bluuebunny/crossref_metadata_2025 huggingface dataset:
Sex‐based differences in cardiac ischaemic injury and protection: therapeutic implications
Authors: Ostadal B , Ostadal P
Published: June 2013

Ischaemic heart disease (IHD) is the most frequent cause of mortality among men and women. Many epidemiological studies have demonstrated that premenopausal women have a reduced risk for IHD compared with their male counterparts. The incidence of IHD in women increases after menopause, suggesting that IHD is related to declining oestrogen levels. Experimental observations have confirmed the results of epidemiological studies investigating sex‐specific differences in cardiac tolerance to ischaemia. Female sex appears also to favourably influence cardiac remodelling after ischaemia/reperfusion injury. Furthermore, sex‐related differences in ischaemic tolerance of the adult myocardium can be influenced by interventions during the early phases of ontogenetic development. Detailed mechanisms of these sex‐related differences remain unknown; however, they involve the genomic and non‐genomic effects of sex steroid hormones, particularly the oestrogens, which have been the most extensively studied. Although the protective effects of oestrogen have many potential therapeutic implications, clinical trials have shown that oestrogen replacement in postmenopausal women may actually increase the incidence of IHD. The results of these trials have illustrated the complexity underlying the mechanisms involved in sex‐related differences in cardiac tolerance to ischaemia. Sex‐related differences in cardiac sensitivity to ischaemia/reperfusion injury may also influence therapeutic strategies in women with acute coronary syndrome. Women undergo coronary intervention less frequently and a lower proportion of women receive evidence‐based therapy compared with men. Although our understanding of this important topic has increased in recent years, there is an urgent need for intensive experimental and clinical research to develop female‐specific therapeutic strategies. Only then we will be able to offer patients better evidence‐based treatment, a better quality of life and lower mortality.

Linked Articles

This article is part of a themed section on Biological Sex and Cardiovascular Pharmacology. To view the other articles in this section visit http://dx.doi.org/10.1111/bph.2014.171.issue‐3
Interactive research and the construction of knowledge in conflict‐affected settings
Authors: van der Haar Gemma , Heijmans Annelies , Hilhorst Dorothea
Published: June 2013

This paper contributes to ongoing debates about the possibilities/impossibilities and particular challenges related to conducting field research in conflict settings by addressing a particular topic of concern: collaboration between researchers, organisations, respondents, and other actors present in the field. Whereas collaboration with local actors has been common for reasons of access and security, there seems to be a lack of recognition of the manner in which collaboration in the field shapes the generation of knowledge on conflict and post‐conflict settings. The objectives of this paper are twofold: (i) to highlight the potential contribution of research collaborations in conflict environments beyond pragmatic considerations of access and security; and (ii) to argue for more explicit attention to how such forms of collaboration influence the construction of knowledge and for more rigour in tracing the implications of such cooperation. The paper seeks to contribute to continuous learning on the possibilities/impossibilities of working with interactive research under conditions of conflict and insecurity.
Fractures in children with cerebral palsy: a total population study
Authors: Uddenfeldt Wort Ulrika , Nordmark Eva , Wagner Philippe , Düppe Henrik , Westbom Lena
Published: June 2013

Aim

To analyse factors associated with fractures in children with cerebral palsy (CP) in different levels of Gross Motor Function Classification System (GMFCS).

Method

This was an epidemiological retrospective study of a total population of 536 children (214 females, 322 males) with CP born between 1990 and 2005. CP type was unilateral spastic (n=159), bilateral spastic (n=225), ataxic (n=60), dyskinetic (n=80), and mixed type (n=12); 384 children were in Gross Motor Function Classification Scale (GMFCS) levels I–III and 152 children were in GMFCS levels IV–V. Data were collected for a 9‐year period on sex, CP‐type, GMFCS level, gastrostomy, height, weight, the use of a standing device, antiepileptic drug (AED) therapy, and fractures.

Results

The risk of fracture in the total population of children with CP was similar to that for typically developing children. The risk for fractures of those in GMFCS levels I–III was not significantly associated with any of the studied risk factors. The risk of fractures for those in GMFCS levels IV–V on AED therapy was a twofold increase (p=0.004). The risk for fractures without trauma in children with stunted growth (height for age <−3 SD) and those who did not use standing devices was significantly increased: adjusted incidence rate ratio (AIRR) 4.16 (p=0.011) and 3.66 (p=0.010) respectively. Results regarding gastrostomy feeding for those in GMFCS levels IV–V were conflicting: a gastrostomy was associated with a reduced risk of fractures with trauma, but with increased risk of fractures without trauma (AIRR 0.10, p=0.003 and 4.36, p=0.012) respectively.

Interpretation

Children in GMFCS levels I–III had a similar incidence and pattern for fractures as normally developing children. Those in GMFCS levels IV–V had stunted growth, often a sign of longstanding undernourishment, and were associated with an increased risk of fractures. Children using standing devices had a fourfold reduction of fractures without trauma. Regular loading exercises and early adequate nutritional intake could prevent fractures in severe CP.
Incidence of convulsive epilepsy in a rural area in Kenya
Authors: Ngugi Anthony K. , Bottomley Christian , Scott J. Anthony G. , Mung'ala–Odera Victor , Bauni Evasius , Sander Josemir W. , Kleinschmidt Immo , Newton Charles R.
Published: June 2013

Purpose

There are only a few studies of incidence of epilepsy in low and middle income countries (LMICs). These are often small and conducted in specific age groups or areas where the prevalence of risk factors is high; therefore, these studies are not representative of the wider populations. We determined the incidence of convulsive epilepsy (CE) in a large rural population in Kenya.

Methods

We conducted two cross‐sectional surveys 5 years apart within a health and demographic surveillance system. Initially we identified residents without epilepsy who were then reexamined in the follow‐up survey to determine incidence. We estimated the overall incidence of CE and incidence by age‐group, sex, and by administrative location. Estimates were adjusted for attrition during case identification and for the sensitivity of the screening method.

Key Findings

In a cohort of 151,408 people, 194 developed CE over the 5 years. The minimum crude incidence rate was 37.6/100,000 persons per year (95% confidence interval (CI) 32.7–43.3) and adjusted for loss to follow‐up, and the sensitivity of the survey methodology was 77.0/100,000 persons per year (95% CI 67.7–87.4). Incidence was highest in children 6–12 years (96.1/100,000 persons per year; 95% CI 78.4–117.9), and was lowest in the 29–49 year age group (37.4/100,000 persons per year; 95% CI 25.7–54.7).

Significance

We estimated a high incidence of convulsive epilepsy in this population. Incidence was highest early and late in life, suggesting that preventive interventions should target exposures that occur in these age groups. Incidence of focal epilepsy was more than twice that of generalized epilepsy, suggesting that etiologies that are amenable to intervention were most important in this population. It is likely that incidence is underestimated because of the early mortality of incident cases.
The principal PINK1 and Parkin cellular events triggered in response to dissipation of mitochondrial membrane potential occur in primary neurons
Authors: Koyano Fumika , Okatsu Kei , Ishigaki Shinsuke , Fujioka Yusuke , Kimura Mayumi , Sobue Gen , Tanaka Keiji , Matsuda Noriyuki
Published: June 2013

PINK1 and PARKIN are causal genes for hereditary Parkinsonism. Recent studies have shown that PINK1 and Parkin play a pivotal role in the quality control of mitochondria, and dysfunction of either protein likely results in the accumulation of low‐quality mitochondria that triggers early‐onset familial Parkinsonism. As neurons are destined to degenerate in PINK1/Parkin‐associated Parkinsonism, it is imperative to investigate the function of PINK1 and Parkin in neurons. However, most studies investigating PINK1/Parkin have used non‐neuronal cell lines. Here we show that the principal PINK1 and Parkin cellular events that have been documented in non‐neuronal lines in response to mitochondrial damage also occur in primary neurons. We found that dissipation of the mitochondrial membrane potential triggers phosphorylation of both PINK1 and Parkin and that, in response, Parkin translocates to depolarized mitochondria. Furthermore, Parkin's E3 activity is re‐established concomitant with ubiquitin–ester formation at Cys431 of Parkin. As a result, mitochondrial substrates in neurons become ubiquitylated. These results underscore the relevance of the PINK1/Parkin‐mediated mitochondrial quality control pathway in primary neurons and shed further light on the underlying mechanisms of the PINK1 and Parkin pathogenic mutations that predispose Parkinsonism in vivo.
Systemic perspective of violence and aggression in mental health care: Towards a more comprehensive understanding and conceptualization: Part 1
Authors: Cutcliffe John R. , Riahi Sanaz
Published: June 2013

Aggression and violence (A/V) in mental health care are all too frequent occurrences; they produce a wide range of deleterious impacts on the individual client, staff, organizations, and the broader community. A/V is a multifaceted and highly‐complex problem, and is associated empirically with a wide range of phenomena. However, most attempts to reduce A/V in mental health care have invariably focused on one or two aspects of the problem at the expense of a more comprehensive, systemic approach; these have produced inconclusive results. As a result, this two‐part paper seeks to: (i) recognize the wide range of phenomena that have been found to have an association with A/V in mental health care; (ii) synthesize these propositions according to fit or congruence into a systemic model of A/V; (iii) explore empirical evidence pertaining to these propositions; and (iv) begin to consider the application of this model to better inform our individual and/or organizational responses to A/V in mental health care. The paper advances a systemic model of these phenomena comprised of four thematic categories, with Part 1 of this paper focusing on the first two categories: environmental and intrapersonal (client‐related) phenomena.
Reservoir parameter classification of a Miocene formation using a fractal approach to well logging, porosimetry and nuclear magnetic resonance
Authors: Jarzyna Jadwiga A. , Bala Maria J. , Mortimer Zofia M. , Puskarczyk Edyta
Published: June 2013

A methodology for rock classification is presented that considers lithology and reservoir parameters on the basis of a combined fractal analysis of well logs and mercury porosimetry results with nuclear magnetic resonance outcomes. A sandy‐shaly thinly‐bedded Miocene gas bearing formation in the Carpathian Foredeep is investigated. Fractal correlation dimensions D2 calculated for standard logs are used to distinguish sandstone as the most homogeneous lithological group with the highest porosity. The fractal analysis also confirmed observations of gas accumulations in sandstone, shaly sandstone and sandy claystone as rocks of high porosity. The results of two laboratory methods are combined to improve reservoir properties assessment and evaluate movable media in pore space; this technique was based on the similarity of mercury porosimetry results plotted as cumulative intrusion volume versus pressure or pore diameter and also the curves of cumulative porosity and transverse relaxation time distributions using nuclear magnetic resonance. Close values of porosity from logs, recorded in situ and in laboratory measurements, provide the link between fractal analysis and porosimetry and nuclear magnetic resonance measurements.
Determinants of Endothelial Cell Phenotype in Venules
Authors: THURSTON GAVIN , BALUK PETER , MCDONALD DONALD M.
Published: June 2013

Inflammatory stimuli cause plasma leakage and leukocyte adhesion in venules but not in capillaries or arterioles. The specific response of venules is governed by phenotypic specialization of the venular endothelial cells. What regulates this specialized phenotype? Several recent developments have shed new light on this question and may challenge our thinking about regulation of the venular endothelial cell phenotype. In this review, we consider some of the molecular markers of venular endothelial cells, the hemodynamic and molecular factors that may regulate the phenotype of venular endothelial cells, and abnormalities in endothelial cell phenotype in disease‐related angiogenesis and microvascular remodeling. The expanding list of molecular markers may help clarify the physiologic and molecular factors that regulate the phenotype of venular endothelial cells in normal development and disease.
The Nurse's Role in Addressing Unmet Treatment and Management Needs of Patients With Rheumatoid Arthritis: Delphi‐Based Recommendations
Authors: Cottrell Jane E. D. , Jonas Monique , Bergsten Ulrika , Blaas Etienne , de la Torre Aboki Jenny , Howse Catriona , Korandova Jana , Löfman Päivi , Logtenberg Carin , Lupton Terri , Mallon Catherine , Oliver Susan , Pickles David , Bulinckx Leeanna
Published: June 2013

Purpose

Evaluate nurse's role in management of patients with rheumatoid arthritis (RA).

Methods

Modified Delphi with two rounds of questionnaires, followed by in‐person meeting. International group of 12 nurses experienced with RA patients receiving biologic therapy.

Findings

Nurses often spend more time with patients than doctors do. Nurse is in unique position to explore patient needs; educate about treatment, administration, product storage, and self‐injection technique; determine readiness for and understanding of treatment; monitor safety and progress; and coordinate care within multidisciplinary setting.

Conclusions

Nurse's role is complex and vitally important to optimal RA patient care. Additional nurse involvement may address unmet needs.

Implications for nursing practice

Rheumatology nurses can address unmet patient needs by expanding current roles and by adopting additional functions.
Complex evolutionary history of the pallid dotted‐blue butterfly (Lycaenidae: Euphilotes pallescens) in the Great Basin of western North America
Authors: Wilson Joseph S. , Sneck Michelle , Murphy Dennis D. , Nice Chris C. , Fordyce James A. , Forister Matthew L.
Published: June 2013

Aim

The aim of this study was to investigate patterns of genetic isolation associated with populations in discrete habitat patches in a North American cold desert through analysis of the pallid dotted‐blue butterfly, Euphilotes pallescens. This small butterfly is largely restricted to low‐elevation habitats across the Great Basin. The apparent geographical isolation and reported morphological variation among E. pallescens populations makes this species an ideal candidate with which to investigate patterns of genetic isolation and diversification in this arid region.

Location

Great Basin, western North America.

Methods

We used sequence data from nuclear and mitochondrial genes to investigate genetic diversity among E. pallescens populations, and among E. pallescens and a number of closely related Euphilotes species, using Bayesian phylogenetic analyses, as well as population genetic analyses. In conjunction with genetic variation, morphological variation was examined in the context of geographical and subspecific differentiation.

Results

Our genetic and morphological analyses suggest a moderate amount of isolation among populations, consistent with the hypothesis of restricted gene flow among isolated dune habitats, and possibly associated with isolation in distinct Pleistocene refugia. The patterns of diversification within E. pallescens and among closely related species are complicated by discordance among phylogenetic reconstructions based on nuclear and mitochondrial genes. Discordance among gene genealogies suggests a complex evolutionary history, perhaps involving alternating periods of reticulation and divergence in isolation.

Main conclusions

Although E. pallescens may be a vagile species, we find that persistence on isolated dunes in the Great Basin is associated with appreciable genetic and morphological differentiation among populations. However, genetic, morphological and taxonomic axes of variation are only partially in agreement. More generally, the discordance we find among genetic regions is consistent with the ascendant paradigm in phylogenetic reconstruction: gene genealogies often do not perfectly match species trees. Thus we present Euphilotes as a model for future biogeographical and phylogenetic reconstructions employing larger data sets of independent sequence markers.
A Multidisciplinary Approach to Supply Chain Agility: Conceptualization and Scale Development
Authors: Gligor David M. , Holcomb Mary C. , Stank Theodore P.
Published: June 2013

Although agility has been identified as one of the most important issues of contemporary supply chain management, the theoretical basis for understanding supply chain agility is fragmented. This research addresses the gap related to the ambiguity surrounding the dimensions and definitions of firm supply chain agility by employing a multidisciplinary literature review to gain an in‐depth understanding of agility. In addition, a comprehensive measurement instrument that draws on the foundations of social and life science theory is developed and empirically validated. The results of the research indicate that firm supply chain agility is composed of five distinct dimensions including alertness, accessibility, decisiveness, swiftness, and flexibility. Based on these elements, a comprehensive definition of firm supply chain agility is developed for further theoretical testing of the concept.
Detection of Test Collusion via Kullback–Leibler Divergence
Authors: Belov Dmitry I.
Published: June 2013

The development of statistical methods for detecting test collusion is a new research direction in the area of test security. Test collusion may be described as large‐scale sharing of test materials, including answers to test items. Current methods of detecting test collusion are based on statistics also used in answer‐copying detection. Therefore, in computerized adaptive testing (CAT) these methods lose power because the actual test varies across examinees. This article addresses that problem by introducing a new approach that works in two stages: in Stage 1, test centers with an unusual distribution of a person‐fit statistic are identified via Kullback–Leibler divergence; in Stage 2, examinees from identified test centers are analyzed further using the person‐fit statistic, where the critical value is computed without data from the identified test centers. The approach is extremely flexible. One can employ any existing person‐fit statistic. The approach can be applied to all major testing programs: paper‐and‐pencil testing (P&P), computer‐based testing (CBT), multiple‐stage testing (MST), and CAT. Also, the definition of test center is not limited by the geographic location (room, class, college) and can be extended to support various relations between examinees (from the same undergraduate college, from the same test‐prep center, from the same group at a social network). The suggested approach was found to be effective in CAT for detecting groups of examinees with item pre‐knowledge, meaning those with access (possibly unknown to us) to one or more subsets of items prior to the exam.
Analyses of the NAC Transcription Factor Gene Family in Gossypium raimondii Ulbr.: Chromosomal Location, Structure, Phylogeny, and Expression Patterns
Authors: Shang Haihong , Li Wei , Zou Changsong , Yuan Youlu
Published: June 2013

NAC domain proteins are plant‐specific transcription factors known to play diverse roles in various plant developmental processes. In the present study, we performed the first comprehensive study of the NAC gene family in Gossypium raimondii Ulbr., incorporating phylogenetic, chromosomal location, gene structure, conserved motif, and expression profiling analyses. We identified 145 NAC transcription factor (NAC‐TF) genes that were phylogenetically clustered into 18 distinct subfamilies. Of these, 127 NAC‐TF genes were distributed across the 13 chromosomes, 80 (55%) were preferentially retained duplicates located in both duplicated regions and six were located in triplicated chromosomal regions. The majority of NAC‐TF genes showed temporal‐, spatial‐, and tissue‐specific expression patterns based on transcriptomic and qRT‐PCR analyses. However, the expression patterns of several duplicate genes were partially redundant, suggesting the occurrence of sub‐functionalization during their evolution. Based on their genomic organization, we concluded that genomic duplications contributed significantly to the expansion of the NAC‐TF gene family in G. raimondii. Comprehensive analysis of their expression profiles could provide novel insights into the functional divergence among members of the NAC gene family in G. raimondii.
Brainstem Raphe Alterations Depicted by Transcranial Sonography Do Not Result in Serotonergic Functional Impairment
Authors: Krogias Christos , Fischer Gerrit , Meves Saskia H. , Gold Ralf , Juckel Georg , Norra Christine
Published: June 2013

In transcranial sonography (TCS), hypoechogenic signal of mesencephalic raphe structures has been described as a frequent finding in unipolar depression. It remains unclear if raphe hypoechogenicity represents a correlate for an altered serotonergic system. The loudness dependence of auditory evoked potentials (LDAEP) has been proposed as an indirect indicator of central serotonergic activity. Aim of this study was to evaluate TCS and LDAEP as independent variables of the human cerebral serotonergic system. Sonographic and electrophysiological investigations as well as psychometric assessment were performed blindly in 44 healthy subjects (28.7 ± 7.0 years; 24 females). Hypoechogenic raphe was detected in 6 subjects (13.6%). Three probands (6.8%) exhibit hyperechogenicity of Substantia nigra. LDAEP values ranged between −2.80 and 8.40 mVeff/10dB (2.31 ± 2.44). No correlations between LDAEP and sonographic findings were found. There were no significant correlations with the psychometric assessments. At least in healthy subjects, our findings do not support the hypothesis that abnormal structural finding of hypoechogenic BR in TCS is accompanied by a functional impairment of serotonergic system as assessed by LDAEP. Further multimodal studies on patients with depressive disorders are needed to elucidate the impact of the hypoechogenic raphe signal in the pathophysiology of depression.
FasL expression in articular discs of human temporomandibular joint and association with osteoarthrosis
Authors: de Alcântara Camejo Flavio , Almeida Luis Eduardo , Doetzer Andrea Duarte , Caporal Karina São Thiago , Ambros Viviane , Azevedo Marina , Alanis Luciana Reis Azevedo , Olandoski Marcia , Noronha Lucia , Trevilatto Paula Cristina
Published: June 2013

Background

Apoptosis is a programme of cell death which does not induce an inflammatory response. Recent previous research has suggested a correlation between temporomandibular internal derangement and apoptosis. Fas ligand (FasL) is an apoptosis‐inducing factor, known to trigger apoptosis through distinct signal pathways. This study aims to examine, by immunohistochemistry, the expression of FasL in temporomandibular joint (TMJ) articular discs of patients with anterior disc displacement with reduction (ADDwR) and without reduction (ADDwoR) in patients with and without osteoarthrosis (OA).

Methods

Forty‐two (n = 42) TMJ articular discs were divided into two cut‐offs: (i) 8 control, 17 ADDwR, 17 ADDwoR, and (ii) without OA (n = 25) and with OA (n = 17). The area of immunostaining was compared statistically between groups (P < 0.05).

Results

Statistically significant differences were found in the expression of FasL in TMJ discs between the three groups (P = 0.001). ADDwR presented significant higher FasL expression when compared with ADDwoR (P < 0.001). Significant higher FasL expression was observed in the group without OA (P = 0.001). All patients without OA presented ADDwR, while all the patients with OA presented ADDwoR.

Conclusion

A higher area of in situ immunostaining of FasL was found in temporomandibular discs with reduction, which is the less severe condition. Moreover, a reduced expression of FasL in the discs of patients with osteoarthrosis was found, suggesting that some aspects of apoptosis might underlie the progression of TMJ disorders.
Influence of fluorescence on screening decisions for oral mucosal lesions in community dental practices
Authors: Laronde Denise M. , Williams P. M. , Hislop T. G. , Poh Catherine , Ng Samson , Bajdik Chris , Zhang Lewei , MacAulay Calum , Rosin Miriam P.
Published: June 2013

Background

Quality of oral screening examinations is dependent upon the experience of the clinician and can vary widely. Deciding when a patient needs to be referred is a critical and difficult decision for general practice clinicians. A device to aid in this decision would be beneficial.

The objective of this study was to to examine the utility of direct fluorescence visualization (FV) by dental practitioners as an aid in decision‐making during screening for cancer and other oral lesions.

Methods

Dentists were trained to use a stepwise protocol for evaluation of the oral mucosa: medical history, head, neck and oral exam, and fluorescent visualization exam. They were asked to use clinical features to categorize lesions as low (LR), intermediate (IR), or high (HR) risk and then to determine FV status of these lesions. Clinicians made the decision of which lesions to reassess in 3 weeks and based on this reassessment, to refer forward.

Results

Of 2404 patients screened over 11 months, 357 initially had lesions with 325 (15%) identified as LR, 16 (4.5%) IR, and 16 (4.5%) HR. Lesions assessed initially as IR and HR had a 2.7‐fold increased risk of FV loss persisting to the reassessment appointment versus the LR lesions. The most predictive model for lesion persistence included both FV status and lesion risk assessment.

Conclusion

A protocol for screening (assess risk, reassess, and refer) is recommended for the screening of abnormal intraoral lesions. Integrating FV into a process of assessing and reassessing lesions significantly improved this model.
Attachment‐Related Individual Differences in the Consistency of Relationship Behavior Interpretation
Authors: Marks Michael J. , Trafimow David , Rice Stephen C.
Published: June 2013

The consistency with which people interpret relationship‐based information has important implications for attachment theory and research. Our objective is to determine whether there are attachment‐related individual differences in the manner and the consistency with which individuals interpret hypothetical relationship behaviors. In two studies (N = 629, 79% female, 63% American, Mage = 29; N = 820, 78% female, 65% American, Mage = 29), we assessed participants' ability and consistency in relationship behavior interpretation across two blocks and estimated how they would have performed had they interpreted information perfectly consistently. Secure participants were generally more consistent in their interpretations relative to insecure participants. Estimates of perfectly consistent interpretation revealed that improvements to both systematic factors related to behavior interpretation (e.g., working models) and consistency would have led to a more secure interpretation style for participants of all attachment styles. Results imply that both secure and insecure individuals process relationship‐based information according to secure scripts, but insecure individuals do so inconsistently. Our results imply that, due to the inconsistent behavioral responses that may occur as a result of inconsistent information processing, the consistency with which people process relationship‐related information will be related to relationship satisfaction. Further directions for future research are discussed.
Fitness limitations in non‐disabled extremely low birthweight adolescents
Authors: Danks Marcella , Burns Yvonne R , Gibbons Kristen , Gray Peter H , O'Callaghan Michael J , Poulsen Leith , Watter Pauline
Published: June 2013

Aim

This study aims to compare non‐disabled otherwise healthy extremely low birthweight (ELBW) (<1000 g) children and term‐born peers in an investigation of relationship between cardiorespiratory endurance and parent report of competence.

Methods

Forty‐eight of 105 eligible ELBW 11‐ to 13‐year‐old children (27 male) and 55 term‐born school peers (28 male) completed a 20‐m shuttle run, anthropometric measures, respiratory function tests and the Motor Assessment Battery for Children. Parents completed the Child Behavior Checklist (CBCL).

Results

The ELBW group had poorer cardiorespiratory endurance (P = 0.002), growth (P = 0.002), respiratory function (P = 0.003) and motor ability (P < 0.001) than term‐born peers. Parents reported the ELBW children to be less competent than term‐born peers: CBCL total T score mean difference −9, 95% confidence interval −14, −5 (P < 0.001). Cardiorespiratory endurance predicted competence (regression coefficient 0.865; 95% confidence interval 0.352, 1.378; P = 0.001) independent of prematurity, growth, respiratory function, motor score, gender and socio‐economic status. Cardiorespiratory endurance had association with social competence for all participating children, but was related to CBCL Activities Competence only for the ELBW children who were the significantly less fit group.

Conclusions

The poor cardiorespiratory endurance prevalent in non‐disabled otherwise healthy ELBW children is associated with general competence independent of prematurity and of the impact of other mild physical deficits, gender or socio‐economic status. The relationship demonstrated between cardiorespiratory endurance and competence to engage in general activities of daily living, seen only in the less fit ELBW children, identifies the fitness levels in non‐disabled ELBW children as a barrier to participation.
Effects of morning report case presentation on length of stay and hospitalisation costs
Authors: Boushehri Elham , Khamseh Mohammad E , Farshchi Amir , Aghili Rokhsareh , Malek Mojtaba , Ebrahim Valojerdi Ameneh
Published: June 2013

Context

The primary goal of discussing patient cases during the morning report is to teach appropriate clinical decision making. In addition, the selection of the best diagnostic strategy and application of evidence‐based patient care are important. Reducing hospital costs is fundamental to controlling inflation in health care costs, especially in university hospitals that are subject to budget constraints in developing countries. The goal of this study was to explore the effect of morning report case presentation on length of stay (LoS) and hospitalisation costs in a university teaching hospital.

Methods

A total of 54 patients whose cases had been presented at morning report sessions in the department of internal medicine during a 3‐month period (presented group) were selected and their medical records reviewed for data on final diagnosis, hospital LoS and detailed hospital costs. A control group of 104 patients, whose cases had not been presented, were selected on the basis that their final diagnoses matched with those of the presented group. In addition, the groups were matched for age, sex, occupation, comorbidities and insurance coverage. Final diagnoses were based on International Classification of Disease 10 (ICD‐10) diagnostic code criteria.

Results

The mean ± standard deviation (SD) hospital LoS was 8.32 ± 4.11 days in the presented group and 10.46 ± 4.92 days in the control group (p = 0.045). Mean ± SD hospitalisation costs per patient were significantly lower in the presented group (US$553.43 ± 92.16) than the control group (US$1621.93 ± 353.14) (p = 0.004). Although costs for paraclinical services were similar, there were very significant reductions in costs for medications used during hospitalisation and bed‐days (p = 0.002).

Conclusions

Discussing clinical aspects of patient cases in morning report sessions facilitates the management process and has a significant effect on LoS and hospitalisation costs in patients admitted to hospital.
A call to order at the spirochaetal host–pathogen interface
Authors: Zückert Wolfram R.
Published: June 2013

As the Lyme disease spirochaete Borrelia burgdorferi shuttles back and forth between arthropod vector and vertebrate host, it encounters vastly different and hostile environments. Major mechanisms contributing to the success of this pathogen throughout this complex transmission cycle are phase and antigenic variation of abundant and serotype‐defining surface lipoproteins. These peripherally membrane‐anchored virulence factors mediate niche‐specific interactions with vector/host factors and protect the spirochaete from the perils of the mammalian immune response. In this issue of Molecular Microbiology, Tilly, Bestor and Rosa redefine the roles of two lipoproteins, OspC and VlsE, during mammalian infection. Using a variety of promoter fusions in combination with a sensitive in vivo ‘use it or lose it’ gene complementation assay, the authors demonstrate that proper sequential expression of OspC followed by VlsE indeed matters. A previously suggested general functional redundancy between these and other lipoproteins is shown to be limited and dependent on an immunodeficient experimental setting that is arguably of diminished ecological relevance. These data reinforce the notion that OspC plays a unique role during initial infection while the antigenically variant VlsE proteins allow for persistence in the mammalian host.
A single amino acid substitution in the MurF UDP‐MurNAc‐pentapeptide synthetase renders Streptococcus pneumoniae dependent on CO2 and temperature
Authors: Burghout Peter , Quintero Beatríz , Bos Linda , Beilharz Katrin , Veening Jan‐Willem , de Jonge Marien I. , van der Linden Mark , van der Ende Arie , Hermans Peter W. M.
Published: June 2013

The respiratory tract pathogen Streptococcus pneumoniae encounters different levels of environmental CO2 during transmission, host colonization and disease. About 8% of all pneumococcal isolates are capnophiles that require CO2‐enriched growth conditions. The underlying molecular mechanism for caphnophilic behaviour, as well as its biological function is unknown. Here, we found that capnophilic S. pneumoniae isolates from clonal complex (CC) 156 (i.e. Spain9V‐3 ancestry) and CC344 (i.e. NorwayNT‐42 ancestry) have a valine at position 179 in the MurF UDP‐MurNAc‐pentapeptide synthetase. At ≤ 30°C, the growth characteristics of capnophilic and non‐capnophilic CC156 strains were equal, but at > 30°C growth and survival of MurFV179 strains was dependent on > 0.1% CO2‐enriched conditions. Expression of MurFV179 in S. pneumoniae R6 and G54 rendered these, otherwise non‐capnophilic strains, capnophilic. Time‐lapse microscopy revealed that a capnophilic CC156 strain undergoes rapid autolysis upon exposure to CO2‐poor conditions at 37°C, and staining with fluorescently labelled vancomycin showed a defect in de novo cell wall synthesis. In summary, in capnophilic S. pneumoniae strains from CC156 and CC344 cell wall synthesis is placed under control of environmental CO2 levels and temperature. This mechanism might represent a novel strategy of the pneumococcus to rapidly adapt and colonize its host under changing environmental conditions.
Determinants of the dynamics of electricity consumption in Nigeria
Authors: Ubani Obinna
Published: June 2013

The persistent electricity supply problems in Nigeria are attributable to the inability of energy planners to accurately forecast the effect of the various socioeconomic and physical factors that influence the electricity consumption across the country. The major problem with the existing forecasts of electricity consumption is often assumed to be associated with poor identification of these socioeconomic and physical factors upon which they are based. The goal of this study is to empirically determine the various factors that affect the electricity consumption rate in Nigeria. The study covers an annual time series data from 1985 to 2005. Data for the study were collected through secondary sources. Multiple linear regression was used to test the research hypothesis. The result suggests that electricity consumption was significantly related to 6 of the 12 socioeconomic and physical factors of this consumption rate studied at 0.01 level (R2 = 0.992). These are degree of urbanisation, population density, number of manufacturing industry, number of households with electricity, employment rate and distance to nearest power generating station. These six variables are significantly in determining the electricity consumption in Nigeria. Policies based on the outcome of this study will produce positive and sound policy actions.
Inspired gas humidity and temperature during mechanical ventilation with the Stephanie ventilator
Authors: Preo Bianca L. , Shadbolt Bruce , Todd David A.
Published: June 2013

Aims

To measure inspired gas humidity and temperature delivered by a Stephanie neonatal ventilator with variations in (i) circuit length; (ii) circuit insulation; (iii) proximal airway temperature probe (pATP) position; (iv) inspiratory temperature (offset); and (v) incubator temperatures.

Methods

Using the Stephanie neonatal ventilator, inspired gas humidity and temperature were measured during mechanical ventilation at the distal inspiratory limb and 3 cm down the endotracheal tube. Measurements were made with a long or short circuit; with or without insulation of the inspiratory limb; proximal ATP (pATP) either within or external to the incubator; at two different inspiratory temperature (offset) of 37(−0.5) and 39(−2.0)°C; and at three different incubator temperatures of 32, 34.5, and 37°C.

Results

Long circuits produced significantly higher inspired humidity than short circuits at all incubator settings, while only at 32°C was the inspired temperature higher. In the long circuits, insulation further improved the inspired humidity especially at 39(−2.0)°C, while only at incubator temperatures of 32 and 37°C did insulation significantly improve inspired temperature. Positioning the pATP outside the incubator did not result in higher inspired humidity but did significantly improve inspired temperature. An inspiratory temperature (offset) of 39(−2.0)°C delivered significantly higher inspired humidity and temperature than the 37(−0.5)°C especially when insulated.

Conclusions

Long insulated Stephanie circuits should be used for neonatal ventilation when the infant is nursed in an incubator. The recommended inspiratory temperature (offset) of 37(−0.5)°C produced inspired humidity and temperature below international standards, and we suggest an increase to 39(−2.0)°C.
Effects of nutrient enrichment and herbivory on morphology, reproduction and chemical content of Turbinaria conoides (Phaeophyceae)
Authors: Mayakun Jaruwan , Kim Jeong Ha , Lapointe Brian E. , Prathep Anchana
Published: June 2013

The effects of nutrient enrichment and herbivory on resource allocation patterns among morphology, reproduction, and chemical content of the brown alga, Turbinaria conoides (J. Agardh) Kützing were tested in the shallow subtidal zone of the Gulf of Thailand. The field experimental design comprised 36 plots (50 × 50 cm2) with and without herbivores, and two nutrient levels. Cages (uncaged and fully caged plots) were used to exclude herbivorous fishes and two nutrients levels were achieved by experimental enrichment above ambient nutrient concentrations. For morphology of Turbinaria, the maximum length (holdfast to frond apex), the width of the base of the stipe, number of blades, holdfast and stipe diameter were measured. Biomass, reproductive output, and tissue nutrient (carbon: nitrogen: phosphorus) content of T. conoides were examined. Phlorotannin concentrations were examined using a modified Folin‐Ciocalteu method. The results showed that herbivory had no effect on morphology, reproduction, or phlorotannin concentrations. This could be due to the structural and morphological deterrents of alga, which might minimize grazing effects from herbivorous fishes. Nutrient enrichment had no effect on morphology and reproduction of T. conoides, possibly due to low nutrient demand in Turbinaria. However, nutrient enrichment did affect phlorotannin concentrations, as phlorotannins in the enriched plots were lower than the ambient plots. These results support, in part, the carbon–nutrient balance hypothesis that states algae will allocate fewer resources to production of anti‐herbivore chemical compounds when enriched with potential growth‐limiting nutrients.
Symbolic dimensions of the anti‐opium campaign in Laos
Authors: Cohen Paul T.
Published: June 2013

This article is concerned with the campaign to eradicate opium consumption and cultivation among highland minorities of northern Laos. The campaign has attracted political explanations that emphasise external pressure and enticements from the United States and the United Nations as part of the global War on Drugs. I argue that such explanations ignore the symbolic aspects of the domestic process of Laoisation in post‐socialist Laos that has marginalised ethnic minorities and has transformed opium into a key symbol of primitiveness and backwardness and into a fetishised cause of poverty.
Molecular angiogenic events of a two‐herb wound healing formula involving MAPK and Akt signaling pathways in human vascular endothelial cells
Authors: Liu Cheuk‐Lun , Tam Jacqueline Chor Wing , Sanders Andrew J. , Ko Chun‐Hay , Fung Kwok‐Pui , Leung Ping‐Chung , Harding Keith G. , Jiang Wen G. , Lau Clara Bik‐San
Published: June 2013

The emergence of electric cell‐substrate impedance sensing (ECIS) technology has provided new insight in advanced cell behavioral study by its nanometer sensitivity, precise electrical wounds generation, and high reproducibility that can be monitored in real time in a noninvasive way. However, little is known regarding pro‐angiogenic agents in wound healing studies using endothelial cells evaluated with ECIS technology. Our previous studies showed a prominent wound healing effect of a two‐herb formula (NF3) comprising of Astragali Radix and Rehmanniae Radix in a rat chronic wound model through actions including angiogenesis. Here we further investigated the angiogenic effect and its underlying molecular mechanism through proliferation, motility, and tubule formation of human vascular endothelial cells (HECV) using ECIS technology. It was first shown that HECV treated with NF3 had a higher resistance than that of control using ECIS cell attachment and cell migration model (p < 0.01). We further validated in a scratch assay that NF3 treatment significantly stimulated HECV cell migration (p < 0.01–0.05). Also, NF3‐treated HECV were observed to develop into a significantly more branched tubular structure when compared with control (p < 0.05–0.01). Meanwhile, Western blot analysis of NF3‐treated HECV revealed the activated expression of p‐Akt, and mitogen‐activated protein (MAP) kinases for p‐ERK, p‐p38, and p‐JNK. We propose that the effect of NF3 in the promotion of endothelial cell migration and tubule formation could be mediated through pathways involving p‐Akt and activated MAP kinases. Hence, we demonstrated the complexity of the angiogenic effect activated by NF3 molecularly and functionally. NF3 treatment could offer therapeutic value to chronic wound healing for its pro‐angiogenic efficacy.
Oxygen and wound care: A review of current therapeutic modalities and future direction
Authors: Howard Michael A. , Asmis Reto , Evans Karen Kim , Mustoe Thomas A.
Published: June 2013

While the importance of oxygen to the wound healing process is well accepted, research and technological advances continue in this field and efforts are ongoing to further utilize oxygen as a therapeutic modality. In this paper, the authors briefly review the role of oxygen in wound healing and discuss the distinct mechanism of action as well as the advantages and disadvantages of the three major oxygen‐based therapies currently in clinical use (Hyperbaric Oxygen and Topical Oxygen and Continuous Diffusion of Oxygen), as well as review the existing literature regarding these distinct therapeutic modalities.
Calcium regulation of neural rhythms, memory and Alzheimer's disease
Authors: Berridge Michael J.
Published: June 2013

Alzheimer's disease (AD) begins with a decline in cognition followed by neuronal cell death and dementia. These changes have been linked to a deregulation of Ca2+ signalling caused by a progressive increase in the resting level of Ca2+, which may influence cognition by interfering with the rhythm rheostat that controls the sleep/wake cycle. The rise in resting levels of Ca2+ may not alter the processes of memory acquisition during consciousness (gamma and theta rhythms), but may duplicate some of the events that occur during the slow oscillations responsible for the twin processes of memory consolidation and memory erasure that occur during sleep. The persistent elevation in the resting level of Ca2+ induced by an accumulation of amyloid β (Aβ) oligomers duplicates a similar small global elevation normally restricted to the period of slow oscillations when memories are erased during sleep. In AD, such a rapid erasure of memories soon after they are acquired during the wake period means that they are not retained for consolidation during sleep. The Aβ deregulates Ca2+ signalling through direct effects on the neurons and indirectly by inducing inflammatory responses in the microglia and astrocytes. Some of these deleterious effects of Aβ may be alleviated by vitamin D.
Eddy Current Nondestructive Testing for Carbon Fiber- Reinforced Composites
Authors: Koyama Kiyoshi , Hoshikawa Hiroshi , Kojima Gouki
Published: June 2013

This paper describes the use of an eddy current testing (ECT) method for the inspection and detection of impact damage in carbon fiber-reinforced composites (CFRP). ECT method is a nondestructive testing (NDT) method where electric induction is used. This method is widely used for detecting cracks and corrosion in metals, or checking their electric conductivity. Because carbon fiber in CFRP has electric conductivity, ECT method has a potential to inspect the defects. However, electric conductivity of CFRP is much smaller than that of metals. Moreover, from the view of the eddy current probe, CFRP to be checked looks as a inhomogeneous conductive materials where conductive fibers are bundled and laid up, and this is completely different situation comparing with metal samples that are homogeneous. Therefore, there are several problems to be solved for applying ECT method to CFRP such as proper selection of test frequency, shape of probe, or signal processing.