bluuebunny/crossref_metadata_2025 huggingface dataset:
Molecular events in germ cell tumours: linking chromosome‐12 gain, acquisition of pluripotency and response to cisplatin
Authors: Korkola James E. , Houldsworth Jane , Bosl George J. , Chaganti R.S.K.
Published: October 2009

Germ cell tumours (GCTs) represent the leading cause of cancer‐related morbidity and mortality in young men aged 18–35 years. Transformation of the cell of origin results in tumours with several unique properties. GCTs are characterized by gain of the short arm of chromosome 12 in almost all cases, a frequency of genomic alteration not seen in any other solid tumours. GCTs are truly pluripotent, giving rise to cells of somatic and extra‐embryonic lineages, which results in tumours with a spectrum of differentiation that rivals that seen in normal embryogenesis and development. Despite the presence of genomic instability and many oncogenic changes, GCTs are highly curable, even in the metastatic setting, due to their extreme sensitivity to cisplatin‐based chemotherapy. In this review we highlight some of the molecular events associated with the genesis, differentiation and chemotherapeutic response of these tumours, and discuss how these alterations are linked with biological features unique to germ cells.
Diabetic retinopathy screening: a systematic review of the economic evidence
Authors: Jones S. , Edwards R. T.
Published: October 2009

Diabet. Med. 27, 249–256 (2010)

This paper systematically reviews the published literature on the economic evidence of diabetic retinopathy screening. Twenty‐nine electronic databases were searched for studies published between 1998 and 2008. Internet searches were carried out and reference lists of key studies were hand searched for relevant articles. The key search terms used were ‘diabetic retinopathy’, ‘screening’, ‘economic’ and ‘cost’. The search identified 416 papers of which 21 fulfilled the inclusion criteria, comprising nine cost‐effectiveness studies, one cost analysis, one cost‐minimization analysis, four cost–utility analyses and six reviews. Eleven of the included studies used economic modelling techniques and/or computer simulation to assess screening strategies. To date, the economic evaluation literature on diabetic retinopathy screening has focused on four key questions: the overall cost‐effectiveness of ophthalmic care; the cost‐effectiveness of systematic vs. opportunistic screening; how screening should be organized and delivered; and how often people should be screened. Systematic screening for diabetic retinopathy is cost‐effective in terms of sight years preserved compared with no screening. Digital photography with telemedicine links has the potential to deliver cost‐effective, accessible screening to rural, remote and hard‐to‐reach populations. Variation in compliance rates, age of onset of diabetes, glycaemic control and screening sensitivities influence the cost‐effectiveness of screening programmes and are important sources of uncertainty in relation to the issue of optimal screening intervals. There is controversy in relation to the economic evidence on optimal screening intervals. Further research is needed to address the issue of optimal screening interval, the opportunities for targeted screening to reflect relative risk and the effect of different screening intervals on attendance or compliance by patients.
Influence of elastin‐like peptide fusions on the quantity and quality of a tobacco‐derived human immunodeficiency virus‐neutralizing antibody
Authors: Floss Doreen M. , Sack Markus , Arcalis Elsa , Stadlmann Johannes , Quendler Heribert , Rademacher Thomas , Stoger Eva , Scheller Jürgen , Fischer Rainer , Conrad Udo
Published: October 2009

The use of vaginal microbicides containing human immunodeficiency virus (HIV)‐neutralizing antibodies (nAbs) is a promising strategy to prevent HIV‐1 infection. Although antibodies are predominantly manufactured using mammalian cells, elastin‐like peptide (ELP) fusion technology improves the stability of recombinant, plant‐produced proteins and facilitates their purification, making plants an alternative platform for antibody production. We generated transgenic tobacco plants accumulating four different formats of the anti‐HIV‐1 antibody 2G12 in the endoplasmic reticulum (ER), i.e. with ELP on either the light or heavy chain, on both, or on neither. Detailed analysis of affinity‐purified antibodies by surface plasmon resonance spectroscopy showed that the kinetic binding parameters of all formats were identical to 2G12 lacking ELP produced in Chinese hamster ovary (CHO) cells. Importantly, protein purification from seeds by inverse transition cycling (ITC) did not affect the binding kinetics. Analysis of heavy chain N‐glycans from leaf‐derived antibodies showed that retrieval to the ER was efficient for all formats. In seeds, however, N‐glycans on the naked antibody were extensively trimmed compared with those on the ELP fusion formats, and were localized to a different subcellular compartment. The in vitro HIV‐neutralization properties of the tobacco‐derived 2G12 were equivalent to or better than those of the CHO counterpart.
A leaf‐based assay using interchangeable design principles to rapidly assemble multistep recombinant pathways
Authors: Wood Craig C. , Petrie James R. , Shrestha Pushkar , Mansour Maged P. , Nichols Peter D. , Green Allan G. , Singh Surinder P.
Published: October 2009

The assembly of multistep recombinant pathways in stably transformed plants is a cornerstone of crops producing new products yet can be a laborious and time‐consuming process. Any heterologous expression platform capable of providing a rapid estimation of the functional assembly of an entire pathway would guide the design of such transgenic traits. In this study, we use a Nicotiana benthamiana transient leaf expression system to simultaneously express five genes, from five independent TDNA binary vectors, to assemble a complete recombinant pathway in five days. In this study, we demonstrate the production of long‐chain polyunsaturated fatty acids (LC‐PUFA) requiring five transgene‐encoded reactions to convert endogenous fatty acids to LC‐PUFA. The addition of a triacylglycerol assembly enzyme, Arabidopsis thaliana diacylglyceride‐O‐acyltransferase, and fractionation of the total lipid profile demonstrated that leaf oils contained 37% newly synthesised LC‐PUFA, including 7% arachidonic acid (AA), 6% eicosopentaenoic acid and 3% docosahexaenoic acid. The calculation of enzymatic conversion efficiencies at each step of LC‐PUFA synthesis suggests that this transient assembly of a complicated multistep pathway is highly efficient. Unlike experiments using stably transformed plants our assembly of an intricate pathway maintained full gene‐for‐gene interchangeability and required a fraction of the time and glasshouse space. Furthermore, an exogenous LC‐PUFA fatty acid substrate, AA, was fed and metabolised by a transiently expressed Δ17‐desaturase enzyme, and provided results similar to those obtained in yeast feeding experiments. Although the assay was ideal for LC‐PUFA pathways, this assay format may become a powerful tool for the characterisation and step‐wise improvement of other recombinant pathways and multigenic traits.
Oil Exports, Non‐Oil GDP, and Investment in the GCC Countries
Authors: Harb Nasri
Published: October 2009

This paper studies the long‐run and short‐run relationships between oil exports, non‐oil GDP, and investment in five major oil‐exporting countries. Its goal is to verify the effect of natural resources exports on economic performance. It considers the effect of cross‐sectional correlations and uses the corresponding panel unit‐root tests to study the long‐run characteristics of the data series. The results show that resources' exports have no long‐run relationship with the macroeconomic variables. A VAR analysis is used to estimate the short‐run dynamics and shows that the effect of oil exports on those variables depends on local policies.
An Exploration into the Successful Development of the Leather‐Shoe Industry in Ethiopia
Authors: Sonobe Tetsushi , Akoten John E. , Otsuka Keijiro
Published: October 2009

The leather‐shoe industry in Ethiopia is thriving, and in the early 2000s it managed to recover the domestic market which had once been swept by imported Chinese shoes. Using primary enterprise‐level data, this paper finds that the industry has been growing not only because of a number of new entrants but also because of the growth of enterprises that have been improving product quality and developing new marketing systems. Such multifaceted improvements have been introduced by highly educated entrepreneurs, who have successfully expanded the size of their enterprises. This development pattern is similar to that commonly found in East Asia.
Size and Foreign Ownership Effects on Productivity and Efficiency: An Analysis of Turkish Motor Vehicle and Parts Plants
Authors: Yaşar Mahmut , Paul Catherine J. Morrison
Published: October 2009

The levels and interactions of foreign connections and size may be important determinants of plant productivity and efficiency, particularly in a developing country such as Turkey. We explore the productive contributions of foreign ownership (FDI), emphasizing its linkages with plant size and input composition, for plants in the Turkish motor vehicle and parts industry. We evaluate the implications of FDI for overall productivity, input‐specific contributions, and returns to scale, using OLS, stochastic production frontier, and quantile (size‐specific) regression estimates of a translog production function model. We find significantly higher productivity of plants with foreign ownership, driven by a higher marginal product of labor, particularly for smaller plants. This effect augments the productive contributions of technical progress, capital intensity, and increasing returns to scale. FDI is also associated with a greater productive contribution of imported capital investment.
Union and separation in the therapy of pervasive developmental disorders and ADHD
Authors: Kawai Toshio
Published: October 2009

Abstract:  This paper discusses the characteristics of psychotherapy for pervasive developmental disorders (PDD) in the context of the curative effects of the movement of images. The ‘autistic spectrum’ is widened here and includes not only PDD, but also ADHD. The main common characteristic in these two sets of disorders seems to be the lack of a subject, which manifests itself as the absence of awareness of otherness and difficulties with boundaries and language.

In these cases a normal psychotherapy is ineffective as it presupposes an established subject. However a psychotherapeutic approach with these patients can contribute to the emergence of a subject. In severe cases the process of union and separation which is enacted either in the therapeutic relationship or in symbolic play leads to the birth of a subject, and of language. In milder cases, such as ADHD, the moments of separation and confrontation with the therapist suffice.

I will discuss a case of my own with Asperger's syndrome in which union and separation in the play therapy occurred simultaneously. This indicates that union and separation are not a consecutive process, but are simultaneous and lead to dialectical movement. However, in neurotic cases with an established subjectivity the symbolic meaning of image plays a central role. This corresponds to Jung's understanding of image in alchemy.
Quantitative analysis of patch patterns in mosaic tissues with ClonalTools software
Authors: Mort Richard L.
Published: October 2009

Quantitative analysis of mosaic tissues is a powerful method for following developmental lineages; however, analytical techniques are often subjective and repetitious. Here a flexible, semi‐automated image analysis method for mosaic patterns is described. ClonalTools is a free customizable tool‐set designed for the open‐source image analysis package ImageJ. Circular, polygonal or linear one‐dimensional mosaic arrays can be interrogated to provide measurements of the total number and width of positive and negative patches in a region of interest. These results are adjusted for the effects of random clumping using a previously described method to correct for differences in the contribution of the positive and negative cell type. The applicability of ClonalTools to different systems is discussed with reference to the analysis of mosaic patterns in the mouse corneal epithelium and adrenal cortex and in the outgrowth of neurites from explant cultures of mouse retina as example systems. To validate ClonalTools quantitatively, a recently published manual clonal analysis of the corneal epithelium of X‐inactivation β‐Gal‐mosaic mice was re‐analysed. The semi‐automated results did not differ significantly from the published data. Rapid quantification of such patterns to produce biologically relevant results represents a welcome improvement in terms of ease and speed of use over previous methods.
Fetal growth from mid‐ to late pregnancy is associated with infant development: the Generation R Study
Authors: HENRICHS JENS , SCHENK JACQUELINE J , BARENDREGT CHARLOTTE S , SCHMIDT HENK G , STEEGERS ERIC AP , HOFMAN ALBERT , JADDOE VINCENT WV , MOLL HENRIETTE A , VERHULST FRANK C , TIEMEIER HENNING
Published: October 2009

Aim  The aim of this study was to investigate within a population‐based cohort of 4384 infants (2182 males, 2202 females) whether fetal growth from early pregnancy onwards is related to infant development and whether this potential relationship is independent of postnatal growth.

Method  Ultrasound measurements were performed in early, mid‐, and late pregnancy. Estimated fetal weight was calculated using head and abdominal circumference and femur length. Infant development was measured with the Minnesota Infant Development Inventory at 12 months (SD 1.1mo, range 10–17mo). Information on postnatal head size and body weight at 7 months was obtained from medical records.

Results  After adjusting for potential confounders and for postnatal growth, faster fetal weight gain from mid‐ to late pregnancy predicted a reduced risk of delayed social development (odds ratio [OR] 0.82; 95% confidence interval [CI] 0.71–0.95, p=0.008), self‐help abilities (OR 0.84; 95% CI 0.73–0.98, p=0.023), and overall infant development (OR 0.65; 95% CI 0.49–0.87, p=0.003). Similar findings were observed for fetal head growth from mid‐ to late pregnancy.

Interpretation  Faster fetal growth predicts a lower risk of delayed infant development independent of postnatal growth. These results suggest that reduced fetal growth between mid‐ and late pregnancy may determine subsequent developmental outcomes.
Fertility and pregnancy following pelvic arterial embolisation for postpartum haemorrhage
Authors: Sentilhes L , Gromez A , Clavier E , Resch B , Verspyck E , Marpeau L
Published: October 2009

Objectives  To determine and compare the fertility and pregnancy outcomes following embolisation with or without uterine‐sparing surgery for postpartum haemorrhage, and to attempt to identify specific risk factors associated with an increased likelihood of intrauterine synechia.

Design  Retrospective study.

Setting  University‐affiliated tertiary referral centre.

Population  All consecutive women who had an embolisation with or without uterine‐sparing surgery (vessel ligation and/or uterine compression) for postpartum haemorrhage between 1994 and 2007 were included.

Methods  Data were retrieved from medical files and telephone interviews.

Main outcome measure(s)  Fertility and pregnancy outcomes, synechia.

Results  Data were available for 68 of the 85 women (80%) included in the study. Among the 15 women who complained of amenorrhoea or decreased flow of menstruation, synechia was found in all those who decided to undergo an ambulatory hysteroscopy (n = 8). Seventeen women had 26 pregnancies with 19 term deliveries, one ectopic pregnancy, two abortions and four miscarriages. The clinical courses of the 19 complete gestations were uneventful, but postpartum haemorrhage recurred in six women (31.6%) (caused by placenta accreta in two women). Fertility and pregnancy outcomes did not differ between women who had undergone embolisation versus both embolisation and a uterine‐sparing surgical procedure. The occurrence of synechia was significantly associated with a higher rate of placenta accreta/percreta (P < 0.001) and postpartum fever above 38.5 °C (P = 0.04).

Conclusions  Embolisation, whether or not associated with a uterine‐sparing surgical procedure, for postpartum haemorrhage does not appear to compromise a woman’s subsequent fertility and obstetric outcome. Nevertheless, these women should be considered at high risk for postpartum haemorrhage during future deliveries.
A rapid evidence‐based service by librarians provided information to answer primary care clinical questions
Authors: McGowan Jessie , Hogg William , Rader Tamara , Salzwedel Doug , Worster Danielle , Cogo Elise , Rowan Margo
Published: October 2009

Background:  A librarian consultation service was offered to 88 primary care clinicians during office hours. This included a streamlined evidence‐based process to answer questions in fewer than 20 min. This included a contact centre accessed through a Web‐based platform and using hand‐held devices and computers with Web access. Librarians were given technical training in evidence‐based medicine, including how to summarise evidence.

Objectives:  To describe the process and lessons learned from developing and operating a rapid response librarian consultation service for primary care clinicians.

Methods:  Evaluation included librarian interviews and a clinician exit satisfaction survey.

Results:  Clinicians were positive about its impact on their clinical practice and decision making. The project revealed some important ‘lessons learned’ in the clinical use of hand‐held devices, knowledge translation and training for clinicians and librarians.

Conclusions:  The Just‐in‐Time Librarian Consultation Service showed that it was possible to provide evidence‐based answers to clinical questions in 15 min or less. The project overcame a number of barriers using innovative solutions. There are many opportunities to build on this experience for future joint projects of librarians and healthcare providers.
The impact of shrub encroachment on savanna bird diversity from local to regional scale
Authors: Sirami Clélia , Seymour Colleen , Midgley Guy , Barnard Phoebe
Published: October 2009

Aim  Evidence is accumulating of a general increase in woody cover of many savanna regions of the world. Little is known about the consequences of this widespread and fundamental ecosystem structural shift on biodiversity.

Location  South Africa.

Methods  We assessed the potential response of bird species to shrub encroachment in a South African savanna by censusing bird species in five habitats along a gradient of increasing shrub cover, from grassland/open woodland to shrubland dominated by various shrub species. We also explored historical bird species population trends across southern Africa during the second half of the 20th century to determine if any quantifiable shifts had occurred that support an ongoing impact of shrub encroachment at the regional scale.

Results  At the local scale, species richness peaked at intermediate levels of shrub cover. Bird species composition showed high turnover along the gradient, suggesting that widespread shrub encroachment is likely to lead to the loss of certain species with a concomitant decline in bird species richness at the landscape scale. Finally, savanna bird species responded to changes in vegetation structure rather than vegetation species composition: bird assemblages were very similar in shrublands dominated by Acacia mellifera and those dominated by Tarchonanthus camphoratus.

Main conclusions  Shrub encroachment might have a bigger impact on bird diversity in grassland than in open woodland, regardless of the shrub species. Species recorded in our study area were associated with historical population changes at the scale of southern Africa suggesting that shrub encroachment could be one of the main drivers of bird population dynamics in southern African savannas. If current trends continue, the persistence of several southern African bird species associated with open savanna might be jeopardized regionally.
Using the biogeographical distribution and diversity of seaweed species to test the efficacy of marine protected areas in the warm‐temperate Agulhas Marine Province, South Africa
Authors: Anderson R. J. , Bolton J. J. , Stegenga H.
Published: October 2009

Aim  To study the siting of marine protected areas (MPAs) with respect to the biogeographical distribution of seaweeds within the Agulhas Marine Province and to assess the effectiveness of current MPAs in including (conserving) seaweeds of the South African south coast.

Location  South Africa – the south coast between Cape Agulhas and the Eastern Cape/Kwazulu‐Natal border, and eight MPAs within that area.

Methods  We used interpolated seaweed distribution records from all available sources, in 50‐km coastal sections. Cluster analysis (Jaccard Average Linkage) of species presence/absence data provided measures of similarity between coastal sections and between MPAs. Complementarity analyses identified the sequence of ‘importance’ of sections/MPAs for conserving seaweed species.

Results  Species presence/absence data indicated two main groups, representing western (cooler water) and eastern (warmer water) biogeographical divisions, as well as several biogeographical subdivisions within each of these groups. Complementarity analysis yielded a sequence of ‘importance’ of coastal sections (in terms of the highest number of species included) that began with a section just east of central in the Agulhas Marine Province, around Port Alfred, where there is no MPA. This was followed by the easternmost section (warmest water), which contains the Pondoland MPA, and then by the westernmost (coolest water) section, containing the De Hoop MPA. Similar analysis of the actual species collected in MPAs showed a generally similar pattern.

Main conclusions  Seven current MPAs and one proposed coastal MPA in the Agulhas Marine Province appear to be well distributed and well sited to include (conserve) the full biogeographical range of seaweeds. However, if further MPAs are to be considered, the Port Alfred area is recommended for improved conservation. This study did not examine estuaries, which may require improved conservation efforts. Seaweed distribution data, which are often relatively complete, offer a good tool for planning the siting of coastal MPAs.
Drug reimbursement and GPs’ prescribing decisions: a randomized case‐vignette study about the pharmacotherapy of obesity associated with type 2 diabetes: how GPs react to drug reimbursement
Authors: Verger Pierre , Rolland Sophie , Paraponaris Alain , Bouvenot Julien , Ventelou Bruno
Published: October 2009

This study sought to identify the effect of drug reimbursability – a decision made in France by the National Authority for Health – on physicians’ prescribing practices for a diet drug such as rimonabant, approved for obese or overweight patients with type‐2 diabetes. A cross‐sectional survey of French general practitioners (GPs) presented a case‐vignette about a patient for whom this drug is indicated in two alternative versions, differing only in its reimbursability, to two separate randomized subsamples of GPs in early 2007, before any decision was made about reimbursement. The results indicate that (i) more than 20% of GPs in private practice would be willing to prescribe a non‐reimbursed diet drug for patients with obesity complicated by type 2 diabetes; (ii) the number of GPs willing to prescribe it would increase by 47.6% if the drug were reimbursed, and (iii) such a drug would be adopted at a higher rate by GPs who have regular contacts with pharmaceutical sales representatives. In France, unlike most other countries, drug reimbursement status is a signal of quality. However, our results suggest that a significant proportion of GPs would spontaneously adopt anti‐obesity drugs even if they were not reimbursed. Decisions about reimbursement of pharmaceutical products should be made taking into account that reimbursement is likely to intensify prescription.
Arterial transducer placement and cerebral perfusion pressure monitoring: a discussion
Authors: Jones Helen A.
Published: October 2009

Aim: To discuss existing disparity of practice and clinical implications of measuring cerebral perfusion pressure (CPP) from differing reference points thus highlighting the need for standardized benchmarks.

Background: When managing traumatic brain injury (TBI), the arterial transducer level is a key to an accurate CPP reading; however, there is a lack of national standards about where to zero arterial transducers when monitoring CPP.

Methods: A systematized search using the Cochrane library database, Pubmed database, Medline, British Library on line, CINAHL and PROQUEST using key search terms was used to identify articles that could form a basis for a discussion. Papers published between 2000 and 2008 were included. Papers that did not discuss arterial transducer level placement and CPP were excluded. The Brian Trauma Guidelines 2007 were scrutinized for recommendations.

Results: Of 57 empirical studies accessed, none reported or explored the placement of the arterial transducer during CPP measurement. Conflicting opinions were identified within the literature and there were no recommendations made for practice within the Brain Trauma Foundation Guidelines 2007.

Discussion: At the present time, there is insufficient evidence for recommending standard placement for mean arterial pressure (MAP) measurements for patients with TBI. There are implications to consider as the treatment prescribed will differ depending on where the arterial transducer is placed because the MAP and CPP displayed will fall by 15 mm Hg at a head elevation of 30 degrees. This poses a number of questions: is the CPP underestimated with the arterial transducer placed at head level? Is the CPP overestimated if the transducer is placed at mid axilla level?

Recommendations: Further research is recommended. However, studies would be difficult to power as head‐injured patients constitute a heterogeneous population. Professional consensus should be applied and standardized benchmarks agreed.
Recovering from the psychological impact of intensive care: how constructing a story helps
Authors: Williams Susan Lecky
Published: October 2009

Background:Numerous studies have demonstrated both the risk of post‐traumatic stress as a result of intensive care unit (ICU) treatment and the efficacy of successful narrative processing for recovery from psychological trauma.

Aim:This article is based on recent doctoral research exploring the impact of unanticipated life threats after admission to hospital. It examines the difficulties ICU patients have with constructing coherent narratives of their illness experience and the significance of those difficulties for psychological recovery from critical illness.

Methods:The original research used a qualitative design blending discourse, narrative, and phenomenological approaches guided by hermeneutical sensitivity to the evolving language of narrative processing. Patients chosen from ICU discharge summaries showing a critical life‐threatening event after admission to hospital were interviewed soon after discharge from hospital and then again 1 year later. Unstructured interviews explored participant experience of a critical event and its aftermath.

Results:This article focuses in particular on one finding from the doctoral research. Unanticipated critical illness presented some patients with difficulties in accomplishing the fundamental human task of constructing a narrative of their experience. Risk factors were observed identifying specific vulnerabilities. The extent to which difficulties were overcome impacted positively on the patient's sense of well‐being 1 year after discharge.

Conclusions:In order to recover psychologically, some ICU patients need help overcoming obstacles to their ability to construct an adequately coherent narrative of their experience.

Relevance to clinical practice:ICU follow‐up clinics could gain increased clarity of purpose from this narrative conceptual framework, eventually evaluating and validating benchmarks for assessing psychological recovery in relation to specified dimensions of narrative processing. Practice development informed by narrative process theory could also enhance ICU nursing communication. Since story construction is central to a person's core identity processes, person‐centred nursing would also be implicated.
The importance of knowing the patient in weaning from mechanical ventilation
Authors: Crocker Cheryl , Scholes Julie
Published: October 2009

Aim: The aim of the research was to understand how nurses used technology to wean patients from mechanical ventilation.

Background: The literature concerned with the development of critical care centres on the role of technology with little emphasis on the nursing contribution.

Design: An ethnographic approach was used to understand how nurses used technology to wean patients from mechanical ventilation.

Methods: Data were gathered by participant observation and interviewing over a 6‐month period. In total, 250 h of field notes were recorded.

Results: Data were analysed by the content analysis method. Knowing the patient was a central theme identified. Three sub‐themes were identified: ways of knowing, continuity of care and the role of the patient in the weaning trajectory.

Conclusion: ‘Knowing the patient' was implied during the interviews as essential to the delivery of patient‐centred care. There were two main factors that needed to be present in order for nurses to know their patients: continuity of care and expertise. ‘Ways of knowing’ was reliant on gaining information about the patient. The role of the patient was a passive recipient of treatment.

Implications for practice: Knowing the patient has been defined as a characteristic of expert nursing. To be truly patient‐centred nursing needs to address the barriers that prevent nurses from getting to ‘know’ their patients.
Mechanism leading to the development of pressure ulcers based on shear force and pressures during a bed operation: Influence of body types, body positions, and knee positions
Authors: Mimura Maki , Ohura Takehiko , Takahashi Makoto , Kajiwara Ryuji , Ohura Jr. Norihiko
Published: October 2009

Surface pressures and shear forces were measured in order to clarify the mechanism leading to the development of a pressure ulcer at five sites on the body during the operation of a bed (bed) using a device for simultaneously measuring pressure and shear force. Changes of shear force and pressure when three body types adopted different supine positions, with or without raising/bending the knees (raising the knees), were investigated and analyzed. The results are as follows: a slender body type tends to have the highest shear force at the coccygeal bone site and also has a higher surface pressure at the coccygeal and at the lateral sacral bone sites than an obese body type. On the other hand, an obese body type has a higher surface pressure at the other sites than the slender type. Shear forces at the sacrum and coccygeal bone sites can be reduced during a bed operation by raising the knees. Furthermore, shear forces can be reduced during a bed operation in a supine position by matching the body's bending points with those of the bed or by shifting the subjects 10 cm toward the head of the bed. These new findings are clinically useful in the treatment and the prevention of the onset of pressure ulcers.
Neonatal Sporotrichosis
Authors: Tlougan Brook E. , Podjasek Joshua O. , Patel Sapna P. , Nguyen Xuan H. , Hansen Ronald C.
Published: October 2009

Abstract:  Sporotrichosis is caused by the dimorphic fungus, Sporothrix schenckii. Classically, infection occurs after implantation of the organism into the skin by abrasion of a puncture wound by contaminated thorns, hay, or sphagnum moss. Cats are also a commonly recognized source of sporotrichosis. In children, fixed cutaneous lesions are more common than lymphocutaneous lesions, and the face is a frequent location for infection. We present a neonate with a fixed cutaneous facial lesion and both pre‐auricular and cervical lymphadenopathy who developed signs of infection at 3 weeks of age. This patient is currently the youngest reported case of sporotrichosis in the literature. The patient’s family denied any trauma and denied contact with flowers, gardens, and cats; thus, the source of infection remains unknown.
Linear Nodular Collagenoma—Successful Treatment with Intralesional Triamcinolone acetonide
Authors: SARDANA KABIR , BANSAL SHIKHA , GARG VIJAY K. , KHURANA NITA
Published: October 2009

Abstract:  A 17‐year‐old boy presented with papules and nodules arranged linearly on the neck and on the forehead. A diagnosis of collagenoma was made. Intralesional injection of triamcinolone acetonide resulted in marked effacement of the lesions.
Ascher Syndrome: A Case Report
Authors: CHANDER RAM , MAL JYOTI , JAIN ARPITA , JAYKAR KRANTI
Published: October 2009

Abstract:  Ascher syndrome is a rare disease described by Ascher, an ophthalmologist from Prague, in 1920. We report a case of an 8‐year‐old child, who presented with recalcitrant recurrent swelling of bilateral upper eyelids, probably a forme fruste of Ascher syndrome.
The Influence of Historical Land Use and Water Availability on Grassland Restoration
Authors: Xu Zhuwen , Wan Shiqiang , Zhu Guilin , Ren Haiyan , Han Xingguo
Published: October 2009

The ecological role of historical land use has rarely been explored in the context of grassland restoration. We conducted a 4‐year field experiment in a steppe and an old field in Inner Mongolia in northern China to examine the influence of historical land use and water availability on ecosystem restoration. Species richness, evenness, and plant cover were higher in the steppe than in the old field. The steppe was more temporally stable compared with the old field in terms of species richness, evenness, plant density, and cover. Water addition increased peak aboveground biomass, belowground net primary productivity, species richness, plant density, and cover in both the steppe and the old field. Water addition also enhanced the stability of ecosystems and the restoration of grassland. Our findings suggested that historical land use determines community structure and influences the process of grassland restoration. Converting grasslands to farmland in semiarid areas can cause the long‐term loss of biodiversity and instability of ecosystem with consequent impacts on ecosystem services. The amendment of limited resources is an effective practice to increase the success of ecosystem restoration.
Biomasses of Arthropod Taxa Differentially Increase on Nitrogen‐Fertilized Willows and Cottonwoods
Authors: Wiesenborn William D.
Published: October 2009

I evaluated soil application of nitrogen fertilizer to 1‐year‐old, flood‐irrigated Salix exigua willows and Populus fremontii cottonwoods as a method for increasing arthropod abundances and biomasses (wet masses) available to insectivorous birds. Shrubs and trees, planted near the lower Colorado River in southeast California for wildlife habitat, were fertilized during April 2008. I collected spiders and insects monthly during the following May–August from unfertilized and fertilized plants by fumigating branches with insecticide. Percentages of N in leaves, and to a lesser extent percentages of water in branches, were greater on fertilized plants (averaging 2.5% N of dry mass) compared with unfertilized plants (1.6% N) in both species. Most arthropods collected were predaceous Araneae (44% of abundance, 52% of biomass) followed by phytophagous Homoptera (34%, 11%) and predaceous or phytophagous Heteroptera (10%, 11%). Abundances and biomasses of Araneae, Heteroptera, and all Arthropoda across months did not differ between unfertilized and fertilized plants in either species controlling for masses of sampled branches. In contrast, biomasses of Homoptera, mostly Cicadellidae followed by Aphididae, were 197% greater on fertilized willows and 228% greater on fertilized cottonwoods. Greater biomasses on fertilized plants were consistent across months. Biomasses of homopterans on branches of each species also increased as leaf N‐concentrations increased. Applying N‐fertilizer to willows and cottonwoods can increase leaf N‐contents and abundances and biomasses of Homoptera. Increased homopteran biomass on N‐fertilized plants may in turn diversify prey available to insectivorous birds.
Processes Limiting Native Shrub Recovery in Exotic Grasslands after Non‐Native Herbivore Removal
Authors: Yelenik Stephanie G. , Levine Jonathan M.
Published: October 2009

Although non‐native herbivores are well known to increase the prevalence of exotic species in plant communities, herbivore removal is only sometimes sufficient for native plant recovery. Better predicting the influence of grazer removal, and identifying effective restoration approaches, requires a mechanistic understanding of the processes limiting native plant recovery in post‐grazing landscapes. We evaluated the factors limiting the recovery of native shrubs in exotic annual grasslands after a century of sheep grazing on Santa Cruz Island, CA. To evaluate the life stage transitions most limiting the recovery of the two dominant native shrubs (Eriogonum arborescens and Artemisia californica), we quantified seed rain and censused establishment and growth rates over 5 years that varied widely in rainfall. In addition, we conducted competitor removal experiments to evaluate the influence of exotic annual grasses on shrub establishment. We found that seed rain is unlikely to limit native recovery; shrub recovery was most limited at the seedling establishment stage. For Eriogonum, the wet El Niño year increased establishment by almost an order of magnitude over average rainfall years, while grass competition reduced growth and survival by two thirds. Artemisia failed to recruit in any year of the study. Our results suggest that management efforts seeking to increase shrub recovery need to overcome barriers at the establishment life stage, but once such limitations are overcome, adult shrubs will persist with exotic grass competitors. Our work shows how understanding the factors limiting native recovery can inform the restoration of post‐grazing landscapes.
Quantifying Disturbance in Terrestrial Communities: Abundance–Biomass Comparisons of Herpetofauna Closely Track Forest Succession
Authors: Smith Walter H. , Rissler Leslie J.
Published: October 2009

Herpetofauna are frequently cited as ideal indicators for environmental and restoration monitoring due to their importance to ecological functioning, dominance of vertebrate biomass, and sensitivity to environmental change. Despite this relevance, herpetofauna have yet to be fully integrated into comprehensive, community‐scale restoration monitoring methodologies. We tested the applicability of one such method, abundance–biomass comparisons (ABCs), to monitoring restoration success in a longleaf pine ecosystem currently undergoing restoration via prescribed burning. W statistics (a metric of environmental perturbation) for herpetofaunal assemblages in longleaf pine stands managed under varying fire intervals closely tracked forest succession from recently burned longleaf pine stands to those characterized by longer times since last burn and high levels of hardwood encroachment. Our results suggest that ABCs may be an applicable method for terrestrial restoration monitoring that encompasses entire faunal assemblages and allows for generality in restoration or disturbance response. We emphasize, however, that applications of this method and others need to take into account the specific ecological characteristics of study organisms and the natural history of study sites to avoid incorrect interpretations of disturbance response and inappropriate management recommendations.
Response of Small Mammal Populations to Fuel Treatment and Precipitation in a Ponderosa Pine Forest, New Mexico
Authors: Bagne Karen E. , Finch Deborah M.
Published: October 2009

Mechanical and fire treatments are commonly used to reduce fuels where land use practices have encouraged accumulation of woody debris and high densities of trees. Treatments focus on restoration of vegetation structure, but will also affect wildlife populations. Small mammal populations were monitored before and after dense tree stands were thinned on 2,800 ha in NM, U.S.A. Mammals were live‐trapped in upland and riparian habitats from 2002 to 2006 in thinned and unthinned forests. Populations of deer mice (Peromyscus maniculatus) and voles (Microtusspp.) were estimated using mark–recapture data. An index of abundance was used for chipmunks (Tamiasspp.) and woodrats (Neotomaspp.). Deer mice responded positively to thinning in 2005 in upland and riparian habitats. Voles responded positively to thinning in 2005 and 2006 in riparian habitats. There was no change related to thinning in relative abundance of chipmunks and woodrats or in total small mammal biomass. Because abiotic processes affect wildlife populations, we also examined response of deer mouse populations to precipitation. After removing treatment effects, populations were modeled with winter and summer precipitation. In both upland and riparian habitats, deer mouse populations had a curvilinear response to precipitation from the preceding winter, while responding negatively to summer rainfall only in riparian habitats. Increases in deer mice populations occurred on thinned sites during a year of high winter precipitation, generally associated with depressed populations, indicating that forest thinning moderated this relationship. Results suggest that precipitation plays a role in determining timing and presence of response to restoration treatments.
Building Administrative Capacities in Developing Countries: SWAT Teams or Beat Cops?
Authors: Tankha Sunil
Published: October 2009

After reading Professor Ali Farazmand's essay “Building Administrative Capacity in the Age of Rapid Globalization: A Modest Prescription for the Twenty‐First Century,” one is reminded that the list of capacities we need to develop is long, the tasks are diverse, and the challenges are tremendous. By offering a “modest” prescription, Farazmand departs emphatically from recent attempts to rewrite administrative capacity by downgrading it and outsourcing it to the market or by making it imitate corporate structures and techniques. Such exercises of yesteryear are correctly being excoriated now, but it would be well to remember that this failed model was inspired and facilitated by the stagnation and many perversities of the state‐centered model that it replaced. As we stand at the cusp of a new generation of public administration reforms, we are reminded by Professor Farazmand's exposition that we no longer have any widely accepted and integrative theories left to guide our practice of reform, and that a search must begin to look at past evidence with a critical eye toward developing practical and theoretical insights to advance the public administration agenda.
Residual renal function and arterial stiffness mediated the blood pressure change during interdialytic weight gain in hemodialysis patients
Authors: TIAN Jun‐Ping , DU Feng‐He , CHENG Li‐Tao , WANG Tao
Published: October 2009

Volume overload is thought to be the main cause of hypertension in dialysis patients. However, the effect of interdialytic weight gain (IDWG) in hemodialysis (HD) patients, which was considered as an increase in extracellular water (ECW), on blood pressure (BP) change, was controversial. Our aim was to examine the changes in hemodynamics and arterial stiffness during IDWG in HD patients and attempt to explore the possible mechanism of diverse BP change. Thirty prevalent patients on HD were enrolled. The height, weight, BP, blood chemistry, volume status assessed by bioelectrical impedance analysis, hemodynamic parameters obtained by echocardiography, and pulse wave velocity (PWV) were collected within 1 hour postdialysis and again just before the next dialysis session. Meanwhile, blood samples were drawn to analyze vasoactive hormones, including renin, angiotensin II, catecholamine, and endothelin. The patients' weights and ECWs during the next predialysis were significantly higher than those during the postdialysis. The BP showed no difference between postdialysis and the next predialysis. There was an obvious increase in cardiac output and decrease in total peripheral resistance as a whole during the next predialysis than that during postdialysis. When patients were divided into the BP increase group (BPI group, 13 patients) and BP decrease group (BPD group, 11 patients) according to the change in systolic BP higher than 10 mmHg, both groups displayed a significant increase in weight, ECW, cardiac output, and a decrease in total peripheral resistance. As compared with the BPI group, patients in the BPD group had significantly lower IDWG, shorter time on dialysis treatment, and higher residual renal function. A decrease in catecholamine and endothelin in the next predialysis was obvious in the BPD group. There was a significant decrease in PWV at the next predialysis in the BPD group while the PWV did not change significantly in the BPI group. Our results showed that the diverse BP change during IDWG was significantly affected by residual renal function, PWV, and vasoactive substances.
Cannulation and vascular access‐related complications in hemodialysis: Factors determining successful cannulation
Authors: VAN LOON Magda M. , KESSELS Alfons G. H. , VAN DER SANDE Frank M. , TORDOIR Jan H. M.
Published: October 2009

Little is known about cannulation of the vascular access (VA), such as the number of successful cannulation procedures, frequency of complications caused by cannulation, and VA failure. Incident patients were followed for 6 months, from the first successful cannulation with 2 needles—both used for the hemodialysis treatment. Data included patient characteristics, comorbidities, and medication. Vascular access characteristics included: type of VA and location, vein diameter assessed by Duplex ultrasound, length of the cannulation route, and maturation period. Longitudinal data were collected by dialysis nurses, using identical questionnaires, and a standardized method to register data from each dialysis session. Among 10 Dutch dialysis facilities, clinical data from 120 patients were collected from June 2005 to March 2007. The use of autogenous arteriovenous fistulae (P<0.001) and limited length of the cannulation route (P<0.003) negatively affect the outcome of cannulation and complications such as use of single‐needle (SN) dialysis and central vein catheters (CVC). Previous use of CVC and SN hemodialysis were significant predictors for VA failure (P<0.0001). The present study demonstrated that during the first 6 months of a newly placed VA, a huge number of cannulation‐related complications such as miscannulation, use of CVC, and SN dialysis are encountered. Despite the fact that guidelines recommended the arteriovenous fistulae as the preferred VA, cannulation‐related complications can lead to increased morbidity. The length of the cannulation route positively correlates with successful cannulation. Therefore, adjusted cannulation techniques might be indicated to improve VA outcome.
Changing Lives, Resistant Institutions: A New Generation Negotiates Gender, Work, and Family Change1
Authors: Gerson Kathleen
Published: October 2009

Sociology’s enduring concern with explaining the links between individual and social change has never been more relevant. We are poised at a moment when changing lives are colliding with resistant institutions. These tensions have created social conflicts and personal dilemmas for women and men alike. To explain the interplay between lives and institutions and to develop effective strategies for transcending the impasse between public demands and private needs, we need a deeper understanding of how these structural and cultural conflicts play out in the lives of young women and men. This article proposes a framework for such an inquiry.