bluuebunny/crossref_metadata_2025 huggingface dataset:
Instantaneous paleomagnetic record from the Miocene Kozagawa Dike of the Kumano Acidic Rocks, Kii Peninsula, Southwest Japan: cautionary note on tectonic interpretation
Authors: Hoshi Hiroyuki , Kamiya Naohiro , Kawakami Yuu
Published: June 2013

We have conducted a paleomagnetic investigation of the Kozagawa Dike, which is part of the Kumano Acidic Rocks that are the product of a Middle Miocene volcano–plutonic complex cropping out on the Kii Peninsula of Southwest Japan. The granite porphyry facies of the dike yields stable remanent magnetization components. Precisely determined site‐mean directions of characteristic components, as revealed by principal component analysis of stepwise alternating‐field and thermal demagnetization results, form a tight cluster. The overall mean direction exhibits an approximately 40° clockwise declination shift from the south and a steep negative inclination (D = 217.3°, I = −59.8°, α95 = 2.8°; 10 sites). Rock magnetic analyses suggest that magnetite is the main stable component carrier. The overall mean direction is interpreted to be a geologically instantaneous record of the paleomagnetic field that was acquired in a relatively short time interval relative to paleomagnetic secular variations. The mean direction in geographic (in situ) coordinates obtained for the Kozagawa Dike is distinct from previously published data for laccolithic granite porphyry intrusions of the Kumano Acidic Rocks. This difference may result from a time lag during acquisition of remanent magnetization by the different units of the Kumano Acidic Rocks. The southwest and up paleomagnetic direction has previously been interpreted as representing clockwise rotation of Southwest Japan associated with back‐arc opening of the Japan Sea. However, we contend that these directions actually reflect the transient capture of an extraordinary paleomagnetic field at ca 14.3 Ma, such as a transitional or excursional state, and are not of tectonic origin.
Aqueous Gelcasting and Pressureless Sintering of Zirconium Diboride Ceramics
Authors: Yin Jie , Zhang Zhaoquan , Huang Zhengren , Zhang Hui , Yan Yongjie , Liu Xuejian , Liu Yan , Jiang Dongliang
Published: June 2013

Dense (97.3%) zirconium diboride (ZrB2) ceramics were obtained via gelcasting and pressureless sintering. Four wt% B4C was used as sintering aid. ZrB2, SiC, and B4C can codisperse well in the alkaline region, using a polyacrylate dispersant. Compared with monolithic ZrB2 (Z), the mechanical properties of ZrB2‐SiC (ZS) were enhanced. The Vickers hardness and fracture toughness of ZS were (13.1 ± 0.6) GPa and (2.5 ± 0.4) MPa m1/2, respectively.
A typology of Polish consumers and their behaviours in the market for sustainable textiles and clothing
Authors: Koszewska Małgorzata
Published: June 2013

The paper discusses Polish consumers' behaviours in the market for sustainable textiles and clothing.

The analysis presented in this article was undertaken because of:

the scarcity of studies on socially responsible consumption in so‐called new consumer countries characterized by slowly developing ethical consumer movement;

few studies analysing consumer behaviour compared with the volume of literature exploring sustainable development and corporate social responsibility of textile and clothing manufacturers.

The typology of Polish consumers presented in this article was developed based on consumers' buying habits and general apparel selection criteria, and also on ecological and social criteria that other typologies and clothing market segmentations omit. The six types of consumers that emerged from the analysis were described with respect to their specific attitudes to sustainable textiles and clothing. In analysing the consumers' behaviours, the following aspects were addressed: communication between customers and producers, product differentiation and actual purchases made by consumers.
Biochemical composition of broccoli seeds and sprouts at different stages of seedling development
Authors: López‐Cervantes Jaime , Tirado‐Noriega Lidia G. , Sánchez‐Machado Dalia I. , Campas‐Baypoli Olga N. , Cantú‐Soto Ernesto U. , Núñez‐Gastélum José A.
Published: June 2013

The proximate composition, amino acids content, fatty acid profile, total polyphenols, total flavonoids, DPPH radical scavenging capacity and sulforaphane content in broccoli seeds and sprouts were evaluated in this study. The results showed significant differences in the nutritional composition and the phytochemical level in the different stages of germination. Aspartic acid, glutamic acid, serine‐histidine, proline and threonine were found in larger concentrations. Polyphenols and flavonoids content ranged from 9 to 77 mg GAE g−1 and 33 to 117 μg QE g−1, respectively. DPPH radical scavenging capacity ranged from 174 to 674 μmol TE g−1. The sulforaphane content in seeds and sprouts ranged from 273 to 3632 μg g−1–the highest values were found in seeds and the 8‐ and 11‐day‐old sprouts. The results suggest that the broccoli sprouts are a rich source of nutrients and phytochemicals, these have a high potential as functional food.
Hours of work and rest in the rail industry
Authors: Anderson C. , Grunstein R. R. , Rajaratnam S. M. W.
Published: June 2013

Currently, the National Transport Commission is considering four options to form the regulatory framework for rail safety within Australia with respect to fatigue. While the National Transport Commission currently recommends no limitations around hours of work or rest, we provide evidence which suggests regulatory frameworks should incorporate a traditional hours of service regulation over more flexible policies. Our review highlights: Shift durations >12 h are associated with a doubling of risk for accident and injury. Fatigue builds cumulatively with each successive shift where rest in between is inadequate (<12 h). A regulatory framework for fatigue management within the rail industry should prescribe limits on hours of work and rest, including maximum shift duration and successive number of shifts. Appropriately, validated biomathematical models and technologies may be used as a part of a fatigue management system, to augment the protection afforded by limits on hours of work and rest. A comprehensive sleep disorder screening and management programme should form an essential component of any regulatory framework.
Distribution of influenza and other acute respiratory viruses during the first year after the 2009–2010 influenza pandemic in the English‐ and Dutch‐speaking Caribbean countries
Authors: Edwards Leslie , Boisson Eldonna , Nathaniel‐Girdharrie SueMin , Morris‐Glasgow Victoria
Published: June 2013

Background

Limited specimen collection and testing for influenza occurred in the English and Dutch‐speaking Caribbean countries prior to the 2009/2010 influenza pandemic. Caribbean Epidemiology Centre (CAREC) member countries rapidly mobilized to collect specimens during the pandemic and a vast majority of confirmed cases during the pandemic period were influenza A(H1N1)pdm09.

Objectives

To describe the aetiology and distribution of acute respiratory illness (ARI) among laboratory confirmed cases during the first year after the 2009/2010 influenza pandemic in the English‐ and Dutch‐speaking Caribbean.

Results

In total, 774 specimens were tested and 394 (52.7%) cases had positive laboratory confirmation. Respiratory syncytial virus (RSV) (28.4%) and influenza A(H3N2) (23.1%) were most frequently detected. RSV activity peaked in July 2011 while influenza A(H3N2) peaked in October 2010. Influenza was responsible for illness in greater numbers in persons 15–64 years while RSV was seen in primarily in children <5 years and adults >65 years. Other agents confirmed include rhinovirus (12.9%), influenza B (10.9%) and influenza A(H1N1)pdm09 (9.4%).

Conclusions

RSV and influenza A(H3N2) were the most common viruses identified during the first year after the influenza A(H1N1)pdm09 pandemic. Influenza was detected every month with peak activity corresponding to that typically seen in North America (October to March). In order to determine the seasonality of influenza and RSV, laboratory data from subsequent years and increased specimen submission is needed.
Decomposition of meta‐frontier inefficiency in the two‐stage network directional distance function with quasi‐fixed inputs
Authors: Chiu Ching‐Ren , Lu Kuo‐Hsien , Tsang Seng‐Su , Chen Yi‐Fen
Published: June 2013

Few studies have considered the quasi‐fixed inputs that have an impact on hospitality. The number of guest rooms and the area of the catering department of international tourist hotels are shown to be constant in Taiwan from 2008 to 2009. Therefore, this paper proposes the use of the two‐stage network directional distance function with quasi‐fixed inputs to explore the productive and service efficiencies of tourist hotel formats (chained versus independent). In addition, a new approach is developed to decompose the technical inefficiency of the hotels within the meta‐frontier; this approach helps to identify the source of the meta‐frontier inefficiency. Demonstration of this new approach with practical data reveals that the average productive efficiency is greater than the average service efficiency for Taiwanese tourist hotels. Additionally, the causes of the overall productive inefficiency and the overall service inefficiency are mainly derived from the input excess of the productive process and the output shortfall of the service process, respectively.
Integrating probabilistic design and rare‐event simulation into the requirements engineering process for high‐reliability systems
Authors: Saling Kristin Graham , White K. Preston
Published: June 2013

Early in a program, engineers must determine requirements for system reliability and availability. We suggest that existing techniques gathered from diverse fields can be incorporated within the framework of systems engineering methodology to accomplish this. Specifically, adopting probabilistic (Monte Carlo) design techniques allows the designer to incorporate uncertainty explicitly into the design process and to improve the designer's understanding of the root causes of failures and how often these might realistically occur. In high‐reliability systems in which failure occurs infrequently, rare‐event simulation techniques can reduce the computational burden of achieving this understanding. This paper provides an introductory survey of the literature on systems engineering, requirements engineering, Monte Carlo simulation, probabilistic design, and rare‐event simulation with the aim of assessing the degree to which these have been integrated in systems design for reliability. This leads naturally to a proposed framework for the fusion of these techniques.
Predictive Factors for Relapse in Patients on Buprenorphine Maintenance
Authors: Ferri Michael , Finlayson Alistair J. Reid , Wang Li , Martin Peter R.
Published: June 2013

Background and Objectives

Despite the dramatic increase in the use of buprenorphine for the treatment of opioid dependence, clinical outcomes of this treatment approach continue to need evaluation. This study examines factors associated with relapse and retention during buprenorphine treatment in a sample of opioid dependent outpatients.

Methods

In a retrospective chart review of 62 patients with opioid dependence, relapse was determined by self‐report, urine toxicology screens, and by checking the state controlled substance monitoring database. Data was analyzed using two‐way tests of association and logistic regression.

Results

Patients with comorbid anxiety disorders, active benzodiazepine use (contrary to clinic policy), or active alcohol abuse, were significantly more likely to relapse. Patients who relapsed were also more likely to be on a higher buprenorphine maintenance dose.

Conclusion

This study identifies relapse risk factors during buprenorphine treatment for opioid dependence. Future research is needed to determine whether modifying these factors may lead to improved treatment outcomes. (Am J Addict 2014;23:62–67)
Posttraumatic Stress Symptoms and Alcohol Problems: Self‐Medication or Trait Vulnerability?
Authors: Read Jennifer P. , Merrill Jennifer E. , Griffin Melissa J. , Bachrach Rachel L. , Khan Saba N.
Published: June 2013

Background and Objectives

Posttraumatic stress symptoms (PTSD) and problem alcohol use (ALC) commonly co‐occur, but the nature of this co‐occurrence is unclear. Self‐medication explanations have been forwarded, yet traits such as tendency toward negative emotionality and behavioral disconstraint also have been implicated. In this study we test three competing models (Self‐Medication, Trait Vulnerability, Combined Dual Pathway) of PTSD–ALC prospectively in a college sample.

Method

Participants (N = 659; 73% female, M age = 18) provided data at college matriculation (Time 1) and 1 year later (Time 2).

Results

Structural equation models showed disconstraint to meditate the path from PTSD symptoms to alcohol problems, supporting a trait vulnerability conceptualization. Findings regarding negative emotionality and self‐medication were more mixed. Negative emotionality played a stronger role in cross‐sectional than in prospective analyses, suggesting the importance of temporal proximity.

Conclusions and Scientific Significance

Self‐regulation skills may be an important focus for clinicians treating PTSD symptoms and alcohol misuse disorders concurrently. (Am J Addict 2014;23:108–116)
Foley catheter insertion into a kidney
Authors: Lin Yi‐Li , Chen Chia‐Ying , Huang Yu‐Ya , Yan Yuan‐Horng
Published: June 2013

ABSTRACT

Female urethral catheterization (UC) is a common procedure. Nurses need to be aware of the complications associated with catheterization to practice it safely and minimize the risks to the patient. The most common complications are trauma and infection. We report the case of a 62‐year‐old woman with an unusual complication of UC‐mimicking perforation. The catheter was blindly inserted into the renal pelvis.
The Synthesis of Ba‐ and Fe‐ Substituted CsAlSi2O6 Pollucites
Authors: Rodriguez Mark A. , Garino Terry J. , Rademacher David X. , Zhang Xiaoyi , Nenoff Tina M.
Published: June 2013

Barium‐substituted CsAlSi2O6 pollucites, CsxBa(1−x)/2AlSi2O6, and barium‐ and iron‐substituted pollucites, CsxBa(1−x)/2AlxFe1−xSi2O6 and CsxBa1−xAlxFe1−xSi2O6 were synthesized with 1 ≥ x≥ 0.7 using a hydrothermal synthesis procedure. Rietveld analysis of X‐ray diffraction data confirmed the substitution of Ba for Cs and Fe for Al, respectively. The crystallographic analysis also describes the effects of three different types of pollucite substitutions on the pollucite unit cell: Ba2+ for Cs1+ cation results in little effect on cell dimensions, intermediate concentrations of Ba2+ and Fe3+ substitution result in net minor expansion due to Fe3+ addition, and large Ba and Fe substitutions result in overall framework contraction. Elemental analysis combined with microscopy further supports the phase purity of these new phases. These materials can be used to study the stability of CsAlSi2O6 as a durable ceramic waste form, which could accommodate with time Cs and its decay product, Ba. Furthermore, success in iron substitution for aluminum into the pollucite lattice predicts that redox charge compensation for Cs cation decay is possible.
Preparation of Nitrogen‐Doped Mullite Fiber by Nitridation of Silica–Alumina Gel Fiber in Ammonia
Authors: Zhang Li , Zhang Litong , Lin Zhijun , Jiang Yan , He Jing , Li Siwei
Published: June 2013

Nitrogen‐doped mullite fibers were first synthesized through the nitridation of Al2O3–SiO2 gel fibers in NH3. The results showed that nitrogen take‐up began at 800°C, reached the maximum at 900°C, and then decreased with increasing temperature. The ceramic fibers nitridated at 900°C were essentially amorphous, but contained a small amount of nano‐sized Al–Si spinel crystals. Mullite was formed after nitridation at 1200°C, accompanied by crystallization of χ‐SiAlON and δ‐Al2O3. The incorporation of nitrogen resulted in the formation of a variety of nitrogen‐containing crystalline phases. The grain size of the mullite fibers can be adjusted by changing of the nitrogen content.
Effect of ZnO on Crystallization of Zircon from Zirconium‐Based Glaze
Authors: Wang Shaohua , Peng Cheng , Lü Ming , Wu Jianqing
Published: June 2013

The promotion of zircon (ZrSiO4) crystallization by ZnO from a zirconium‐based frit glaze was studied and the possible mechanism was discussed. X‐ray diffraction was used to analyze the relative quantities of zircon and other transitional crystals in the samples. The results show that ZnO can significantly decrease the crystallization temperature of zirconium‐based glaze, depress the formation of Ca2ZrSi4O12, and promote the devitrification of transitional crystals t‐ZrO2 and Ca2ZnSi2O7, as well as lead to the formation of more zircon than the ZnO‐free glaze. It was also found that zircon not only can form from the interaction between t‐ZrO2 and SiO2 but also can devitrify directly from the glass phase of zirconium‐based glaze.
High Conductivity Electrolyte: Zn2GeO4
Authors: Wu Songping , Ma Qing , He Fan
Published: June 2013

Zn2GeO4 ceramic materials were synthesized by the solid‐state method. Zn2GeO4 powders were investigated with X‐ray powder diffraction (XRD) and high‐resolution transmission electron microscopy (HRTEM). Oxygen defects in the Zn2GeO4 ceramics were investigated by photoluminescence, Raman, and EDS spectra. Conductivity of Zn2GeO4 was 0.18 S/cm at low temperature of 773 K, and its activation energy was 0.49 eV. The results showed that Zn2GeO4 was a promising low‐temperature electrolyte with high conductivity.
Association of Atrial Fibrosis Quantified Using LGE‐MRI with Atrial Appendage Thrombus and Spontaneous Contrast on Transesophageal Echocardiography in Patients with Atrial Fibrillation
Authors: Akoum Nazem , Fernandez Genaro , Wilson Brent , Mcgann Christopher , Kholmovski Eugene , Marrouche Nassir
Published: June 2013

Atrial Fibrosis and Appendage Thrombus

Introduction

Transesophageal echocardiography (TEE) is used to evaluate for left atrial appendage (LAA) thrombi prior to restoration of sinus rhythm in atrial fibrillation (AF). We examined the relationship of atrial fibrosis quantified using late gadolinium enhancement MRI (LGE‐MRI) with TEE findings.

Methods and Results

We included 178 patients with AF, undergoing TEE and LGE‐MRI prior to ablation or cardioversion. LGE‐MRI and subsequent image processing was used to quantify atrial fibrosis based on signal intensity analysis. The mean CHADS2 score was 1.24 ± 1.08 and CHA2DS2‐VASc was 2.08 ± 1.33. The LAA was classified as normal, spontaneous echocardiographic contrast (SEC) present or thrombus present. LAA thrombus was found in 12 patients (6.7%) while SEC was identified in 19 patients (10.7%). Patients with thrombus had higher atrial fibrosis compared to patients without thrombus (26.9 ± 17.4% vs 16.7 ± 10.5%; P < 0.01). Atrial fibrosis was also higher in patients with SEC (23.3 ± 13.7%) compared to those without SEC (16.7 ± 10.8%; P = 0.01). Patients with high atrial fibrosis (>20%) were more likely to have a LAA thrombus (odds ratio 4.6; P = 0.02) and SEC (odds ratio 2.6; P = 0.06). Multivariate logistic regression showed high fibrosis (odds ratio 3.6; P < 0.01) and CHADS2 ≥2 (odds ratio 3.5; P < 0.01) were significant predictors of TEE abnormalities (LAA thrombus or SEC). The area under the curve for the model including high fibrosis, AF type and CHADS2 ≥2 or CHA2DS2‐VASc ≥2 was 0.73 compared to 0.63 and 0.65 for CHADS2 and CHA2DS2‐VASc alone.

Conclusions

Atrial fibrosis is independently associated with appendage thrombus and spontaneous contrast. It provides additional risk stratification not captured by clinical parameters.
Spatiotemporal Evolution and Prediction of [Ca2+]i and APD Alternans in Isolated Rabbit Hearts
Authors: VISWESWARAN RAMJAY , McINTYRE STEPHEN D. , RAMKRISHNAN KARTIK , ZHAO XIAOPENG , TOLKACHEVA ELENA G.
Published: June 2013

Prediction of Alternans in the Heart

Introduction

Action potential duration (APD) alternans can be accompanied by alternans in intracellular calcium transients ([Ca2+]i), leading to electromechanical alternans. Electromechanical alternans is considered a substrate for ventricular fibrillation. Although some techniques have been developed to predict APD alternans, the onset of [Ca2+]i alternans has never been predicted.

Methods and Results

Simultaneous mapping of voltage and calcium was performed in 8 Langendorff‐perfused rabbit hearts. APD, [Ca2+]i amplitude (CaA) and duration (CaD) alternans were induced using a perturbed downsweep protocol. Local onset of alternans (Bonset) was defined as the cycle length (BCL) at which at least 10% of the RV exhibited alternans. We observed that the local onset of CaA alternans always occurred first, followed by APD and then CaD alternans. We constructed APD, CaD, and CaA restitution portraits for 2 regions of the heart defined at Bonset: the 1:1alt region, which developed alternans, and the 1:1 region, which did not. Our results also show that the slopes and SDyn were higher in 1:1alt region (SDyn = 0.99 ± 0.04 vs 0.73 ± 0.06;  = 0.95 ± 0.13 vs 0.65 ± 0.1, P < 0.05) prior to onset of CaD alternans, while S12 and were significantly higher in the 1:1alt region (S12 = 0.59 ± 0.19 vs 0.19 ± 0.02;  = 1.09 ± 0.1 vs 0.61 ± 0.08, P < 0.05) prior to onset of CaA alternans.

Conclusion

We successfully applied the restitution portrait technique to the prediction of [Ca2+]i (both CaA and CaD) alternans. The slopes of the APD/CaD/CaA restitution portrait are definitive indicators of APD, CaD, and CaA alternans.
Fragmented QRS Complex Predicts the Arrhythmic Events in Patients with Arrhythmogenic Right Ventricular Cardiomyopathy/Dysplasia
Authors: CANPOLAT UĞUR , KABAKÇI GIRAY , AYTEMIR KUDRET , DURAL MUHAMMET , ŞAHINER LEVENT , YORGUN HIKMET , SUNMAN HAMZA , BARIŞ KAYA ERGÜN , TOKGÖZOĞLU LALE , OTO ALI
Published: June 2013

frQRS and Outcomes in ARVC/D

Background

Fragmented QRS (frQRS) complex, with various morphology, has been recently described as a diagnostic criterion of arrhythmogenic right ventricular cardiomyopathy/dysplasia (ARVC/D). However, there are little data regarding the prognostic role of frQRS in these patients. Therefore, we aimed to investigate the association of frQRS with arrhythmic events in patients with ARVC/D.

Methods

Seventy‐eight patients (51 men, 65.4%; mean age: 31.25 ± 11.5 years) with the diagnosis of ARVC/D according to 2010 modified Task Force Criteria were analyzed retrospectively. Baseline ECG evaluation revealed frQRS complex in 46 patients (59%). Eleven patients with complete/incomplete right bundle branch block were excluded from the study. The phenomenon of frQRS was defined as deflections at the beginning of the QRS complex, on top of the R‐wave, or in the nadir of the S‐wave similar to the definition in CAD in either one right precordial lead or in more than one lead including all standard ECG leads.

Results

During 38 ± 14 months follow‐up period, 3 patients (3.8%) died suddenly, 36 patients (46.1%) experienced arrhythmic events (32 ventricular tachycardias [VTs] and 4 ventricular fibrillation [VF], 30 in the ICD group). The frQRS was significantly associated with arrhythmic events (P < 0.001). Also, the number of ECG leads with frQRS complex was higher in patients with arrhythmic events (5.08 ± 2.5 vs 1.14 ± 1.7, P < 0.001, respectively).

Conclusion

The frQRS complex on standard 12‐lead ECG predicts fatal and nonfatal arrhythmic events in patients with ARVC/D. Therefore, large scale and prospective studies are needed to confirm those findings.
Long‐Term Follow‐Up of Moderately Hypercholesterolemic Hypertensive Patients Following Randomization to Pravastatin vs Usual Care: The Antihypertensive and Lipid‐Lowering Treatment to Prevent Heart Attack Trial (ALLHAT‐LLT)
Authors: Margolis Karen L. , Davis Barry R. , Baimbridge Charles , Ciocon Jerry O. , Cuyjet Aloysius B. , Dart Richard A. , Einhorn Paula T. , Ford Charles E. , Gordon David , Hartney Thomas J , Julian Haywood L. , Holtzman Jordan , Mathis David E. , Oparil Suzanne , Probstfield Jeffrey L. , Simpson Lara M. , Stokes John D. , Wiegmann Thomas B. , Williamson Jeff D. ,   ALLHAT Collaborative Research Group
Published: June 2013

The authors conducted a randomized, controlled, multicenter trial, in which they assigned well‐controlled hypertensive participants aged 55 years and older with moderate hypercholesterolemia to receive pravastatin (n=5170) or usual care (n=5185) for 4 to 8 years, when trial therapy was discontinued. Passive surveillance using national databases to ascertain deaths and hospitalizations continued for a total follow‐up of 8 to 13 years to assess whether mortality and morbidity differences persisted or new differences developed. During the post‐trial period, fatal and nonfatal outcomes were available for 98% and 64% of participants, respectively. The primary outcome was all‐cause mortality and the secondary outcomes included cardiovascular mortality, coronary heart disease (CHD), stroke, heart failure, cardiovascular disease, and end‐stage renal disease. No significant differences appeared in mortality for pravastatin vs usual care (hazard ratio [HR], 0.96; 95% confidence interval [CI], 0.89–1.03) or other secondary outcomes. Similar to the previously reported in‐trial result, there was a significant treatment effect for CHD in black patients (HR, 0.79; 95% CI, 0.64–0.98). However, the in‐trial result showing a significant treatment by race effect did not remain significant during the entire follow‐up (P=.08). These findings are consistent with evidence from other large trials that show statins prevent CHD and add evidence that they are effective for CHD prevention in black patients.
The Association Between Obstructive Sleep Apnea and Hypertension by Race/Ethnicity in a Nationally Representative Sample
Authors: Sands‐Lincoln Megan , Grandner Michael , Whinnery Julia , Keenan Brendan T. , Jackson Nick , Gurubhagavatula Indira
Published: June 2013

The association between obstructive sleep apnea (OSA) and hypertension by race/ethnicity has not been well characterized in a national sample. Adult participants in the 2007–2008 National Health and Nutrition Examination Survey were reviewed by self‐report of sleep apnea diagnosis, snorting, gasping or stopping breathing during sleep, and snoring to derive whether OSA was probable (pOSA). Multivariable logistic regression determined whether pOSA predicted hypertension in the overall cohort, and by body mass index (BMI) group and ethno‐racial strata. pOSA predicted hypertension in several groups: (1) Within BMI strata, there was a significant association among overweight individuals [odds ratio [OR], 1.82; 95% confidence interval [CI], 1.26–2.62); (2) In race/ethnicity subgroups, the association was significant among Hispanic/Latinos (OR, 1.69; 95% CI, 1.13–2.53) and whites (OR, 1.40; 95% CI, 1.07–1.84); (3) In models stratified by both race/ethnicity and BMI, pOSA predicted hypertension among overweight black/African Americans (OR, 4.74; 95% CI, 1.86–12.03), overweight whites (OR, 1.65; 95% CI, 1.06–2.57), and obese Hispanic/Latino participants (OR, 2.01; 95% CI, 1.16–3.49). A simple, self‐report tool for OSA was strongly associated with hypertension, and may serve as a potential future opportunity for OSA diagnosis.
The Relationship Between Blood Pressure and Pain
Authors: Saccò Marcella , Meschi Michele , Regolisti Giuseppe , Detrenis Simona , Bianchi Laura , Bertorelli Marcello , Pioli Sarah , Magnano Andrea , Spagnoli Francesca , Giuri Pasquale Gianluca , Fiaccadori Enrico , Caiazza Alberto
Published: June 2013

The relationship between pain and hypertension is potentially of great pathophysiological and clinical interest, but is poorly understood. The perception of acute pain initially plays an adaptive role, which results in the prevention of tissue damage. The consequence of ascending nociception is the recruitment of segmental spinal reflexes through the physiological neuronal connections. In proportion to the magnitude and duration of the stimulus, these spinal reflexes cause the activation of the sympathetic nervous system, which increases peripheral resistances, heart rate, and stroke volume. The response also involves the neuroendocrine system, and, in particular, the hypothalamic‐pituitary‐adrenal axis, in addition to further activation of the sympathetic system by adrenal glands. However, in proportion to an elevation in resting blood pressure, there is a contemporary and progressive reduction in sensitivity to acute pain, which could result in a tendency to restore arousal levels in the presence of painful stimuli. The pathophysiological pattern is significantly different in the setting of chronic pain, in which the adaptive relationship between blood pressure and pain sensitivity is substantially reversed. The connection between acute or chronic pain and cardiovascular changes is supported observationally, but some of this indirect evidence is confirmed by experimental models and human studies. The pain regulatory process and functional interaction between cardiovascular and pain regulatory systems are briefly reviewed. Various data obtained are described, together with their potential clinical implications.
Changes in Medical Student and Doctor Attitudes Toward Older Adults After an Intervention: A Systematic Review
Authors: Samra Rajvinder , Griffiths Amanda , Cox Tom , Conroy Simon , Knight Alec
Published: June 2013

Research investigating the effects of attitude‐focused interventions on doctors' and medical students' attitudes toward older adults has produced mixed results. The objective of this systematic review was to determine whether factors pertaining to study design and quality might provide some explanation of this inconclusive picture. Articles were judged of interest if they reported doctors' or medicals students' attitude scores before and after a geriatric‐focused intervention. Articles that did not report the measure used, mean scores, or inferential statistics were excluded. Twenty‐seven databases, including Medline, PsychInfo, and Embase, were searched through April 2011 using a systematic search strategy. After assessment and extraction, 27 studies met the eligibility criteria for this review. These studies demonstrated inconsistent results; 14 appeared successful in effecting positive attitude change toward older adults after an intervention, and 13 appeared unsuccessful. Attitude change results differed in line with the content of the intervention. Of the 27 studies, 11 interventions contained solely knowledge‐building content. Three of these studies demonstrated positive changes in doctors' or medical students' attitudes toward older adults after the intervention. The remaining 16 interventions incorporated an empathy‐building component, such as an aging simulation exercise or contact with a healthy older adult. Of these, 11 successfully demonstrated positive attitude change after the intervention. The inclusion of an empathy‐building task in an intervention appears to be associated with positive attitude change in medical students' and doctors' attitudes toward older adults.
Counteracting Effect of Supine Leg Resistance Exercise on Systolic Orthostatic Hypotension in Older Adults
Authors: Galizia Gianluigi , Abete Pasquale , Testa Gianluca , Vecchio Anna , Corrà Tjibbo , Nardone Antonio
Published: June 2013

Objectives

To assess the efficacy of a leg exercise performed in supine position to prevent orthostatic hypotension (OH) in older adults.

Design

Case–control study.

Setting

Division of Physical Medicine and Rehabilitation, Salvatore Maugeri Foundation, Scientific Institute of Veruno, Veruno, Italy.

Participants

Individuals aged 65 and older admitted with degenerative joint disease screened (n = 90) and found positive for OH (n = 42).

Measurements

Systolic blood pressure (SBP), diastolic blood pressure (DBP), and heart rate (HR) were recorded using an automatic oscillometric device in the supine position after 10 minutes of bed rest; immediately upon standing up; and after 1, 3 and 5 minutes standing. In 42 participants, a fall in SBP of 20 mmHg or more within 3 minutes of standing was found. Participants with OH were alternately assigned to the control or exercise group. The following day, both groups were reassessed as above. In the exercise group, before standing up, participants were required to perform 10 full extensions of the lower limbs, starting from 60° flexion of hip and 90° flexion of knee and ankle joints, against the resistance of an elastic band.

Results

In both participant groups, SBP, DBP, and HR were similar in the supine position. When standing, the same decrease in SBP and DBP and increase in HR occurred over a similar time‐course in both participant groups. The next day, the reduction in SBP was significantly smaller at each time interval after standing up in the exercise than in the control group, but no difference between the exercise and control groups was observed in DBP or HR.

Conclusion

Supine leg exercise is effective in reducing an initial fall in SBP when passing from a supine to an upright position in older adults. The duration of the effect requires further investigation.
Challenges associated with delivering education to patients after heart surgery
Authors: Fredericks Suzanne , Bechtold Aaron
Published: June 2013

Aim

The aim of this report is to provide a detailed description of the challenges that arose throughout the implementation of an individualized patient education intervention delivered to patients during their home recovery following heart surgery.

Methods

The intervention was delivered at two points in time by telephone to patients following heart bypass and/or valvular replacement.

Results

The individualized patient education intervention was found to be effective in reducing the rate and number of complications developed during the first three months following hospital discharge. However, throughout the implementation of this intervention, specific challenges arose that included: onset of symptoms that interfered with intervention delivery, patient's request for information beyond the scope of the teaching interaction, and the need to provide continued support to the therapist.

Conclusion

These challenges were addressed throughout the course of the study and the strategies are currently being implemented into the planned knowledge translation activities associated with this intervention.
Identification of coronin‐1a as a novel antibody target for clinically isolated syndrome and multiple sclerosis
Authors: Rouwette Myrthe , Noben Jean‐Paul , Van Horssen Jack , Van Wijmeersch Bart , Hupperts Raymond , Jongen Peter J. , Verbeek Marcel M. , De Deyn Peter P. , Stinissen Piet , Somers Veerle
Published: June 2013

Recently, we identified the mimotope UH‐CIS6 as a novel candidate antibody target for clinically isolated syndrome (CIS) and relapsing‐remitting (RR) multiple sclerosis (MS). The purpose of this study was to further validate UH‐CIS6 as an antibody target for CIS and MS and to identify the in vivo antibody target of UH‐CIS6. First, a UH‐CIS6 peptide ELISA was optimized. Next, we investigated the antibody response toward UH‐CIS6 in cerebrospinal fluid (CSF) from patients with CIS (n = 20), MS (n = 43) and other neurological diseases (n = 42). Immunoprecipitation of anti‐UH‐CIS6 antibodies on a normal human brain lysate was performed to identify the in vivo antibody target of UH‐CIS6. The cellular expression of an in vivo candidate target was investigated by immunohistochemistry using MS brain tissue sections. Antibody reactivity toward UH‐CIS6 was detected in a significantly increased proportion of CSF samples from CIS and RR‐MS patients as compared with neurological controls (p = 0.046). We identified and confirmed coronin‐1a as the in vivo antibody target for UH‐CIS6. Furthermore, coronin‐1a was expressed by T cells and macrophages in an active MS lesion. Together, these results demonstrate that coronin‐1a is a novel antibody target for CIS and MS.
Characteristics of Quantitative Nursing Research from 1990 to 2010
Authors: Yarcheski Adela , Mahon Noreen E.
Published: June 2013

Purpose

To assess author credentials of quantitative research in nursing, the composition of the research teams, and the disciplinary focus of the theories tested.

Design

Nursing Research, Western Journal of Nursing Research, and Journal of Advanced Nursing were selected for this descriptive study; 1990, 1995, 2000, 2005, and 2010 were included. The final sample consisted of 484 quantitative research articles.

Findings

From 1990 to 2010, there was an increase in first authors holding doctoral degrees, research from other countries, and funding. Solo authorship decreased; multi‐authorship and multidisciplinary teams increased. Theories tested were mostly from psychology; the testing of nursing theory was modest. Multidisciplinary research far outdistanced interdisciplinary research.

Conclusions

Quantitative nursing research can be characterized as multidisciplinary (distinct theories from different disciplines) rather than discipline‐specific to nursing. Interdisciplinary (theories synthesized from different disciplines) research has been conducted minimally.

Clinical Relevance

This study provides information about the growth of the scientific knowledge base of nursing, which has implications for practice.
Perceived emotional intelligence in nursing: psychometric properties of the Trait Meta‐Mood Scale
Authors: Aradilla‐Herrero Amor , Tomás‐Sábado Joaquín , Gómez‐Benito Juana
Published: June 2013

Aims and objectives

To examine the psychometric properties of the Trait Meta‐Mood Scale in the nursing context and to determine the relationships between emotional intelligence, self‐esteem, alexithymia and death anxiety.

Background

The Trait Meta‐Mood Scale is one of the most widely used self‐report measures for assessing perceived emotional intelligence. However, in the nursing context, no extensive analysis has been conducted to examine its psychometric properties.

Design

Cross‐sectional and observational study.

Methods

A total of 1417 subjects participated in the study (1208 nursing students and 209 hospital nurses). The Trait Meta‐Mood Scale, the Toronto Alexithymia Scale, the Rosenberg Self‐Esteem Scale and the Death Anxiety Inventory were all applied to half of the sample (n = 707). A confirmatory factor analysis was carried out, and statistical analyses examined the internal consistency and test–retest reliability of the Trait Meta‐Mood Scale, as well as its relationship with relevant variables.

Results

Confirmatory factor analysis confirmed the three dimensions of the original scale (Attention, Clarity and Repair). The instrument showed adequate internal consistency and temporal stability. Correlational results indicated that nurses with high scores on emotional Attention experience more death anxiety, report greater difficulties identifying feelings and have less self‐esteem. By contrast, nurses with high levels of emotional Clarity and Repair showed less death anxiety and higher levels of self‐esteem.

Conclusions

The Trait Meta‐Mood Scale is an effective, valid and reliable tool for measuring perceived emotional intelligence in the nursing context. Training programmes should seek to promote emotional abilities among nurses.

Relevance to clinical practice

Use of the Trait Meta‐Mood Scale in the nursing context would provide information about nurses' perceived abilities to interpret and manage emotions when interacting with patients.
Health related quality of life across the perinatal period among Australian women
Authors: Emmanuel Elizabeth N , Sun Jing
Published: June 2013

Aims and objectives

To investigate the significant features in health‐related quality of life and to examine the changes over time during the perinatal period.

Background

Health‐related quality of life during the perinatal period is significant for women. Screening or surveillance during the perinatal period is inconsistent and often not part of continued assessment.

Design

Prospective.

Methods

Setting involved antenatal clinics at three public hospitals in metropolitan Brisbane, Australia. A total of 363 participants out of a cohort of 605 women completed all items of the Short Form‐12 Health Survey in late pregnancy and again at 6 and 12 weeks postpartum.

Results

There was a significant difference across the three perinatal time periods in all the health‐related quality‐of‐life subscales. Significant improvements were noted from late pregnancy to 6 weeks following childbirth and again at 12 weeks particularly in physical health, role physical, bodily pain, vitality, role emotional and mental health. Even when confounding variables such as maternal ages, partner status, parity, delivery type and ethnicity were introduced, significant improvements were noted. Maternal distress significantly related to almost all quality‐of‐life factors over time even when all possible confounding factors were controlled.

Conclusion

Significant changes occur in health‐related quality of life across the perinatal period. All dimensions of health‐related quality of life except for social functioning and maternal distress showed marked improvement following childbirth. During this period, maternal distress was negatively related to health‐related quality of life.

Relevance to clinical practice

Nurses need to be mindful of the broader view of health as encompassed in health‐related quality‐of‐life measures and the potential these have for alerting health professionals when providing care. More rigorous health assessment for mothers at risk is useful so that appropriate support and follow‐up can be given.
Change Over Time in Brain Serotonin Transporter Binding in Major Depression: Effects of Therapy Measured with [123I]‐ADAM SPECT
Authors: Amsterdam Jay D. , Newberg Andrew B. , Newman Cory F. , Shults Justine , Wintering Nancy , Soeller Irene
Published: June 2013

Several studies have reported low brain serotonin transporter (SERT) binding in individuals with major depression. We hypothesized that the SERT standardized uptake ratio (SUR) values using [123I]‐ADAM single photon emission computed tomography would increase in depressed subjects who responded to cognitive behavior therapy (CBT) compared to CBT nonresponders. [123I]‐ADAM scans were acquired before and after 12 weeks of CBT from 20 depressed subjects and on two occasions 12 weeks apart from 10 nondepressed, healthy volunteers. The primary outcome measure was change over time in SUR values in the midbrain, medial temporal lobe, and basal ganglia regions. Depressed subjects demonstrated low pretreatment mean SUR values that significantly increased over time in the midbrain (P = .011), right medial temporal lobe (P = .008), and left medial temporal lobe (P = .000) regions. Treatment responders showed a significant increase over time in SUR values in left medial temporal lobe (P = .029) and right medial temporal lobe (P = .007) regions. Partial and nonresponder subjects also showed a significant increase over time in SUR values in the left medial temporal region (P = .040) (vs. healthy volunteers), but to a lesser degree. The findings suggest that low pretreatment SERT binding may increase over time in some depressed individuals who experience symptom improvement.
Memory‐Related Hippocampal Activity Can Be Measured Robustly Using fMRI at 7 Tesla
Authors: Theysohn Nina , Qin Shaozheng , Maderwald Stefan , Poser Benedikt A. , Theysohn Jens M. , Ladd Mark E. , Norris David G. , Gizewski Elke R. , Fernandez Guillen , Tendolkar Indira
Published: June 2013

High field strength functional magnetic resonance imaging (fMRI) has developed rapidly. However, it suffers from increased artifacts in brain regions such as the medial temporal lobe (MTL), challenging functional imaging of the hippocampus with the objective of high‐spatial resolution, which is particularly useful for this region both from a clinical and cognitive neuroscience perspective. We set out to compare a BOLD sequence at 7 T versus 3 T to visualize the MTL activity during an associative memory‐encoding task. Twenty‐eight healthy volunteers underwent a blocked‐design fMRI at either 3 T or 7 T while performing a face‐profession associative memory encoding task. Qualitative analyses of overall image quality revealed that functional images at 7 T were of high quality, showing a good white/gray matter contrast, with reasonably acceptable signal dropouts and artifacts at the lower portion of the temporal lobe. Analyses of task‐related fMRI data revealed robust activations in the bilateral MTL during associative memory encoding at both field strengths. Notably, we observed significantly stronger memory‐related hippocampal activation at 7 T than at 3 T, suggesting higher BOLD sensitivity at 7 T. These results are discussed in the light of the feasibility of 7 T scanning protocols for the MTL.
Systematic review of duration and choice of systemic antibiotic therapy for acute haematogenous bacterial osteomyelitis in children
Authors: Howard‐Jones Annaleise R , Isaacs David
Published: June 2013

Aim

Historically, children with acute osteomyelitis received 4–6 weeks of parenteral antibiotics; however, evidence to guide optimal duration of therapy is limited. This study aims to summarise the available evidence on the duration and choice of antimicrobial therapy for acute haematogenous osteomyelitis in children.

Methods

We systematically reviewed the literature on children with acute osteomyelitis to determine if shorter durations of antibiotic treatment compared with protracted treatment gave different cure rates. We also analysed studies for choice of antibiotics to determine differences in success rates. Randomised controlled trials, cohort studies, case‐control studies and case series were eligible for inclusion.

Results

We identified six randomised controlled trials, three of which addressed duration of antibiotic use and three choice of antibiotic for acute osteomyelitis in children. We found 28 observational studies, 20 of which focused on duration and 22 of which allowed analysis of choice of antibiotic. A range of therapy durations and types of antibiotics were assessed. Only one small study looked at treatment of neonates.

Conclusions

The quality of evidence on antibiotic treatment for acute osteomyelitis is limited, allowing only weak (GRADE 2B) recommendations. Our review suggests that early transition from intravenous to oral therapy, after 3–4 days in patients responding well, followed by oral therapy to a total of 3 weeks may be as effective as longer courses for uncomplicated acute osteomyelitis. This recommendation does not apply to neonates.
Studies of face perception in humans using magneto‐ and electro‐encephalography
Authors: Miki Kensaku , Kakigi Ryusuke
Published: June 2013

This article summarizes the results of magneto‐ and electroencephalographic studies on face perception as follows: (a) The perception of movement of facial parts is probably processed in the same manner, different from motion in general; (b) There is specific information processing for eye movements in the occipitotemporal area and this activity is significantly influenced by whether movements appear with the contour and/or features of the face; (c) The activity in the right fusiform area is more affected by the inversion of facial features while that in the left fusiform area is more affected by the disruption of the spatial relation between the contour and features in static face perception, and the activity in the right occipitotemporal area is affected by the inversion of the facial contour in dynamic face perception; and (d) The areas of the brain involved in perceiving changes in facial emotion have not matured by 14 years of age.