bluuebunny/crossref_metadata_2025 huggingface dataset:
Psychometric evaluation of a scale to assess satisfaction with life among people with intellectual disabilities living in community residences
Authors: Bergström H. , Hochwälder J. , Kottorp A. , Elinder L. S.
Published: February 2012

Background  In the context of a health intervention among people with intellectual disabilities (ID), there was a need to assess satisfaction with some aspects of life, in order to monitor both potential positive and negative effects of the intervention. The aim of the present study was to develop and evaluate an easily administered scale for assessing satisfaction with home environment and leisure time among people with mild or moderate ID, living in community residences.

Methods  A number of questions were constructed to measure satisfaction with home environment and leisure time. The questions were answered by 132 adults with mild or moderate ID, living in community residences in Sweden. The dimensionality of the scale was evaluated by factor analysis, and the reliability was estimated using Cronbach's alpha coefficients.

Results  The analysis supported a four‐factor solution with 12 items. The four factors were: (I) Satisfaction with housing environment; (II) Satisfaction with life; (III) Satisfaction with meals; and (IV) Satisfaction with recreational activity. The four factors explained almost 70% of the variance in the data set. Cronbach alpha coefficients for all scales were above 0.70, indicating that the reliabilities of the scales were satisfactory. Correlations between the four sub‐scales ranged from 0.06 to 0.52, indicating low to moderate inter‐correlations between the four sub‐scales.

Conclusion  The scale has fairly good psychometric properties and is easy to administer. The scale, which can be further improved, can be an important resource in health intervention studies.
Recent research on aetiology, development and phenomenology of self‐injurious behaviour in people with intellectual disabilities: a systematic review and implications for treatment
Authors: Furniss F. , Biswas A. B.
Published: February 2012

Background  Behavioural interventions conceptualise self‐injurious behaviour (SIB) as developing from early repetitive behaviours through acquisition of homeostatic functions in regulating stimulation and subsequent shaping into SIB through socially mediated or automatic operant reinforcement. Despite high success rates, such interventions rarely completely eliminate SIB, and overall effectiveness has not increased since the 1960s.

Methods  Research (excluding studies of single genetic syndromes) on the early development, functional properties and phenomenology of SIB in persons with intellectual disabilities (IDs) published from 1999 to 2010 inclusive is reviewed.

Results  Despite evidence to support the operant shaping hypothesis, in some cases tissue‐damaging SIB, especially head‐banging, emerges at a similar or younger age than stereotyped behaviours or ‘proto‐SIB’, often associated with tantrums following frustrative non‐reward and/or abrupt situational transitions. Many young children show undifferentiated patterns of responding in functional analyses of SIB, and SIB is associated with aggression and impulsivity as well as with repetitive behaviour.

Conclusions  One dynamic in the development of SIB may be Pavlovian conditioning of aggression, originally elicited by aversive events or frustrative non‐reward, to stimuli associated with such situations. Integration into operant technology of interventions based on Pavlovian principles such as graduated exposure (with or without counterconditioning) to aversive stimuli may enhance the effectiveness of behavioural interventions.
New image analysis of large food particles can discriminate experimentally suppressed mastication
Authors: SUGIMOTO K. , IEGAMI C. M. , IIDA S. , NAITO M. , TAMAKI R. , MINAGI S.
Published: February 2012

Summary  Objective parameters that could provide a basis for food texture selection for elderly or dysphagic patients have not been established. We, therefore, aimed to develop a precise method of measuring large particles (>2 mm in diameter) in a bolus and an analytical method to provide a scientific rationale for food selection under masticatory dysfunction conditions. We developed a new illumination system to evaluate the ability of twenty female participants (mean age, 23·4 ± 4·3 years) to masticate carrots, peanuts and beef with full, half and one quarter of the number of masticatory strokes. We also evaluated mastication under suppressed force, regulated by 20% electromyographic of the masseter muscle. The intercept and inclination of the regression line for the distribution of large particles were adopted as coefficients for the discrimination of masticatory efficiency. Single set of coefficient thresholds of 0·10 for the intercept and 1·62 for the inclination showed excellent discrimination of masticatory conditions for all three test foods with high specificity and sensitivity. These results suggested that our method of analysing the distribution of particles >2 mm in diameter might provide the basis for the appropriate selection of food texture for masticatory dysfunction patients from the standpoint of comminution.
Differences in seed rain composition in small and large fragments in the northeast Brazilian Atlantic Forest
Authors: Knörr U. C. , Gottsberger G.
Published: February 2012

Tropical forests are seriously threatened by fragmentation and habitat loss. The impact of fragment size and forest configuration on the composition of seed rain is insufficiently studied. For the present study, seed rain composition of small and large forest fragments (8–388 ha) was assessed in order to identify variations in seed abundance, species richness, seed size and dispersal mode. Seed rain was documented during a 1‐year period in three large and four small Atlantic Forest fragments that are isolated by a sugarcane matrix. Total seed rain included 20,518 seeds of 149 species of trees, shrubs, palms, lianas and herbs. Most species and seeds were animal‐dispersed. A significant difference in the proportion of seeds and species within different categories of seed size was found between small and large fragments. Small fragments received significantly more very small‐sized seeds (<0.3 cm) and less large‐seeded species (>1.5 cm) that were generally very rare, with only one species in small and eight in large fragments. We found a negative correlation between the inflow of small‐sized seeds and the percentage of forest cover. Species richness was lower in small than in large fragments, but the difference was not very pronounced. Given our results, we propose changing plant species pools through logging, tree mortality and a high inflow of pioneer species and lianas, especially in small forest fragments and areas with low forest cover. Connecting forest fragments through corridors and reforestation with local large‐seeded tree species may facilitate the maintenance of species diversity.
Nucleoside transport across the plasma membrane mediated by equilibrative nucleoside transporter 3 influences metabolism of Arabidopsis seedlings
Authors: Cornelius S. , Traub M. , Bernard C. , Salzig C. , Lang P. , Möhlmann T.
Published: February 2012

The metabolism of nitrogen‐rich nucleosides in Arabidopsis seedlings was investigated at the level of import and subsequent salvage or degradation. Uptake and fate of nucleosides imported by equilibrative nucleoside transporter 3 (ENT3) was analysed and, furthermore, a comprehensive analysis of the effect of exogenously fed nucleosides at the level of metabolic as well as transcriptomic alterations was performed. Expression of nucleoside transporters ENT1 and ENT3, together with nucleoside import, was increased upon nitrogen limitation. Thereby a role for ENT3, which is expressed mainly in the vasculature of roots and leaves, as a major import route for nucleosides was supported. Exogenously fed nucleosides were able to attenuate nitrogen starvation effects such as chlorophyll breakdown, anthocyanin accumulation, RNA breakdown and reduced levels of amino acids. In response to nucleoside supply, up‐regulation of genes involved in nitrogen distribution in plants was observed. In addition, genes involved in nucleoside metabolism were identified as regulated upon nitrogen limitation. In summary, an overall beneficial effect of nucleoside supply to Arabidopsis seedlings, especially under limiting nitrogen conditions, was observed.
A genetic approach to the species problem in wild potato
Authors: Camadro E. L. , Erazzú L. E. , Maune J. F. , Bedogni M. C.
Published: February 2012

Wild potatoes are native to the Americas, where they present very wide geographical and ecological distribution. Most are diploid, obligate out‐crossers due to a multiallelic gametophytic self‐incompatibility (S) locus that prevents self‐fertilisation and crossing between individuals carrying identical S‐alleles. They have two alternative modes of reproduction: sexual (by seeds) and asexual (by stolons and tubers), which provide, respectively, for genetic flexibility in changing environments and high fitness of adapted genotypes under stable conditions. Since the early twentieth century, their taxonomic classification has been mostly based on morphological phenotypes (Taxonomic Species Concept). More recently, attempts have been made to establish phylogenetic relationships, applying molecular tools in samples of populations (accessions) with a previously assigned specific category. However, neither the reproductive biology and breeding relations among spontaneous populations nor the morphological and genetic variability expected in obligate allogamous populations are considered when the taxonomic species concept is applied. In nature, wild potato populations are isolated through external and internal hybridisation barriers; the latter, which are genetically determined, can be either pre‐zygotic (pollen–pistil incompatibility) or post‐zygotic (abortion of embryo, endosperm or both tissues, sterility, and hybrid weakness and breakdown in segregating generations). The internal barriers, however, can be incomplete, providing opportunities for hybridisation and introgression within and between populations and ploidy levels in areas of overlap. The widespread occurrence of spontaneous hybrids in nature was recognised in the mid‐twentieth century. Using genetic approaches, results have been obtained that provide strong support to the assertion that populations are at different stages of genetic divergence and are not at the end of the evolutionary process, as presupposed by the Taxonomic Species Concept. Furthermore, since wild potatoes have uniparental and biparental overlapping generations, the Biological Species Concept – developed for sexually reproducing biparental organisms – cannot be applied to them. In this paper, morphological, genetic, molecular and taxonomic studies in wild potato are reviewed, considering the genetic consequences of their reproductive biology, in an attempt to shed light on the species problem, because of its relevance in germplasm conservation and breeding.
Comparison between stearoyl‐CoA desaturase expression in milk somatic cells and in mammary tissue of lactating dairy cows
Authors: Jacobs A. A. A. , Dijkstra J. , Hendriks W. H. , van Baal J. , van Vuuren A. M.
Published: February 2012

Stearoyl‐CoA desaturase (SCD) is an important enzyme in the bovine mammary gland, where it inserts a cis‐double bond at the Δ9 position in a wide range of fatty acids. Investigating SCD expression in the bovine mammary gland generally requires invasive biopsy to obtain mammary tissue. The aim of this study was to evaluate the use of milk somatic cells as a non‐invasive alternative to biopsy for measuring mammary SCD expression in dairy cows. Both milk somatic cells and mammary tissue were collected from 14 Holstein‐Friesian cows and used for analysis of SCD expression by real‐time PCR. The SCD5 mRNA levels in mammary tissue compared with SCD1 were low, and for several milk somatic cell samples, SCD5 expression was even below the limit of detection. A significant relationship was found between SCD1 expression in milk somatic cells and in mammary tissue. In addition, SCD1 expression in milk somatic cells was significantly related to Δ9‐desaturase indices in milk, which are commonly used as an indicator of SCD1 activity within the mammary gland. Our study showed that milk somatic cells can be used as a source of mRNA to study SCD1 expression in dairy cows, offering a non‐invasive alternative to mammary tissue samples obtained by biopsy.
Effect of Several Antioxidants on Thawed Ram Spermatozoa Submitted to 37°C up to Four Hours
Authors: Mata‐Campuzano M , Álvarez‐Rodríguez M , Álvarez M , Anel L , de Paz P , Garde JJ , Martínez‐Pastor F
Published: February 2012

Contents

Thawed ram spermatozoa were incubated at 37°C in the presence of dehydroascorbic acid (DHA), TEMPOL (TPL), N‐acetyl‐cysteine (NAC) and rutin (RUT), at 0.1 and 1 mm, in order to test their effects on sperm physiology. Cryopreserved spermatozoa from four rams were thawed, pooled, washed and incubated in TALP‐Hepes with 1 mm or 0.1 mm of each antioxidant, performing a replicate with induced oxidative stress (Fe2+/ascorbate). Motility (CASA), viability and mitochondrial membrane potential (flow cytometry) were analysed at 2 and 4 h. Lipoperoxidation (MDA production), intracellular reactive oxygen species (ROS) and DNA status (TUNEL) were analysed at 4 h. Antioxidants, except DHA 0.1 mm, decreased motility and kinematic parameters, but had little effect on viability or mitochondrial activity. Except 1 mm DHA, the antioxidants reduced ROS at 4 h. Moreover, NAC 1 mm, rutin and TEMPOL reduced ROS and DNA damage in the presence of oxidative stress. N‐acetyl‐cysteine, rutin 1 mm and TEMPOL reduced lipoperoxidation in the presence of oxidative stress. However, DHA did not affect lipoperoxidation. At 1 mm, DHA increased DNA damage in the absence of oxidative stress. Dehydroascorbic acid effects could arise from spermatozoa having a low capacity for reducing it to ascorbic acid, and it may be tested in the presence of other antioxidants or reducing power. Future research should focus in testing whether the inhibition of motility observed for NAC, rutin and TEMPOL is reversible. These antioxidants might be useful at lower temperatures (refrigerated storage or cryopreservation) when their protective effects could be advantageous.
Guideline use: A survey of dietitians working with adult kidney transplant recipients
Authors: ORAZIO LINDA K , MURRAY ERYN M , CAMPBELL KATRINA L
Published: February 2012

Aim:  To establish current service provision as well as barriers and enablers to guideline implementation in the Nutritional Management of Adult Kidney Transplant Recipients (KTR).

Methods:  Fifteen primary renal transplant centres (15/17; 88% response rate) and 21 secondary renal transplant centres (21/24; 88% response rate) responded to an online survey addressing key questions investigating their current practice in the nutritional management of adult KTR.

Results:  Referral from primary to secondary sites was limited with only two sites (9%) routinely receiving referrals. Allocated funding for KTR at secondary sites was low (n = 4, 14%). Many primary sites received nil or <0.5 full‐time equivalent (FTE) funding for inpatient (n = 8, 53%); and nil or ≤0.2 FTE funding for outpatient services (n = 9, 60%). In sites reporting FTE hours, the average dietitian‐to‐patient ratio was 1 FTE dietitian for every 383 (range 50–1280) annually transplanted patients. Major barriers identified in delivering nutrition services at primary sites included time/lack of resources and limitations with systems to identify or track transplant recipients.

Conclusion:  Dietitian‐to‐patient ratios in the management of KTR at primary sites are inconsistent and likely to be inadequate at secondary transplant sites to implement guideline recommendations, especially for weight management. Investigations into the effectiveness of innovative interventions such as groups or telehealth are warranted, which may assist practitioners to achieve guideline recommendations in an environment of limited resources.
Long‐distance gene flow and adaptation of forest trees to rapid climate change
Authors: Kremer Antoine , Ronce Ophélie , Robledo‐Arnuncio Juan J. , Guillaume Frédéric , Bohrer Gil , Nathan Ran , Bridle Jon R. , Gomulkiewicz Richard , Klein Etienne K. , Ritland Kermit , Kuparinen Anna , Gerber Sophie , Schueler Silvio
Published: February 2012

Ecology Letters (2012) 15: 378–392

Forest trees are the dominant species in many parts of the world and predicting how they might respond to climate change is a vital global concern. Trees are capable of long‐distance gene flow, which can promote adaptive evolution in novel environments by increasing genetic variation for fitness. It is unclear, however, if this can compensate for maladaptive effects of gene flow and for the long‐generation times of trees. We critically review data on the extent of long‐distance gene flow and summarise theory that allows us to predict evolutionary responses of trees to climate change. Estimates of long‐distance gene flow based both on direct observations and on genetic methods provide evidence that genes can move over spatial scales larger than habitat shifts predicted under climate change within one generation. Both theoretical and empirical data suggest that the positive effects of gene flow on adaptation may dominate in many instances. The balance of positive to negative consequences of gene flow may, however, differ for leading edge, core and rear sections of forest distributions. We propose future experimental and theoretical research that would better integrate dispersal biology with evolutionary quantitative genetics and improve predictions of tree responses to climate change.
Sex differences in fetal habituation
Authors: Hepper Peter G. , Dornan James C. , Lynch Catherine
Published: February 2012

There is some evidence for sex differences in habituation in the human fetus, but it is unknown whether this is due to differences in central processing (habituation) or in more peripheral processes, sensory or motor, involved in the response. This study examined whether the sex of the fetus influenced auditory habituation at 33 weeks of gestation, and whether this was due to differences in habituation or in the sensory or motor components using a set of four experiments. The first experiment found that female fetuses required significantly fewer stimulus presentations to habituate than males. The second experiment revealed no difference in the spontaneous motor behaviour of male and female fetuses. The third experiment examined auditory intensity thresholds for the stimuli used to habituate the fetus. No differences in thresholds were found between males and females, although there was inter‐individual variability in thresholds. A final experiment, using stimuli individualized for that particular fetus’ auditory intensity threshold, found that female fetuses habituated faster than males. In combination, the studies reveal that habituation in the human fetus is affected by sex and this is due to a difference in central ‘information processing’ of the stimuli rather than peripheral aspects of the response. It is argued that male and female fetuses present different neurobehavioural developmental trajectories, with females more advanced at 33 weeks than males. This study suggests that research examining prenatal behaviour should consider the factor of fetal sex. This may be particularly pertinent where there is an intention to use the results diagnostically.
Epistemic trust: modeling children’s reasoning about others’ knowledge and intent
Authors: Shafto Patrick , Eaves Baxter , Navarro Daniel J. , Perfors Andrew
Published: February 2012

A core assumption of many theories of development is that children can learn indirectly from other people. However, indirect experience (or testimony) is not constrained to provide veridical information. As a result, if children are to capitalize on this source of knowledge, they must be able to infer who is trustworthy and who is not. How might a learner make such inferences while at the same time learning about the world? What biases, if any, might children bring to this problem? We address these questions with a computational model of epistemic trust in which learners reason about the helpfulness and knowledgeability of an informant. We show that the model captures the competencies shown by young children in four areas: (1) using informants’ accuracy to infer how much to trust them; (2) using informants’ recent accuracy to overcome effects of familiarity; (3) inferring trust based on consensus among informants; and (4) using information about mal‐intent to decide not to trust. The model also explains developmental changes in performance between 3 and 4 years of age as a result of changing default assumptions about the helpfulness of other people.
The effect of collaborative annotation on Chinese reading level in primary schools in China
Authors: Yang Xianmin , Yu Shengquan , Sun Zhong
Published: March 2012

As school networks get more available, reading instruction in a computer classroom has become more and more popular in China. Although information and communication technology (ICT) has brought about some improvements in classroom teaching, it must be admitted that the phenomenon of fast reading with low‐level cognitions is threatening school children's reading literacy. In order to address this problem, a collaborative annotation tool called Sharing Unique Reading Feeling (SURF) was developed for creating and sharing annotations. This study explored SURF‐based collaborative reading instruction, and investigated the effect of collaborative annotation supported by SURF on primary school students' Chinese reading levels with methods of equal group experiment, interview and comparative analysis. Finally, some suggestions were proposed for the development of instructional annotation tools and the implementation of current reading instruction especially in computer classrooms. Results showed that the collaborative annotation supported by SURF could promote students' reading performance, enhance their Chinese reading levels in primary schools, and it was also helpful to develop the higher‐level cognitive abilities such as analyzing, summarizing and evaluating.

Practitioner Notes

What is already known about this topic

Annotation could improve students' reading and writing.

Annotation could enhance reading comprehension.

Full annotation sharing could improve learning outcome.

Reading passages with hypermedia annotations significantly benefited passage comprehension and vocabulary.

What this paper adds

Collaborative annotation could enhance Chinese reading levels in primary schools of China, and is very helpful in addressing the issue of surface reading in Chinese class.

Collaborative annotation is also helpful to develop higher‐level cognitive abilities such as analyzing, summarizing and evaluating.

Implications for practice and/or policy

Collaborative reading assisted by annotation tool should be given profound attention and be applied more generally.

Collaboration is rather significant in developing students' reading literacy, but abuse of collaboration will be a waste of time and will not get good effect.

Do not lose the dominant role of teachers, because excessive freedom for students will result in failure in achieving teaching objectives.

Some competition activities (eg, setting up Reading Stars, giving little and red flowers) should be provided to inspire students to do annotating passionately and seriously.

The Ministry of Education in China should actively encourage Chinese teachers in primary and secondary schools to implement annotation reading instruction in computer classrooms.

Some wonderful annotation tools just like SURF should be developed and generalized in a larger scope supported by the government.
Why the Home Region Matters: Location and Regional Multinationals
Authors: Rugman Alan M. , Oh Chang Hoon
Published: February 2012

Much of the literature in international business analysing the multinational enterprise uses the country as the relevant environmental parameter. This paper presents both theoretical and empirical evidence to demonstrate that country‐level analysis now needs to be augmented by analysis at the ‘regional’ level of the broad triad markets of Europe, North America and the Asia Pacific. The great majority of the world's 500 largest firms concentrate their activities within their home region of the triad. This study uses variance component analysis and finds that this home region effect outperforms the country effect. Together, the regional and industry effects explain most of the geographic expansion of multinational enterprises (MNEs), whereas country, firm and year effects are very minor. The new data and variance component analysis on the activities of large MNEs reported here suggest that new thinking is required about the importance of large regions of the triad as the relevant unit of analysis for business strategy to supplement the conventional focus on the country.
The Recognition, and Res Judicata Effect, of a United States Class Actions Judgment in England: A Rebuttal of Vivendi
Authors: Mulheron Rachael
Published: March 2012

United States' courts have proven willing to certify multi‐jurisdictional class actions which purport to adjudicate the claims of both American and foreign (i.e., non‐US‐domiciled) class members. This article contends, however, that a class actions judgment/settlement issued by a US court would not be recognised, and would not be given preclusive effect, in England, should absent English class members wish to re‐litigate the same grievance before an English court. Specifically, it is argued that two separate preconditions for such recognition and preclusive effect would fail, viz, a US court would usually lack the requisite ‘personal jurisdiction’ over absent English class members; and the necessary ‘identity of parties’ would be absent. The article seeks to anticipate the appropriate answer to a conundrum which is certain to arise for future English judicial consideration, whilst acknowledging the uneasy fit which currently exists between English private international law and multi‐jurisdictional class actions.
Who loses if flood risk is reduced: should we be concerned?
Authors: Penning‐Rowsell Edmund C , Pardoe Joanna
Published: February 2012

Choices are necessary and inevitable in resource management, and these inherently create losers and gainers. The benefits and beneficiaries from plans and schemes to reduce flooding have been researched over many years, but the losers have been almost completely neglected. We would define these as including both those who pay for flood risk management but gain nothing or little from these interventions, and those whose financial situation is adversely affected if flood risk management reduces the number and severity of the flood events that are to be faced. This paper describes research that explores these issues and seeks both to identify these losers, so defined, and to quantify the extent of their ‘loss’. We conclude that while we may not be concerned about the loss suffered by the general taxpayer or insurance premium payer, as the sums are small per household (although very large in total), we certainly should be concerned about other groups who either lose money or lose protection as a result of decisions to reduce risk generally and in specific local examples. These findings should not deter us from continuing to seek risk reduction through wise flood risk management but they should alert us to the fact that this brings losers as well as winners, and that the former deserve much more careful attention than has been the case in the past.
The extrinsic in the architectural thinking of Leon Battista Alberti: a reading of Sant'Andrea in Mantua
Authors: LAWSON JAMES
Published: February 2012

In the treatise, De re aedificatoria, Alberti sought to establish what was intrinsic to the art of building. It can seem that his over‐riding concern was to establish its material and formal nature. However, architecture also figures in his other writings. Surveying the wider panorama of Alberti's thought, it becomes clear that what was extrinsic to architecture, yet crucial to its character, was of no less importance. Consistent with his emphatic naturalism, context was to be kept in view. And context extended from nature to society. His history of architecture values functionalism and his theory of its evolution begins with the material concerns of shelter and store. Yet, as architecture serves, it possesses a moral principle. Alberti, conceiving the conceptual, material, and social and moral object, co‐opts metaphor as the means to describe the building under all these headings. So, ‘roof’ acquires resonant meaning, as do ‘hearth’, ‘table’, and so on – both elements and moral actions of house and church. When Alberti's language is recognized as functioning in this way, it acquires for the reader a singular animation. In Florence Cathedral he finds an exemplary case. A famous and problematic late text – describing Sant'Andrea in Mantua – can be acquitted of the charge of rhetorical insincerity.
The Impact of Seed Policy Reforms and Intellectual Property Rights on Crop Productivity in India
Authors: Kolady Deepthi Elizabeth , Spielman David J. , Cavalieri Anthony
Published: March 2012

The growth of private investment in developing‐country agriculture, new advances in the biological sciences, and rapid integration of developing countries into the global trading system has heightened interest in the topic of seed market and intellectual property rights’ (IPRs) policies among public policy‐makers, corporate decision‐makers and other actors in the agricultural sector. But there are still unanswered questions about whether emerging and evolving seed policy reforms and IPR regimes in developing countries will contribute to increasing crop productivity and improving food security. This paper attempts to answer some of these questions by focusing specifically on the case of India, the regional leader in implementing seed policy reforms and IPRs in agriculture. Findings indicate that maize and pearl millet yields grew significantly during the last two decades due partly to the combination of (1) public policies that encouraged private investment in India’s seed industry during the 1980s, and (2) biological IPRs conferred by hybridisation that conveniently married the private sector’s need for appropriability with the nation’s need for productivity growth. Although past lessons are not an indication of future success, this convergence of policy solutions and technology opportunities can be replicated for other crops that are vital to India’s food security.
A comparative study of efficacy and outcomes of large loop excision of the transformation zone procedure performed under general anaesthesia versus local anaesthesia
Authors: Borbolla Foster Ailsa , Symonds Ian
Published: February 2012

Background

Although Australian National Health and Medical Research Council (NHMRC) guidelines do not specify targets for mode of anaesthesia for large loop excision of the transformation zone (LLETZ) procedures, UK NHS Cervical Screening Programme (NHSCSP) guidelines recommend that >80% of LLETZ procedures be performed under local anaesthesia. There is a paucity of clinical data regarding both the proportion of women receiving general anaesthesia for treatment, factors underpinning this choice and the impact of mode of anaesthesia on treatment outcomes.

Aims

To identify the proportion of women who have a LLETZ under general anaesthesia and to establish the impact of mode of anaesthesia on outcomes including treatment efficacy, overtreatment (negative histology), short‐term morbidity and attendance for follow‐up.

Methods

Single‐centre retrospective analysis of all women treated with LLETZ for suspected cervical dysplasia between 1, May 2005 and 1, May 2009.

Results

Thirty‐three percent of a total 465 LLETZ procedures were carried out under general anaesthesia, although the reason for anaesthesia choice was not recorded in 52% of cases. There were no significant differences in the primary outcomes of unclear LLETZ margins or negative LLETZ histology, or in the secondary outcomes of depth and surface area of LLETZ specimen, short‐term morbidity or rates of incomplete follow‐up.

Conclusions

Although reasons underpinning selection of anaesthesia mode remain elusive, at this centre, outcomes following LLETZ procedure for the management of suspected cervical dysplasia are not affected by the mode of anaesthesia used.
Long‐term safety and efficacy in patients with uncontrolled partial‐onset seizures treated with adjunctive lacosamide: Results from a phase III open‐label extension trial
Authors: Husain Aatif , Chung Steve , Faught Edward , Isojarvi Jouko , McShea Cindy , Doty Pamela
Published: February 2012

Purpose:  To evaluate the long‐term (up to 5 years exposure) safety and efficacy of lacosamide as adjunctive therapy in patients with uncontrolled partial‐onset seizures taking one to three concomitant antiepileptic drugs (AEDs) in open‐label extension trial SP756 (NCT00522275).

Methods:  Patients who completed the double‐blind trial SP754 (NCT00136019) were eligible to participate in this open‐label extension trial (SP756). At the conclusion of trial SP754, patients had transitioned to lacosamide 200 mg/day. Subsequent dosage adjustments of lacosamide (100–800 mg/day) and/or concomitant AEDs were allowed to optimize tolerability and seizure reduction. Treatment‐emergent adverse events (TEAEs), vital signs, body weight, clinical laboratory data, electrocardiography studies, and seizure frequency were evaluated.

Key Findings:  A total of 308 patients received open‐label lacosamide and 138 patients (44.8%) completed the long‐term trial. The median modal dose (defined as the daily lacosamide dose a patient received for the longest duration during the treatment period) was 500 mg/day. The percentages of patients with lacosamide exposure >1, >2, >3, or >4 years were 75%, 63%, 54%, and 29%, respectively. Primary reasons for discontinuation were lack of efficacy (26%) and adverse events (11%). Common TEAEs (≥15%) were dizziness, headache, contusion, nausea, convulsion, nasopharyngitis, fall, vomiting, and diplopia. TEAEs that led to discontinuation in ≥1.0% of patients were dizziness (1.6%) and convulsion (1.0%). The median percent reductions from baseline of trial SP754 in 28‐day seizure frequency were 53.4%, 55.2%, 58.1%, and 62.5%, respectively, for 1‐, 2‐, 3‐, and 4‐year completers. The ≥50% responder rates were 52.8%, 56.5%, 58.7%, and 62.5% for 1‐, 2‐, 3‐, and 4‐year completers, respectively. Seven of eight patients on lacosamide monotherapy for ≥12 months were deemed 50% responders. Of patients exposed to lacosamide ≥2 years, 3.1% remained seizure‐free for a period ≥2 years.

Significance:  Long‐term (up to 5 years) lacosamide treatment was generally well tolerated. The safety profile of lacosamide observed in this trial is consistent with that established in previous double‐blind, placebo‐controlled trials. Although the open‐label trial design limits the analysis of efficacy, long‐term reduction in seizure frequency and maintenance of efficacy was observed.
A meta‐analysis of white matter changes in temporal lobe epilepsy as studied with diffusion tensor imaging
Authors: Otte Willem M. , van Eijsden Pieter , Sander Josemir W. , Duncan John S. , Dijkhuizen Rick M. , Braun Kees P. J.
Published: March 2012

Purpose:  Diffusion tensor imaging (DTI) is used increasingly to study white matter integrity in people with temporal lobe epilepsy (TLE). Most studies report fractional anisotropy (FA) decrease and mean diffusivity (MD) increase in multiple white matter regions. The disturbance of white matter integrity varies across studies and between regions. We aimed to obtain a more consistent estimate of white matter diffusion characteristics and relate these to the distance from the seizure focus.

Methods:  Studies comparing diffusion characteristics of people with epilepsy with those of healthy controls were systematically reviewed and quantified using random and mixed effects meta analysis. In addition to the overall meta‐analysis, pooled FA and MD differences were determined per hemisphere and white matter category separately.

Key Findings:  We included 13 cross‐sectional studies. The pooled FA difference for all white matter was −0.026 (95% confidence interval [CI] −0.033 to −0.019) and MD difference was 0.028 × 10−3 mm2/s (95% CI 0.015–0.04). FA was reduced significantly in people with TLE compared with healthy controls in both ipsilateral (mean difference −0.03) and contralateral white matter (−0.02). MD was significantly increased ipsilaterally and contralaterally. MD differed significantly between white matter connected to the affected temporal lobe and remote white matter.

Significance:  The meta‐analysis provides a better estimation of the true diffusion characteristics. White matter structural integrity in TLE is disturbed more severely in the ipsilateral than in the contralateral hemisphere, and tracts closely connected with the affected temporal lobe are most disturbed. The exact underlying mechanisms remain to be elucidated.
Smile Esthetics: The Influence of Posterior Maxillary Gingival Margin Position
Authors: Crawford Robert W. I. , Tredwin Christopher , Moles David , Gill Daljit
Published: February 2012

Purpose: Successful replacement of posterior teeth using contemporary prosthodontic techniques in esthetically demanding cases relies upon visual replication of the natural posterior dentition and surrounding gingival architecture. There is currently little in the way of guidance for creating ideal or acceptable gingival relationships for posterior teeth.

Materials and Methods: A cross‐sectional study was conducted comparing perceptions of four groups of individuals to six digitally manipulated images with various posterior teeth gingival margin position configurations. A total of 120 volunteers aged 12 years to 80 years, comprising 30 patients diagnosed with hypodontia, 30 patients diagnosed with periodontal disease, 30 patients without either condition, and 30 qualified dentists were recruited from the Eastman Dental Institute & Hospital, London. A ranked order of preference for each set was obtained, and this was repeated after a minimum time interval of 10 minutes.

Results: Posterior gingival margin configurations from 0 mm to 2 mm (measured at the first premolar) were deemed most esthetic by the majority of the patient groups; dentists had a strong preference for the 1 mm configuration. Dentists appeared to be more perceptive to the alterations in gingival positions.

Conclusions: Posterior gingival margin configurations where the first premolar margins were 1 mm lower than the canine margins were deemed the most esthetically pleasing; however, it is likely that a range of acceptability of 1 mm deviations from this ideal exists.
Cell‐to‐Cell Communication and Vascular Dementia
Authors: DIETRICH HANS H.
Published: February 2012

Please cite this paper as Dietrich HH. Cell‐to‐cell communication and vascular dementia. Microcirculation 19: 461–467, 2012.

Objective:  VaD is the second‐most common form of dementia, second only to that caused by AD. As the name indicates, VaD is predominantly considered a disease caused by vascular phenomena.

Methods:  In this invited review, we introduce the reader to recent developments in defining VaD as a unique form of dementia by reviewing the current pertinent literature. We discuss the clinical and experimental evidence that supports the notion that the microcirculation, specifically cell‐to‐cell communication, likely contributes to the development of VaD. Through exploration of the concept of the NVU, we elucidate the extensive cerebrovascular communication that exists and highlight models that may help test the contribution(s) of cell‐to‐cell communication at the microvascular level to the development and progression of VaD. Lastly, we explore the possibility that some dementia, generally considered to be purely neurodegenerative, may actually have a vascular component at the neurovascular level.

Conclusion:  This latter recognition potentially broadens the critical involvement of microvascular events that contribute to the numerous dementias affecting an increasingly larger sector of the adult population.
Prediction of Eye Color from Genetic Data Using Bayesian Approach*
Authors: Pośpiech Ewelina , Draus‐Barini Jolanta , Kupiec Tomasz , Wojas‐Pelc Anna , Branicki Wojciech
Published: February 2012

Abstract:  Prediction of visible traits from genetic data in certain forensic cases may provide important information that can speed up the process of investigation. Research that has been conducted on the genetics of pigmentation has revealed polymorphisms that explain a significant proportion of the variation observed in human iris color. Here, on the basis of genetic data for the six most relevant eye color predictors, two alternative Bayesian network model variants were developed and evaluated for their accuracy in prediction of eye color. The first model assumed eye color to be categorized into blue, brown, green, and hazel, while the second variant assumed a simplified classification with two states: light and dark. It was found that particularly high accuracy was obtained for the second model, and this proved that reliable differentiation between light and dark irises is possible based on analysis of six single nucleotide polymorphisms and a Bayesian procedure of evidence interpretation.
Skeletal Indicators of Pregnancy and Parturition: A Historical Review
Authors: Ubelaker Douglas H. , De La Paz Jade S.
Published: February 2012

Abstract:  Over a century of scientific literature has documented the research and analysis relating to the possible skeletal evidence of pregnancy, parturition, and childcare, yet today, there still exists variation in methodology and interpretation. Historical perspective facilitates understanding of the growth and development of the theories and research currently available to the forensic science community. Review of the relevant literature clearly indicates that specific skeletal alterations are not exclusively connected to obstetrical events. Although parturition and related events have been shown to leave various alterations on bone, the research record also demonstrates that other factors can contribute to the same or similar changes. Additionally, such alterations can often be found in nulliparous women and men and are frequently absent in parous and multiparous women. This literature review calls for the continued exploration of skeletal alterations for determining parity status in human skeletal remains.
An Assessment of the Usefulness of Routine Histological Examination in Hanging Deaths
Authors: Tse Rexson , Langlois Neil , Winskog Calle , Byard Roger W.
Published: February 2012

Abstract:  A retrospective study was carried out on 100 randomly selected medico‐legal autopsies of victims who had committed suicide by hanging. All cases had undergone full police and coronial investigation. Complete external and internal examinations had been carried out including routine histological examination of organs. The age range of victims was 15–94 years (average, 41.7 years) with a male‐to‐female ratio of 7:1. External and internal injuries were consistent with the reported events. Diagnoses based purely on histology included hepatic steatosis (n = 16), asthma (n = 3), lymphocytic thyroiditis (n = 2), and pulmonary and cardiac sarcoidosis (n = 1). A large cell carcinoma of the lung and a rectal adenocarcinoma were confirmed. Histological evaluation was, however, of limited usefulness in contributing to the medico‐legal evaluation of cases, with careful scene, external and internal examinations providing the most relevant information. The results of histological examination of tissues were all incidental to the cause, mechanism, and manner of death.
Fetal growth and later maternal death, cardiovascular disease and diabetes
Authors: LYKKE JACOB A. , PAIDAS MICHAEL J. , TRICHE ELIZABETH W. , LANGHOFF‐ROOS JENS
Published: February 2012

Objectives. Low birthweight of the offspring has been associated with increased risk of early death and ischemic heart disease in the mother. However, other measurements of fetal growth than the basic birthweight are more accurate. We investigated the relation between the standardized birthweight by gestational age and gender and the ponderal index and the mother's subsequent mortality and cardiovascular morbidity. Design. Registry‐based retrospective cohort study. Setting. Women with a first singleton delivery in Denmark from 1978 to 2007. Population. 782 287 women followed for 14.6 years yielding 11 600 945 person‐years. Methods. Cox proportional hazard models. Main outcome measures. The primary exposures were variation in the standardized birthweight and ponderal index. The endpoints were subsequent maternal death, hypertension, ischemic heart disease, stroke, thrombosis, and diabetes mellitus. Results. The risk‐profile for the standardized birthweight and subsequent maternal death had a nadir between –0.5 and –1 SD (HR 0.91; 95%CI 0.83–1.00) and increased with decreasing fetal growth peaking at <−3 SD (HR 2.75; 95%CI 2.37–3.19) compared to the median. The risk‐profile for subsequent diabetes mellitus by standardized ponderal index had a nadir between +0.5 to +1 SD (HR 0.82; 95%CI 0.76–0.89) rising with increasing fetal growth and peaking at >+3 SD (HR 17.8; 95%CI 15.0–21.0). The risk‐profiles for standardized ponderal index paralleled those for birthweight, but with smaller risk estimates. Adjusting for other pregnancy complications diminished the estimates. Conclusion. The fetal growth is a marker of subsequent risk for premature death, cardiovascular disease, and diabetes mellitus in the mother.
The B7 Homologues and their Receptors in Hematologic Malignancies
Authors: Wilcox Ryan A. , Ansell Stephen M. , Lim Megan S. , Zou Weiping , Chen Lieping
Published: February 2012

The B7 homologues and their receptors regulate both peripheral tolerance and adaptive immunity. This field is rapidly evolving as new ligands and receptors are being identified. Much of the work supporting their role in the regulation of host anti‐tumor immunity has been derived from experimental models and clinical trials in solid malignancies. However, a growing body of evidence demonstrates that the B7‐H family has important immunologic and non‐immunologic functions in a variety of hematologic malignancies. Herein, we will review recent evidence that supports the therapeutic targeting of the B7 homologues in hematologic malignancies.