–) mice, and the increases in [Ca2+]i produced by 4αPDD in cultured mouse dorsal root ganglia neurons following exposure to NGF.

Experimental Approach

Withdrawal thresholds to heat, von Frey hairs and pressure were measured in mice before and after systemic administration of NGF. Changes in intracellular Ca2+ concentration were measured by ratiometric imaging with Fura‐2 in cultured DRG and trigeminal ganglia (TG) neurons during perfusion of TRPV4 agonists.

Key Results

Administration of NGF caused a significant sensitization to heat and von Frey stimuli in TRPV4 +/+ and –/– mice, but only TRPV4 +/+ mice showed sensitization to noxious pressure. 4αPDD stimulated a dose‐dependent increase in [Ca2+]i in neurons from +/+ and –/– mice, with the proportion of responding neurons and magnitude of increase unaffected by the genotype. In contrast, the selective TRPV4 agonist GSK1016790A failed to stimulate an increase in intracellular Ca2+ in cultured neurons. Responses to 4αPDD were unaffected by pretreatment with NGF.

Conclusions and Implications

TRPV4 contributes to mechanosensation in vivo, but there is little evidence for functional TRPV4 in cultured DRG and TG neurons. We conclude that 4αPDD activates these neurons independently of TRPV4, so it is not appropriate to refer to 4αPDD as a selective TRPV4 agonist.
The role of Transjugular Intrahepatic Portosystemic Stent‐Shunt (TIPSS) in the management of variceal hemorrhage
Authors: Corbett Chris , Mangat Kamarjit , Olliff Simon , Tripathi Dhiraj
Published: August 2012

Background

Variceal bleeding in cirrhosis represents a lethal complication of their disease. In the last 20 years, management of AVH has improved greatly with reduction in mortality from 43% in 1980 to 15% in 2000.

Aim

Advances in endoscopic therapy, pharmacologic agents including vasoconstrictor therapy and antibiotics have played a large part in improving outcomes, but the role of Transjugular Intrahepatic Portosystemic Stent‐Shunt (TIPSS) remains controversial, which this review will cover.

Methods

MEDLINE search for the following terms was performed to July 2011: variceal hemorrhage, portal hypertension, cirrhosis, transjugular intrahepatic portosystemic stent‐shunt (TIPSS), PTFE, covered stents. Where possible randomized controlled studies were used for this review, although uncontrolled studies were also included if they made a significant contribution to the literature.

Results

Literature used for the present study was selected from a total of 252 publications and abstracts from meetings.

Results

TIPSS has been used as a salvage therapy after initial medical and endoscopic therapy for the bleed given its high success rate in arresting uncontrolled variceal bleeding. The recent trial by Garcia‐ Pagan et al. suggested beneficial effects of an earlier covered TIPSS in those at high risk of treatment failure (Childs C and those who are Childs B with active bleeding).

Conclusions

TIPSS can reduce failure to control bleeding and rebleeding as well as mortality with no increase in the risk of hepatic encephalopathy.This needs to be confirmed in further trials. However, it is clear that prevention of rebleeding is the key to improved outcomes following a variceal bleed.
Herbal hepatotoxicity: a tabular compilation of reported cases
Authors: Teschke Rolf , Wolff Albrecht , Frenzel Christian , Schulze Johannes , Eickhoff Axel
Published: August 2012

Background

Herbal hepatotoxicity is a field that has rapidly grown over the last few years along with increased use of herbal products worldwide.

Aims

To summarize the various facets of this disease, we undertook a literature search for herbs, herbal drugs and herbal supplements with reported cases of herbal hepatotoxicity.

Methods

A selective literature search was performed to identify published case reports, spontaneous case reports, case series and review articles regarding herbal hepatotoxicity.

Results

A total of 185 publications were identified and the results compiled. They show 60 different herbs, herbal drugs and herbal supplements with reported potential hepatotoxicity, additional information including synonyms of individual herbs, botanical names and cross references are provided. If known, details are presented for specific ingredients and chemicals in herbal products, and for references with authors that can be matched to each herbal product and to its effect on the liver. Based on stringent causality assessment methods and/or positive re‐exposure tests, causality was highly probable or probable for Ayurvedic herbs, Chaparral, Chinese herbal mixture, Germander, Greater Celandine, green tea, few Herbalife products, Jin Bu Huan, Kava, Ma Huang, Mistletoe, Senna, Syo Saiko To and Venencapsan®. In many other publications, however, causality was not properly evaluated by a liver‐specific and for hepatotoxicity‐validated causality assessment method such as the scale of CIOMS (Council for International Organizations of Medical Sciences).

Conclusions

This compilation presents details of herbal hepatotoxicity, assisting thereby clinical assessment of involved physicians in the future.
In the Literature: Dispelling Hallucinations About Birthweight: How Hard Is It?
Authors: Keirse Marc J.N.C. , Master Mandana , Plutzer Kamila
Published: August 2012

Birthweight is an important determinant of perinatal outcome and future health well into adulthood. Before weighing newborn infants became enshrined in practice, birthweights tended to be based on an educated guess or, as alleged by Roederer in 1753, on hallucination. Two centuries later, they led to a Babylonic confusion between weight and maturity at birth. Even nowadays, hallucinations about birthweight and its effect on infant health have not entirely disappeared. New hallucinations still emerge and remain as difficult to dispel as they once were. (BIRTH 39:3 September 2012)
Seizure recurrence and remission after switching antiepileptic drugs
Authors: Wang Sophia Pan , Mintzer Scott , Skidmore Christopher T. , Zhan Tingting , Stuckert Erika , Nei Maromi , Sperling Michael R.
Published: August 2012

Purpose:  Studies of seizure outcome in patients undergoing serial antiepileptic drug trials have all been uncontrolled, with no account made for the spontaneous changes in disease state that could confound the elucidation of drug effects. In addition, no study has ever looked at outcome following antiepileptic drug switch in seizure‐free patients, despite the fact that this is done routinely in clinical practice. We aimed to address both of these issues using a matched case‐cohort design.

Methods:  We followed patients taking phenytoin or carbamazepine in monotherapy for focal epilepsy who were being crossed over to a newer agent as part of studies on the metabolic effects of anticonvulsant therapy. Many had been seizure‐free but were being switched nonetheless due to side effects or concerns about long‐term adverse consequences. Each patient was matched with two controls of the same seizure status who were taking anticonvulsant monotherapy and whose drug was not switched. Seizure freedom over the ensuing 6 months was the primary end point.

Key Findings:  There were 43 cases and 86 matched controls. Twenty‐three patients (cases) had been seizure‐free on their old drug; 5 (21.7%) had seizure recurrence after drug switch compared to 2 (4.3%) of 46 matched controls. Twenty patients (cases) were having seizures on their old drug; 6 (30%) entered remission after drug switch, compared to 8 of 40 matched controls (20%). The two groups differed at baseline in number of anticonvulsants previously failed, which was the most important factor for prognosis. After statistical adjustment to account for this, seizure‐free patients had 6.53 times higher odds of seizure recurrence if switched to a new drug (95% confidence interval [CI] 1.02–61.19; p = 0.06). Non–seizure‐free patients had 1.66 times higher odds of remission if they remained on the same drug compared to switching, although this was not significant (95% CI 0.36–8.42; p = 0.532). Neither dose changes, nor drug mechanism, nor duration of seizure freedom had any bearing upon the results.

Significance:  Although the large majority of seizure‐free patients remain so when switched to another agent, about one sixth have a recurrence attributable to the change. Conversely, our study design provides the first evidence to suggest that most improvements in drug‐resistant patients are likely due to spontaneous remissions, not new drug introductions. These findings have conflicting implications for two competing models of comparative antiepileptic drug efficacy, which will require further study to elaborate.
Testing for minimal consciousness in complex partial and generalized tonic–clonic seizures
Authors: McPherson Alison , Rojas Leticia , Bauerschmidt Andrew , Ezeani Celestine C. , Yang Li , Motelow Joshua E. , Farooque Pue , Detyniecki Kamil , Giacino Joseph T. , Blumenfeld Hal
Published: August 2012

Impaired consciousness in epilepsy has a major negative impact on quality of life. Prior work suggests that complex partial seizures (CPS) and generalized tonic–clonic seizures (GTCS), which both cause loss of consciousness, affect similar frontoparietal networks. Milder involvement in CPS than in GTCS may spare some simple behavioral responses, resembling the minimally conscious state. However, this difference in responses has not been rigorously tested previously. During video–electroencephalography (EEG) monitoring, we administered a standardized prospective testing battery including responses to questions and commands, as well as tests for reaching/grasping a ball and visual tracking in 27 CPS (in 14 patients) and 7 GTCS (in six patients). Behavioral results were analyzed in the ictal and postictal periods based on video review. During both CPS and GTCS, patients were unable to respond to questions or commands. However, during CPS, patients often retained minimally conscious ball grasping and visual tracking responses. Patients were able to successfully grasp a ball in 60% or to visually track in 58% of CPS, and could carry out both activities in 52% of CPS. In contrast, during GTCS, preserved ball grasp (10%), visual tracking (11%), or both (7%), were all significantly less than in CPS. Postictal ball grasping and visual tracking were also somewhat better following CPS than GTCS. These findings suggest that impaired consciousness in CPS is more similar to minimally conscious state than to coma. Further work may elucidate the specific brain networks underlying relatively spared functions in CPS, ultimately leading to improved treatments aimed at preventing impaired consciousness.
Uncertain Benefits Estimates for Reductions in Fine Particle Concentrations
Authors: Fraas Art , Lutter Randall
Published: August 2012

The Environmental Protection Agency's (EPA's) estimates of the benefits of improved air quality, especially from reduced mortality associated with reductions in fine particle concentrations, constitute the largest category of benefits from all federal regulation over the last decade. EPA develops such estimates, however, using an approach little changed since a 2002 report by the National Research Council (NRC), which was critical of EPA's methods and recommended a more comprehensive uncertainty analysis incorporating probability distributions for major sources of uncertainty. Consistent with the NRC's 2002 recommendations, we explore alternative assumptions and probability distributions for the major variables used to calculate the value of mortality benefits. For metropolitan Philadelphia, we show that uncertainty in air quality improvements and in baseline mortality have only modest effects on the distribution of estimated benefits. We analyze the effects of alternative assumptions regarding the value of reducing mortality risk, whether the toxicity is above or below the average for fine particles, and whether there is a threshold in the concentration‐response relationship, and show these assumptions all have large effects on the distribution of benefits.
Increased oxidative stress in foam cells obtained from hemodialysis patients
Authors: Gonçalves Marlene S. B. , Fabris Bruno A. , Brinholi Francis F. , Bortolasci Chiara C. , Watanabe Maria A. E. , Oliveira Karen B. , Delfino Vinícius D. A. , Lavado Edson L. , Barbosa Décio S.
Published: August 2012

Premature atherosclerosis represents the main cause of mortality among end‐stage renal disease patients (ESRD). Increased inflammation and oxidative stress are involved in initiation and progression of the atherosclerotic plaque. As foam cells are capable of producing significant amounts of inflammatory mediators and free radicals, we hypothesized that foam cells from uremic patients could produce more inflammation and oxidative stress than foam cells from normal people and be, somehow, involved in the accelerated atherosclerosis of uremia. To test this hypothesis, the levels of a few markers of inflammation and oxidative stress: Tumor necrosis factor‐α, inducible nitric oxide synthase, malondialdehyde, nitric oxide by‐products were measured in the supernatants of macrophage‐derived foam cells cultures from 18 hemodialysis patients and 18 apparently healthy individuals controls. Malondialdehyde levels in the supernatant of cell cultures (macrophages stimulated or not with native and oxidized lipoprotein) were significantly increased in uremic patients; no statistically significant difference was found between the supernatant concentrations of nitric oxide by‐products, inducible nitric oxide synthase activity, and tumor necrosis factor‐α between patients and controls. Our results, obtained with human macrophages and macrophage‐derived foam cells, are compatible with the theory that increased cellular oxidative stress and inflammatory activity in ESRD patients could accelerate the atherosclerotic process. The present culture protocol showed it is possible to use human mononuclear cells to evaluate the oxidative metabolism of foam cells, which are considered to be the initial step of atherosclerotic lesions.
Combination hemodialysis and centrifugal therapeutic plasma exchange: 18 years of Canadian experience
Authors: Farah Myriam , Levin Adeera , Kiaii Mercedeh , Vickars Linda , Werb Ron
Published: August 2012

Hemodialysis (HD) and therapeutic plasma exchange (TPE) are extracorporeal treatments that may both be required in the same patient. When provided separately, 7–8 hours of therapy time is required. Simultaneous administration of both therapies can reduce time and personnel requirements. We report our 18‐year institutional experience with combination HD and centrifugal TPE therapy. During combination therapy, the TPE circuit is attached to the HD circuit through an extension blood line connected to the HD venous return line, allowing simultaneous operation of both circuits. The HD circuit is anticoagulated with heparin and the TPE circuit with regional citrate. Blood flow rates through the HD circuit can reach 350 mL/min with plasma removal rates in the TPE circuit up to 60 mL/min. Ninety‐two patients received a total of 621 treatments between December 1993 and July 2011. All treatments were completed within 4 hours. No major treatment‐related adverse events occurred and less than 10% of treatments were complicated by minor events. Main indications for treatment were ANCA (anti‐neutrophilic cytoplasmic antibody) vasculitis (n = 25), Goodpasture's/antiglomerular basement membrane disease (n = 24), adult thrombotic thrombocytopenic purpura/hemolytic uremic syndrome (n = 24), and acute antibody‐mediated renal transplant rejection (n = 8). Overall rates of renal recovery, in‐hospital mortality, and overall mortality at 18‐year follow‐up were 45% (41/ 92), 2% (2/92), and 21% (19/ 92), respectively, compatible with published literature. Combination HD and TPE is safe, efficient, and requires less human resources and time than conventional sequential therapy. It should be considered in patients whose treatment regimen includes HD and TPE.
Stability of Serotonin‐Selective Antidepressants in Sterile and Decomposing Liver Tissue,
Authors: Butzbach Danielle M. , Stockham Peter C. , Kobus Hilton J. , Sims D. Noel , Byard Roger W. , Lokan Robert J. , Walker G. Stewart
Published: August 2012

It is well established that bacteria are capable of degrading selected drugs during decomposition. The aim of this study was to investigate the stability of several serotonin‐selective reuptake inhibitor antidepressants and venlafaxine during putrefaction in porcine liver macerate inoculated with porcine cecal contents rich in bacteria. Blank liver matrices, sterile liver macerates, and sterile aqueous controls were included with the experiment performed for 57 days at 20°C under anaerobic conditions. A liquid chromatography/mass spectrometry method was developed for quantitative determination of the drugs investigated in both sterile and decomposed liver matrices. The method was found to encounter matrix effects not detected during the validation stage. Citalopram, paroxetine, sertraline, venlafaxine, and fluoxetine were found to be stable under the experimental conditions; however, fluvoxamine was found to be decreased by c. 50% over 57 days in bacterially inoculated liver macerate. This study suggests that fluvoxamine concentrations in cases with evidence of decomposition/putrefaction should be interpreted with extra caution.
Influence of dietary factors, age and nickel contact dermatitis on nickel excretion
Authors: Darsow Ulf , Fedorov Michael , Schwegler Ursula , Twardella Dorothee , Schaller Karl‐Heinz , Habernegg Renate , Fromme Hermann , Ring Johannes , Behrendt Heidrun
Published: August 2012

Background. Nickel is a frequently detected cause of allergic contact dermatitis. Ingestion of nickel may lead to flares of nickel contact dermatitis.

Methods. We examined nickel excretion in the urine of 164 female patients with and without nickel contact dermatitis. The associations between age, atopic dermatitis, nickel contact dermatitis and nickel exposure through nutrition (e.g. dietary supplements) and by patch tests were investigated prospectively. Nickel was measured with atomic absorption spectrometry with two different standardized methods.

Results. A nickel detection limit of 0.2 µg/l was exceeded by all samples. The 95th percentiles of urine nickel concentration were 3.77 µg/l (age 18–30 years) and 3.98 µg/l (age 31–46 years). Bivariate analyses pointed to significantly increased nickel excretion with increasing age, ingestion of dietary supplements, drinking of stagnant tap water, and consumption of nickel‐rich food. In the multivariate analysis, age and dietary supplements remained significant predictors of high nickel excretion. A non‐significant increase in the median concentration of nickel was observed after the administration of conventional nickel patch tests. Patients with atopic eczema showed urine nickel concentrations similar to those in non‐atopic controls.

Conclusions. The 95th percentile of nickel excretion in our study population markedly exceeded the actual reference value of 3 µg/l. Age and consumption of dietary supplements are the most important predictors. The use of stagnant tap water and consumption of nickel‐rich food contribute to the total load. These factors should be explicitly mentioned when allergic patients on a low‐nickel diet are counselled. In contrast, existing nickel contact sensitization was not more frequent in subjects with higher nickel excretion. Nickel patch testing may cause transient minor systemic nickel exposure. The findings of this study extend our understanding and management of factors associated with nickel allergy.
Interacting effect of BDNF Val66Met polymorphism and stressful life events on adolescent depression
Authors: Chen J. , Li X. , McGue M.
Published: August 2012

There is a strong etiological link between brain‐derived neurotrophic factor and depression, but the neurocellular mechanisms and gene–environment interactions remain obscure. This study investigated whether one functional polymorphism in the brain‐derived neurotrophic factor gene (BDNF Val66Met) modulates the influence of stressful life events on adolescent depressive symptoms. A total of 780 pairs of ethnic Han Chinese adolescent twins, 11–17 years of age, were randomly assigned to one of two subgroups (twin1 and twin2). All subjects were genotyped as Val/Val, Val/Met or Met/Met, and assessed for depressive symptoms using the Children's Depression Inventory. The level of environmental stress was estimated by the frequency of stressful life events using the Life Events Checklist. The frequency of stressful life events was significantly correlated with depressive symptoms (twin1: β = 0.21, P = 0.01; twin2: β = 0.27, P < 0.01), but there was no significant main effect of the BDNF Val66Met genotype on depressive symptoms. In both subgroups, however, the interaction between the BDNF Val66Met genotype and stressful life event frequency was significant (twin1: β = 0.19, P = 0.01; twin2: β = 0.15, P = 0.04); individuals with one or two Val alleles demonstrated a greater susceptibility to both the detrimental effects of higher stress and the beneficial effects of lower stress compared to the Met/Met genotype. These findings support the ‘differential‐susceptibility’ hypothesis, whereby the BDNF Val allele modulates the influence of environmental stress on depression by enhancing the neuroplastic response to all life events.
Homozygosity for a mutation in the CYP11B2 gene in an infant with congenital corticosterone methyl oxidase deficiency type II
Authors: Jessen Casper L , Christensen Jane H , Birkebæk Niels H , Rittig Soren
Published: August 2012

Isolated aldosterone synthase deficiency can be the source of life‐threatening salt wasting and failure to thrive in infancy. We studied an infant with failure to thrive and persistent hyponatremia despite oral sodium supplementation. Initial analyses revealed highly elevated plasma renin but normal values of plasma aldosterone. The biochemical diagnosis of corticosterone methyl oxidase deficiency type II was established by multisteroid analysis, revealing a pathognomonic pattern with a highly elevated ratio of 18‐OH‐corticosterone to aldosterone. This reflects an enzymatic defect in the aldosterone synthase that is responsible for the terminal steps in the aldosterone biosynthesis. Molecular genetic analysis supported the diagnosis revealing homozygosity for a pathogenic c.554C>T (p.T185I) variation in exon 3 of the CYP11B2 gene encoding aldosterone synthase. Homozygosity for two other polymorphic variations c.504C>T (p.F168F) and c.518A>G (p.K173R) were identified as well. Treatment with fludrocortisone resulted in catch‐up growth. Discontinuation of treatment at the age of 9 years was later possible without any clinical or biochemical deterioration.

Conclusions:  Isolated deficiency in aldosterone biosynthesis should be considered in neonates and infants with failure to thrive and salt wasting. Normal levels of plasma aldosterone compared with highly elevated levels of plasma renin indicate an impaired aldosterone biosynthesis and suggest the disorder. Recognition of its existence is important as fludrocortisone replacement therapy effectively normalizes sodium balance and growth.
Acute renal failure in Congolese children: a tertiary institution experience
Authors: Aloni Michel N , Nsibu Célestin N , Meeko‐Mimaniye Mobuli , Ekulu Pépé M , Bodi Joseph Mabiala
Published: August 2012

Aim:  Published data on acute renal failure in children from the Democratic Republic of Congo are rare. The objective of this study was to review clinical manifestations, aetiologies and outcome in hospitalized children with acute renal failure.

Methods:  A retrospective study at Pediatric Nephrology Unit of University Hospital of Kinshasa was carried out.

Results:  Fifty‐six children with acute renal failure were eligible. There were 31 boys (55.4%) and 25 girls (44.6%) with a sex ratio of 1.24. The median age was 6.7 years (range 1–13 years). Fever (80.3%), oligo‐anuria (73.2%), jaundice (67.9%) were the common clinical presentation. Blackwater fever (42.8%) was the leading cause of Acute Renal Failure. The incidence of severe dehydration because of gastroenteritis was low (5.3%). Around 12.5% of patients’ misused herbal plants. Acute Peritoneal Dialysis was indicated in 15/56 children and only performed in four patients. Fourteen children (25%) died.

Conclusion:  A wide spectrum of features was seen in hospitalized Acute Renal Failure children and limited access to Acute Peritoneal Dialysis remained an important mortality risk factor.
Effect of Impurities and LiF Additive in Hot‐Pressed Transparent Magnesium Aluminate Spinel
Authors: Rubat du Merac Marc , Reimanis Ivar E. , Smith Charlene , Kleebe Hans‐Joachim , Müller Mathis M.
Published: August 2012

The effect of impurities and LiF sintering additive on the microstructure and optical properties of hot‐pressed transparent MgAl2O4 spinel was investigated. A lower and a higher purity powder were hot pressed with and without LiF and process parameters varied. Microstructure was examined using optical and electron microscopy, optical properties using spectrophotometry, and chemistry using various spectroscopic techniques. Impurities present in parts‐per million were found to segregate at grain boundaries and form an amorphous phase, restricting grain growth and causing scatter and opacity. It was found that LiF reacts with impurities to form volatile species that can be removed with proper processing, resulting in larger grain size and increased transmittance. LiF also counteracts absorption caused by reduction of spinel, but results in MgO loss, grain boundary embrittlement, and if trapped in higher concentration, restricts grain growth and causes scatter and opacity.
The Effect of the Lactobacillus CaseiLock 0900 Probiotic Strain on the Quality of Dry‐Fermented Sausage During Chilling Storage
Authors: Wójciak K.M. , Dolatowski Z.J. , Kołożyn‐Krajewska D. , Trząskowska M.
Published: August 2012

The aim of this study was to assess the effect of various levels of the Lactobacillus casei LOCK 0900 probiotic strain on the quality of dry‐fermented sausages after ripening and during long‐term vacuum storage. The experiment involved dry‐fermented sausages divided into three groups (C – control sausages; Lc1 – sausages with 6.0 log cfu/g of L. casei LOCK 0900 added; Lc2 – sausages with 6.3 log cfu/g of L. casei LOCK 0900 added).

Instrumental color, oxidation‐reduction potential, thiobarbituric acid reacting substances, peroxide value, conjugated dienes and pH values were determined after 21 days of ripening (0) and after 2, 4 and 6 months of refrigerated storage (4C). Determination of heme pigment concentration and count of lactic acid bacteria (LAB) and sensory analysis in meat product were performed after ripening and after 6 months of storage.

The samples Lc1 had better quality inclusive color and lipid oxidative stability than sample Lc2. However, sample Lc2 showed the best survivability of LAB at the level exceeding 6.0 log cfu/g and the highest overall quality both after ripening and after 6 months of storage.

Practical Applications

Probiotics are not widely used in meat products and meat industry. The available global literature presents only information about survival of probiotic strains and sensory quality of fermented meat products. On one hand, using probiotic bacteria contributes to increasing health‐promoting characteristics, but, on the other hand, it can accelerate lipid oxidation as a result of hydroperoxide production, making the shelf life shorter. A crucial element of the tests is the evaluation of the different levels of probiotic on lipid oxidation, which is the main factor that could change quality during the product maturing and storage.
The Antioxidant Activity of Chilean Honey and Bee Pollen Produced in the Llaima Volcano's Zones
Authors: Mejías Enrique , Montenegro Gloria
Published: August 2012

Chile produces a variety of bee products with different botanical origins and several biological characteristics inherited from specific floral sources. Plants and beehives in areas polluted with metals may increase the levels of these elements in beehive products. Thus, it is expected that products that are produced in such places have higher metal content. Furthermore, all of these honey and bee pollen samples have modified biological properties, but their antioxidant activities are determined by their botanical origin and metal content. The honey and bee pollen samples were produced near the Llaima Volcano (South of Chile) and studied to determine metal contents as well as their antioxidant activities. In honey, the highest values for Cu, Mn and Fe were 0.851, 1.043 and 1.82 μg/g, respectively. In bee pollen samples, the higher metal content was for Fe, with a 194.0 μg/g maximum value. Furthermore, in those samples, Pb (0.17–0.28 μg/g), Cd (0.03–0.05 μg/g) and Cr (0.37–0.47 μg/g) were detected. The total phenolic content ranged from 1,000.0 to 1,255.4 mg/kg in honey and from 347.7 to 1,286.5 mg/kg in bee pollen. The selected beehive products herein had higher metal content as well as lower phenolic content and antioxidant activity.

Practical Applications

By determining the metal contents in bee products produced in a potentially polluted zone, it is possible to have a good monitoring of the real impact of natural pollution such as volcano's eruptions. In the same way, these preliminary results allow one to open an alternative option to estimate the impact on the environment of the contaminant activities of humans by using those natural bioindicators, which production occurs in zone exposed to metals. Also, the modification of biological properties of these products can be useful for determining alterations in food compositions of natural products with undesirable presence of toxic elements.
Reduced Risk of Death with Warfarin – Results of an Observational Nationwide Study of 20 442 Patients with Atrial Fibrillation and Ischaemic Stroke
Authors: Åsberg Signild , Eriksson Marie , Henriksson Karin M. , Terént Andreas
Published: August 2012

Background

Warfarin is demonstrated to be superior in efficacy over antiplatelet agents for the prevention of stroke, but the relationship between warfarin and mortality is less clear. Our aim was to investigate this relationship in a large cohort of unselected patients with atrial fibrillation and ischaemic stroke.

Methods

This observational study was based on patients who were discharged alive and registered in the Swedish Stroke Register in 2001 through 2005. Vital status was retrieved by linkage to the Swedish Cause of Death Register. We calculated a propensity score for the likelihood of warfarin prescription at discharge from hospital. The risk of death and 95% confidence intervals were estimated in Cox regression models.

Results

Out of the 20 442 patients with atrial fibrillation and ischaemic stroke (mean age = 79·5 years), 31% ( n = 6399) were prescribed warfarin. After adjustment for the propensity score, warfarin was associated with a reduced risk of death (0·67; 95% confidence interval, 0·63–0·71). The crude rate (per 100 person-years) of fatal non-haemorrhagic stroke was lower in patients who received warfarin (1·60; 95% confidence interval, 1·34–1·89) compared to those who received antiplatelet (6·83; 95% confidence interval, 6·42–7·25). The rates (per 100 person-years) of fatal haemorrhagic stroke were 0·21 (95% confidence interval, 0·12–0·32) and 0·43 (95% confidence interval, 0·34–0·55) in patients prescribed warfarin and antiplatelet therapy, respectively.

Conclusions

In addition to its established benefit for stroke prevention, warfarin therapy in patients with atrial fibrillation and ischaemic stroke was associated with a reduced risk of death, without an increased risk of fatal haemorrhagic stroke.
Nurse assistants’ experience of an intervention focused on a palliative care approach for older people in residential care
Authors: Beck Ingela , Törnquist Agneta , Edberg Anna‐Karin
Published: August 2012

Background.  Nurse assistants working in residential care facilities need support to ensure that they provide high‐quality care for the residents and support for relatives, from admission to bereavement.

Aim.  The aim was to describe the nurse assistants’ experience of how an intervention with a palliative care approach, had influenced them in their work in residential care for older people.

Participants.  Fourteen nurse assistants working in three different municipal residential care facilities.

Methods.  Data were collected by means of semi‐structured individual interviews following an intervention consisting of study circles combined with workshops. The data were analysed using content analysis.

Result.  The nurse assistants felt that, through the intervention, they had gained insight into their understanding of the importance of quality of care. This included an increased awareness of, and respect for, residents’ and relatives’ needs, and an increased understanding of the importance of the outcome of encounters with residents and their relatives. After the intervention, they also felt there was increased openness and understanding between colleagues. However, the nurse assistants also expressed frustration over obstacles to implementing a palliative care approach, such as lack of resources and supportive leadership.

Conclusion.  The nurse assistants felt that the intervention was positive and encouraged them to provide more person‐centred care within the framework of a palliative care approach. Although the intervention was intended to involve and support the management, it was not sufficient. Nurse assistants described lack of resources and supportive leadership. There is, therefore, a need to place greater emphasis on leadership and their support of nurse assistants so that they can provide high‐quality care.

Implications for practice.  To support nurse assistants in the provision of care, clear leadership and opportunities to discuss and reflect on issues associated with care, including systematic improvement work in practice, appear to be essential to ensure high‐quality care.