bluuebunny/crossref_metadata_2025 huggingface dataset:
Follow‐up of 5‐ to 11‐year‐old children treated for persistent pulmonary hypertension of the newborn
Authors: Eriksen Vibeke , Nielsen Lars Holme , Klokker Mads , Greisen Gorm
Published: January 2009

Aim: Determine the prevalence of sensorineural hearing loss (SNHL) and relate this to cumulative exposure to hypoxia, hypocapnia and hypotension. Describe chronic health problems among 5‐ to 11‐year‐old children treated for persistent pulmonary hypertension of the newborn (PPHN).

Methods: The index group consisted of 85 children and a reference group was matched for age, sex and municipality of current residence. Questionnaires were sent to the families. The families in the index group were asked to participate in an examination of their child's hearing.

Results: Seven children (11%) had SNHL. SNHL was not associated with hypoxia, hypocapnia or hypotension during treatment for PPHN. In the index group chronic health problems were reported in 42% compared with 17% in the reference group (chi‐square test, p = 0.001). Twenty‐one percent in the index group were treated with bronchodilator therapy compared with 8% in the reference group (chi‐square test, p = 0.028). In the index group five children had cerebral palsy and two had developmental delay. Nineteen percent in the index group and 5% in the reference group had remedial education (chi‐square test, p = 0.008).

Conclusion: Children treated for PPHN are at high risk for SNHL. Exposure to hypoxia, hypocapnia or hypotension did not predict SNHL. The incidence of chronic health problems and use of remedial education was high.
Assessment of childhood diabetes‐related quality‐of‐life in West Sweden
Authors: Chaplin J E , Hanas R , Lind A , Tollig H , Wramner N , Lindblad B
Published: January 2009

Aim: To investigate health‐related quality‐of‐life (HrQoL) in childhood diabetes and the level of agreement between West Sweden and European reference data for the new multi‐cultural European questionnaire – DISABKIDS.

Method: Twenty percent of the Swedish paediatric diabetes population was included in the survey. Child‐parent pairs completed the DISABKIDS chronic generic (37 questions) and diabetes modules (10 questions) during their routine clinic visit. A one‐page results summary, based on positive domains, was used to provide feedback to clinicians.

Results: Three hundred and sixty‐one child‐parent pairs were included in the analysis. In Sweden, diabetes was perceived by the children as having less impact than the European average. Swedish parents rated the HrQoL of their children lower than did the European parents. Swedish girls had a lower HrQoL than boys and greater difficulty accepting their diabetes; adolescents had greater difficulty accepting the diagnosis than younger children. Parents reported greater impact of diabetes on their children than the children themselves but reported no difference between boys and girls. Parents reported better acceptance of treatment in boys. The child's reported quality‐of‐life (QoL) is related to age and gender.

Conclusion: Our results confirm the applicability of DISABKIDS to the Swedish paediatric diabetes population.
Children with chronic kidney disease: a 3‐year prospective study of growth, bone mass and bone turnover
Authors: Swolin‐Eide Diana , Hansson Sverker , Magnusson Per
Published: January 2009

Aim: Children with chronic kidney disease (CKD) are at risk of developing skeletal problems. This 3‐year prospective study investigated the development of bone mass and bone turnover in children with CKD.

Methods: Fifteen patients, 4–15 years, were included with a median glomerular filtration rate of 48 (range 8–94) mL/min/1.73 m2. Bone mineral density (BMD) and markers of bone and mineral metabolism were investigated over a 3‐year period.

Results: Growth was satisfactory but a delayed bone age was observed. Total body bone mineral density (TBBMD) Z‐scores were below zero in five patients at start and after 3 years, but none had a Z‐score below −2.5. Lumbar spine BMD Z‐scores were below zero in three patients at start and in five patients after 3 years. The median TBBMD and lumbar spine Z‐scores did not change during the study period. Eleven CKD patients had increased PTH levels at baseline and 13 patients after 3 years. Most children had normal levels of leptin and vitamin D. Almost 50% of the patients had increased osteoprotegerin levels after 3 years.

Conclusion: A normal BMD does not exclude mineral bone disorder in patients with CKD, yet the BMD Z‐scores were well preserved and most markers of bone turnover were within the reference intervals.
Is there an increased frequency of food allergy in children delivered by caesarean section compared to those delivered vaginally?
Authors: Kvenshagen Bente , Halvorsen Ragnhild , Jacobsen Morten
Published: January 2009

Aim: Allergic diseases are increasing. At the same time an increasing number of children are delivered by caesarean section. These children do not get the same contact with their mother's gut flora as babies delivered vaginally. Theoretically, lack of exposure to maternal vaginal and perineal bacteria might change the gut flora, with secondary changes in the immune system. The aim of this study was to investigate whether children delivered by caesarean section were more prone to develop food allergy.

Methods: Six hundred and nine children were included at birth. At 2‐year follow‐up, 512 children participated, 171 delivered by caesarean section, 341 born vaginally. The children reported to have symptoms consistent with possible food allergy, were examined at the outpatient clinic. The diagnosis was based on the history, skin prick test (SPT), specific IgE, elimination/challenge test and double blind placebo controlled challenge.

Results: Thirty‐five (6.8%) children were diagnosed with adverse reactions to food, 27 with non‐IgE‐mediated and eight with IgE‐mediated allergy. There was no over representation of children born by caesarean section.

Conclusion: In this study there seems to be no increased risk for food allergy in the first 2 years of life in children delivered by caesarean section.
Use of plastic bags to prevent hypothermia at birth in preterm infants‐do they work at lower gestations?
Authors: Ibrahim CPH , Yoxall CW
Published: January 2009

Background: Hypothermia at birth is strongly associated with mortality and morbidity in preterm infants. Occlusive wrapping of preterm infants during resuscitation, including polythene bags have been shown to prevent hypothermia.

Objectives: To evaluate the effectiveness of the introduction of polythene bags at resuscitation of infants born below 30 weeks gestation in a large tertiary neonatal centre.

Methods: Retrospective audit of admission temperatures of all infants born below 30 weeks gestation for two years before and two years after the introduction of polythene bags. Hypothermia was defined as admission axillary temperature < 36°C.

Results: A total of 334 eligible infants were born during the study period. Two hundred and fifty‐three (75.8%) had admission temperatures recorded. The incidence of hypothermia fell from 25% to 16%(p = 0.098) for the whole group since the introduction of polythene bags. The main reduction in hypothermia was seen in infants born above 28 weeks gestation (19.4% vs. 3.9%, p = 0.017). There was no significant effect in infants born between 28 weeks and 30 weeks (29.3% vs. 24.8%, p = 0.58).

Conclusions Polythene bags are effective in reducing the incidence of hypothermia at admission in infants born below 30 weeks gestation. The benefit in infants born below 28 weeks gestation was only marginal. This is in contrast to previously published studies. This may be related to the comparatively low incidence of hypothermia at the study centre even prior to introduction of polythene bags.
T‐Cell Immunodeficiency in CHARGE syndrome
Authors: Chopra Charu , Baretto Richard , Duddridge Michael , Browning Michael J.
Published: January 2009

CHARGE syndrome comprises coloboma of the eye, heart defects, choanal atresia, growth and developmental retardation, genitourinary anomalies and ear and hearing defects. The association between CHARGE syndrome and T‐cell immunodeficiency is recognized, but has not been reported widely in the literature. We report four patients meeting the diagnostic criteria for CHARGE syndrome, who had moderate or severe T‐cell lymphopenia complicated by infections. The patients presented in Leicester, UK, between 2000 and 2007. All patients were negative for 22q11.2 deletions by FISH analysis, but mutations in the CHD7 gene were identified in three patients in whom the analysis was performed. Our cases indicate that patients with CHARGE syndrome may have a spectrum of T‐cell immune deficiency, and that this association may be more common than has previously been appreciated. We recommend that all patients diagnosed with CHARGE syndrome should have lymphocyte subsets evaluated as part of their initial investigation.

Conclusion: Thymic hypoplasia should be included in the clinical features associated with CHARGE syndrome. All patients with CHARGE syndrome should have lymphocyte subset analysis performed, to exclude T‐cell immunodeficiency.
Reducing blood transfusion requirements in preterm infants by a new device: a pilot study
Authors: Ballin Ami , Livshiz Victoria , Mimouni Francis B , Dollberg Shaul , Kohelet David , Oren Assaf , Arbel Eliana , Boaz Mona , Tal Adina , Matas Zipora , Mandel Dror
Published: January 2009

Objective: To test a new device designed to salvage red blood cells (RBCs) from blood samples drawn from preterm infants, with the intent of decreasing blood loss and lowering the requirements for RBC transfusions.

Design: A case‐controlled pilot study was conducted in two Israeli neonatal intensive care units in large municipal hospitals. Twenty low‐birthweight preterm infants were randomly and equally divided into the ErythroSave™ group or a control group. All blood tests in the study group (except for complete blood count and coagulation parameters) were obtained during the first week of life by the new device in the study group and by ordinary syringes in the control group. The main outcome measure was the total number of units of blood needed.

Results: The average volume of blood obtained for laboratory analyses from each infant was 27 mL in the ErythroSave group and 24 mL in controls (not significant). The average volume of transfused packed cells was 6.4 mL for the ErythroSave group and 21.3 mL for the controls (p = 0.008).

Conclusion: The use of ErythroSave for sampling blood significantly reduced blood transfusion requirements in premature infants compared to sampling by conventional syringes.
Identification of novel carbohydrate modifications on Campylobacter jejuni 11168 flagellin using metabolomics‐based approaches
Authors: Logan Susan M. , Hui Joseph P. M. , Vinogradov Evgeny , Aubry Annie J. , Melanson Jeremy E. , Kelly John F. , Nothaft Harald , Soo Evelyn C.
Published: January 2009

It is well known that the flagellin of Campylobacter jejuni is extensively glycosylated by pseudaminic acid and the related acetamindino derivative, in addition to flagellin glycosylation being essential for motility and colonization of host cells. Recently, the use of metabolomics permitted the unequivocal characterization of unique flagellin modifications in Campylobacter, including novel legionaminic acid sugars in Campylobacter coli, which had been impossible to ascertain in earlier studies using proteomics‐based approaches. To date, the precise identities of the flagellin glycosylation modifications have only been elucidated for C. jejuni 81‐176 and C. coli VC167 and those present in the first genome‐sequenced strain C. jejuni 11168 remain elusive due to lability and respective levels of individual glycan modifications. We report the characterization of the carbohydrate modifications on C. jejuni 11168 flagellin using metabolomics‐based approaches. Detected as their corresponding CMP‐linked precursors, structural information on the flagellin modifications was obtained using a combination of MS and NMR spectroscopy. In addition to the pseudaminic acid and legionaminic acid sugars known to be present on Campylobacter flagellin, two unusual 2,3‐di‐O‐methylglyceric acid modifications of a nonulosonate sugar were identified. By performing a metabolomic analysis of selected isogenic mutants of genes from the flagellin glycosylation locus of this pathogen, these novel CMP‐linked precursors were confirmed to be di‐O‐methylglyceric acid derivatives of pseudaminic acid and the related acetamidino sugar. This is the first comprehensive analysis of the flagellar modifications in C. jejuni 11168 and structural elucidation of di‐O‐methylglyceric acid derivatives of pseudaminic acid on Campylobacter flagellin.
The multi‐replication protein A (RPA) system – a new perspective
Authors: Sakaguchi Kengo , Ishibashi Toyotaka , Uchiyama Yukinobu , Iwabata Kazuki
Published: January 2009

Replication protein A (RPA) complex has been shown, using both in vivo and in vitro approaches, to be required for most aspects of eukaryotic DNA metabolism: replication, repair, telomere maintenance and homologous recombination. Here, we review recent data concerning the function and biological importance of the multi‐RPA complex. There are distinct complexes of RPA found in the biological kingdoms, although for a long time only one type of RPA complex was believed to be present in eukaryotes. Each complex probably serves a different role. In higher plants, three distinct large and medium subunits are present, but only one species of the smallest subunit. Each of these protein subunits forms stable complexes with their respective partners. They are paralogs as complex. Humans possess two paralogs and one analog of RPA. The multi‐RPA system can be regarded as universal in eukaryotes. Among eukaryotic kingdoms, paralogs, orthologs, analogs and heterologs of many DNA synthesis‐related factors, including RPA, are ubiquitous. Convergent evolution seems to be ubiquitous in these processes. Using recent findings, we review the composition and biological functions of RPA complexes.
Frataxin deficiency causes upregulation of mitochondrial Lon and ClpP proteases and severe loss of mitochondrial Fe–S proteins
Authors: Guillon Blanche , Bulteau Anne‐Laure , Wattenhofer‐Donzé Marie , Schmucker Stéphane , Friguet Bertrand , Puccio Hélène , Drapier Jean‐Claude , Bouton Cécile
Published: January 2009

Friedreich ataxia (FRDA) is a rare hereditary neurodegenerative disease characterized by progressive ataxia and cardiomyopathy. The cause of the disease is a defect in mitochondrial frataxin, an iron chaperone involved in the maturation of Fe–S cluster proteins. Several human diseases, including cardiomyopathies, have been found to result from deficiencies in the activity of specific proteases, which have important roles in protein turnover and in the removal of damaged or unneeded protein. In this study, using the muscle creatine kinase mouse heart model for FRDA, we show a clear progressive increase in protein levels of two important mitochondrial ATP‐dependent proteases, Lon and ClpP, in the hearts of muscle creatine kinase mutants. These proteases have been shown to degrade unfolded and damaged proteins in the matrix of mitochondria. Their upregulation, which was triggered at a mid‐stage of the disease through separate pathways, was accompanied by an increase in proteolytic activity. We also demonstrate a simultaneous and significant progressive loss of mitochondrial Fe–S proteins with no substantial change in their mRNA level. The correlative effect of Lon and ClpP upregulation on loss of mitochondrial Fe–S proteins during the progression of the disease may suggest that Fe–S proteins are potential targets of Lon and ClpP proteases in FRDA.
Vasculogenic Erectile Dysfunction is a Predictor of Abnormal Stress Echocardiography
Authors: Mulhall John , Teloken Patrick , Barnas Jennifer
Published: January 2009

Introduction

Erectile dysfunction (ED) and atherosclerotic vascular disease have the same risk factors; furthermore, endothelial dysfunction has been shown to be a common link between these conditions. A high prevalence of silent coronary artery disease (CAD) in patients with ED has been observed.

Aims

The aims of this article were to define the prevalence and identify predictors of occult obstructive CAD in patients with documented vasculogenic ED.

Main Outcome Measures

Duplex Doppler penile ultrasonography (DUS); exercise stress echocardiography; IIEF; CAD risk factors.

Methods

Patients presenting with ED who had penile vascular insufficiency documented by DUS and who had no history of diabetes or symptoms of CAD were prospectively enrolled for noninvasive cardiac stress testing using exercise stress echocardiography.

Results

Forty-nine men (mean age 517 years) with an average duration of ED of 2.52 years were evaluated. Penile arterial insufficiency was present in 94%, and venous leak in 20% of patients. Comorbidities included hypertension (51%), hyperlipidemia (41%), and smoking (35%). All patients had at least one vascular risk factor, with 40% having two, 15% three, and 15% four risk factors. Ten patients (20%) had abnormal cardiac stress test. On univariate analysis, age, IIEF–EF domain score, cavernosal artery insufficiency, presence of venous leak, and history of a first-degree relative with CAD were significant predictors. On multivariate analysis, cavernosal artery insufficiency, venous leak, and family history of CAD continued to be predictors of an abnormal stress test.

Conclusions

A significant proportion of men with vasculogenic ED have abnormal cardiac stress test. The greatest chance for abnormal cardiac stress test was observed in those with corporo-venocclusive dysfunction or family history of CAD. In some men presenting with ED, even without a CAD history, performing penile DUS or cardiology referral for stress testing should be considered.
Neuropeptide Modulation of a Lumbar Spinal Reflex: Potential Implications for Female Sexual Function
Authors: Wilson Lesley A. , Wayman Chris P. , Jackson V. Margaret
Published: January 2009

Introduction

Neuropeptides are known to modulate female receptivity. However, even though receptivity is a spinal reflex, the role of neuropeptides within the spinal cord remains to be elucidated.

Aim

The aims were to (i) investigate neuropeptides in the lumbosacral region; and (ii) determine how neuropeptides modulate glutamate release from stretch Ia fibers, touch sensation Aβ fibers and Aδ/C pain fibers.

Main Outcome Measures

Neuropeptide modulation of the lumbosacral dorsal-root ventral-root reflex in vitro.

Methods

Spinal cords were removed from Sprague-Dawley rats in compliance with UK Home Office guidelines. Hemisected cords were superfused with aCSF and the dorsal root (L4–S1) was stimulated to evoke glutamate release. A biphasic reflex response was evoked from the opposite ventral root consisting of a monosynaptic (Ia fibers) and polysynaptic (Aβ, Aδ/C fibers) component.

Results

The µ opioid receptor (MOR) agonist DAMGO inhibited the monosynaptic (EC50 0.02 ± 0.02 nM) and polysynaptic area (EC50 125 ± 167 nM) but not polysynaptic amplitude. Oxytocin and corticotrophin releasing factor (CRF) inhibited the monosynaptic amplitude (EC50, 1.4 ± 1.0 nM and EC50 4.3 ± 3.5 nM, respectively), polysynaptic amplitude (EC50 18.2 ± 28.0 nM and EC50, 9.5 ± 13.3 nM, respectively), and area (EC50 11.6 ± 13.0 nM and EC50, 2.8 ± 3.3 nM, respectively); effects that were abolished by oxytocin and CRF1 antagonists, L-368899 and 8w. Melanocortin agonists solely inhibited the monosynaptic component, which were blocked by the MC3/4 receptor antagonist SHU9119.

Conclusion

These data suggest endogenous neuropeptides are released within the lumbosacral spinal cord. Melanocortin agonists, oxytocin, CRF, and DAMGO via MC4, oxytocin, CRF1, and MOR inhibit glutamate release but with differing effects on afferent fiber subtypes. Melanocortins, oxytocin, CRF, and DAMGO have the ability to modulate orgasm whereas oxytocin, CRF and DAMGO can increase pain threshold. Oxytocin and CRF may dampen touch sensation.
Beyond Douching: Use of Feminine Hygiene Products and STI Risk Among Young Women
Authors: Ott Mary A. , Ofner Susan , Fortenberry J. Dennis
Published: January 2009

Introduction

Use of feminine hygiene products (feminine wipes, sprays, douches, and yeast creams) by adolescent women is common, yet understudied.

Aim

We examine the association among these genital hygiene behaviors, condom use, and sexually transmitted infection (STI).

Main Outcome Measures

Using the interview as our unit of analysis, we examined associations between genital hygiene behaviors (use of feminine wipes, feminine sprays, douches, or yeast creams), STI risk factors, and infection with Chlamydia trachomatis, Neisseria gonorrhoeae, and Trichomonas vaginalis.

Methods

We recruited 295 adolescent women from primary care clinics as part of a larger longitudinal study of STI among high-risk adolescents. Participants completed face-to-face interviews every 3 months, and provided vaginal swabs for STI testing. Data were analyzed with repeated measures logistic models to control for multiple observations contributed by each participant.

Results

Participants reported douching in 25% of interviews, feminine sprays in 29%, feminine wipes in 27%, and yeast creams in 19% of interviews. We observed a co-occurrence of douching, spraying, and wiping. A past STI (6 months or more prior) was associated with increased likelihood of yeast cream use, and a recent STI (3 months prior) was associated with increased likelihood of feminine wipe use. Condom use was modestly associated with increased likelihood of douching.

Conclusions

Young women frequently use feminine hygiene products, and it is important for clinicians to inquire about use as these products may mimic or mask STI. We found no associations between douching and STI, but instead modest associations between hygiene and STI prevention, suggesting motivation for self-care.
Revealing the Buried Penis in Adults
Authors: Shaeer Osama , Shaeer Kamal
Published: January 2009

Introduction

Several surgical solutions have been proposed for resolving penile concealment with successful outcomes. Those include liposuction, adhesiolysis, and suprapubic lipectomy through the abdominal crease. Nevertheless, some limitations exist and compromise the results of surgical correction.

Aim

This work presents our technique for revealing the hidden penis, addressing the limitations of existing methods for surgical correction.

Methods

Sixty-four adult males with buried penis were operated upon. The penis was revealed by the combination of adhesiolysis, suprapubic and lateral lipectomy, anchoring the penoscrotal and penopubic junctions, and skin coverage by a local flap.

Main Outcome Measures

Penile length in the flaccid and erect states.

Results

Average postoperative length in the flaccid state was approximately 7 cm ± 1.3 (a 293% increase) and in the erect state was 18.4 cm ± 2.9 (185.7% increase), compared with preoperative length of 1.8 cm ± 0.4 in the flaccid state and 6.4 cm ± 1.6 in the erect state. Minor complications occurred. There was no deterioration in sexual function.

Conclusion

Revealing the concealed penis is a complicated procedure. The outcome may be improved by implementing a radical approach to tissue excision, providing adequate skin coverage, and anchoring the penile shaft, skin, and subcutaneous tissues in the revealed state to prevent relapse.
Maternal Predictors of Toddler Health Status
Authors: Fowles Eileen , Walker Lorraine
Published: January 2009

PURPOSE.  The purposes of this study were to examine the relationships among maternal and environmental variables in the first 6 months postpartum and toddler health status, and to identify predictors of toddler health.

DESIGN AND METHODS.  A secondary analysis was conducted on an existing dataset of a longitudinal parent–child survey.

RESULTS.  Maternal stress predicted 8% of the variance in child health status at 18 months of age. Children in nonparental care more than 20 hr per week were perceived as less healthy.

PRACTICE IMPLICATIONS.  Pediatric nurses should assess levels of maternal stress in the early months postpartum and anticipate poorer health status in toddlers who spend more than 20 hr per week in nonparental care.
Challenging emotions
Authors: Bennett Katy
Published: January 2009

This paper contributes to work on emotional geographies by engaging with

Liz Bondi's

focus on relationality and the challenge to geographers to explore how their emotion might connect with the feelings of their subjects. Through the lens of a focus group meeting that created confusing feelings, it shows the hurdles that geographers face when they engage with practices developed in a psychotherapeutic setting. The paper is not so much a critique, more a desire to continue the conversation regarding how to approach and adopt psychotherapy's theory of practice in a research context.
The Fine‐Tuning Argument
Authors: Manson Neil A.
Published: January 2009

The Fine‐Tuning Argument (FTA) is a variant of the Design Argument for the existence of God. In this paper the evidence of fine‐tuning is explained and the Fine‐Tuning Design Argument for God is presented. Then two objections are covered. The first objection is that fine‐tuning can be explained in terms of the existence of multiple universes (the ‘multiverse’) plus the operation of the anthropic principle. The second objection is the ‘normalizability problem’– the objection that the Fine‐Tuning Argument fails because fine‐tuning is not actually improbable.
Musical Recordings
Authors: Kania Andrew
Published: January 2009

In this article, I first consider the metaphysics of musical recordings: their variety, repeatability, and transparency. I then turn to evaluative or aesthetic issues, such as the relative virtues of recordings and live performances, in light of the metaphysical discussion.
Neuroethics: Ethics and the Sciences of the Mind
Authors: Levy Neil
Published: January 2009

Neuroethics is a rapidly growing subfield, straddling applied ethics, moral psychology and philosophy of mind. It has clear affinities to bioethics, inasmuch as both are responses to new developments in science and technology, but its scope is far broader and more ambitious because neuroethics is as much concerned with how the sciences of the mind illuminate traditional philosophical questions as it is with questions concerning the permissibility of using technologies stemming from these sciences. In this article, I sketch the two branches of neuroethics, the applied and the philosophical, and illustrate how they interact. I also consider representative themes from each: the ethics of dampening memory and of cognitive enhancement, on the one hand, and the attack upon the reliability of deontological intuitions and upon free will, on the other.
Welfarism
Authors: Keller Simon
Published: January 2009

Welfarism is the view that morality is centrally concerned with the welfare or well‐being of individuals. The division between welfarist and non‐welfarist approaches underlies many important disagreements in ethics, but welfarism is neither consistently defined nor well understood. I survey the philosophical work on welfarism, and I offer a suggestion about how the view can be characterized and how it can be embedded in various kinds of moral theory. I also identify welfarism's major rivals, and its major attractions and weaknesses.
Recent Work on Free Will and Moral Responsibility
Authors: Levy Neil , McKenna Michael
Published: January 2009

In this article we survey six recent developments in the philosophical literature on free will and moral responsibility: (1) Harry Frankfurt's argument that moral responsibility does not require the freedom to do otherwise; (2) the heightened focus upon the source of free actions; (3) the debate over whether moral responsibility is an essentially historical concept; (4) recent compatibilist attempts to resurrect the thesis that moral responsibility requires the freedom to do otherwise; (5) the role of the control condition in free will and moral responsibility, and finally (6) the debate centering on luck.
Angiotensin II enhances the afferent arteriolar response to adenosine through increases in cytosolic calcium
Authors: Lai E. Y. , Patzak A. , Persson A. E. G. , Carlström M.
Published: January 2009

Aims: Angiotensin II (Ang II) is a strong renal vasoconstrictor and modulates the tubuloglomerular feedback (TGF). We hypothesized that Ang II at low concentrations enhances the vasoconstrictor effect of adenosine (Ado), the mediator of TGF.

Methods: Afferent arterioles of mice were isolated and perfused, and both isotonic contractions and cytosolic calcium transients were measured.

Results: Bolus application of Ang II (10−12and 10−10 m) induced negligible vasoconstrictions, while Ang II at 10−8 mreduced diameters by 35%. Ang II at 10−12, 10−10and 10−8 mclearly enhanced the arteriolar response to cumulative applications of Ado (10−11to 10−4 m). Ado application increased the cytosolic calcium concentrations in the vascular smooth muscle, which were higher at 10−5 mthan at 10−8 m. Ang II (10−11to 10−6 m) also induced concentration‐dependent calcium transients, which were attenuated by AT1receptor inhibition. Simultaneously applied Ang II (10−10 m) additively enhanced the calcium transients induced by 10−8and 10−5 mAdo. The transients were partly inhibited by AT1or A1receptor antagonists, but not significantly by A2receptor antagonists.

Conclusion: A low dose of Ang II enhances Ado‐induced constrictions, partly via AT1receptor‐mediated calcium increase. Ado increases intracellular calcium by acting on A1but not A2receptors. The potentiating effect of Ang II on Ado‐induced arteriolar vasoconstrictions may involve calcium sensitization of the contractile machinery, as Ang II only additively increased cytosolic calcium concentrations, while its effect on the arteriolar constriction was more than additive. The potentiating effect of Ang II might contribute to the resetting of TGF.
Dignity as experienced by nursing home staff
Authors: Dwyer Lise‐Lotte , Andershed Birgitta , Nordenfelt Lennart , Ternestedt Britt‐Marie
Published: January 2009

Aims and objectives.  To explore nursing home staff members’ experiences of what dignity in end of life care means to older people and to themselves.

Background.  Dignity is a concept often used in end‐of‐life care, but its meaning is rarely clarified.

Design.  Qualitative descriptive study.

Methods.  Content analysis. This study is based on interviews with 21 staff members in four different nursing homes in Sweden.

Findings.  The results show that staff members balanced between providing for the older person’s physical needs while wishing to be able to deliver a ‘deeper’ level of care. The older people’s dignity is presented in the main theme: Feeling trust – Showing respect. The staff members’ dignity is presented in the main theme: Maintaining self‐respect – Being shown respect. Threats to dignity are presented in the main theme: conflicts between the ideal and the reality.

Conclusions.  The results reveal that nursing home staff members deal with a moral conflict between what they are able to deliver and what they would like to provide in the care of older people.

Relevance to clinical practice.  To promote older people’s dignity, there is a need to take account of staff members’ work situation. Supervision and continuous education could be one way of achieving this.
Implementation of the abilities‐focused approach to morning care of people with dementia by nursing staff
Authors: Sidani Souraya , LeClerc Chantale , Streiner David
Published: January 2009

Background.  The efficacy of the abilities‐focused approach to morning care has been demonstrated in two studies. However, the extent to which nurses are aware of and actually implement abilities‐focused interventions in day‐to‐day practice is not known.

Aim.  The study aimed to determine the type and number of abilities‐focused interventions delivered by nursing staff to residents with dementia during morning care.

Methods.  A one‐group repeated measure design was used. Seventy‐nine nursing staff attended an educational session to instruct them in the application of abilities‐focused interventions. Data on the type and number of interventions used by nurses were obtained before, after and 3‐months following attendance at the session. Data were collected through participants’ self‐report and observation.

Results.  Most nursing staff used abilities‐focused interventions when providing morning care. Introduction to resident, orientation to resident and conversation with resident were three types of interventions most often applied over time. The number of interventions implemented increased after attendance at the education session and returned to baseline level at 3‐month follow‐up.

Conclusions.  Future research is recommended to examine the long‐term effects of alternative designs of educational sessions.
The meaning of good and bad care in the community care: older people’s lived experiences
Authors: From Ingrid , Johansson Inger , Athlin Elsy
Published: January 2009

In spite of a considerable body of research in the past decades on what does or does not constitute good care for older people, there are still few studies addressing this question in which older people narrate their experiences of being dependent on community care. This study was therefore carried out aiming to explore older people’s lived experiences of what good and bad care meant to them, when it was offered by community care services. Nineteen older persons in three Swedish communities participated in the study, which used a phenomenological–hermeneutic approach. Data were collected through unstructured interviews and Colaizzi’s framework was utilized in the analysis of the data.

The key theme arising from the analysis was that of being encountered as a human being by caregivers who, through the provision of safe and secure care, provide opportunities for living life as usual. When any of these circumstances are lacking, bad care will be the consequence. As the general intention in society is to ensure good quality of care to older people as well as others, the findings in our study should have important implications for providers of community care for older people.
Overcoming the barriers to optimum continence care: the need for an expanded approach to implementation
Authors: Cheater Francine M.
Published: January 2009

In spite of a growing body of evidence to show that urinary incontinence is treatable or symptoms can be significantly improved in the majority of older people significant shortfalls in the quality of continence care are highlighted consistently in the international literature. The key barriers to providing optimal continence care for older people points to a need to address change not only from an individual practitioner perspective but also at the levels of the multidisciplinary team and organization. Examples of some emerging implementation frameworks that incorporate the broader context in which change occurs in ‘real world’ practice are introduced which may serve as useful guides. It is argued that if national and international standards of good practice for continence care are to be achieved, implementation methods have to take account of the complex interplay of patient, practitioner, social and organizational factors that mediate change.
Movements and diving behavior of pelagic spotted dolphins
Authors: Scott Michael D. , Chivers Susan J.
Published: January 2009

Abstract

We radio tracked 20 pantropical spotted dolphins (Stenella attenuata) in the pelagic waters of the eastern tropical Pacific Ocean during three research cruises in 1992, 1993, and 2001. Dolphins were tracked for up to 6 d from 20 to 1,000 km offshore. Seventeen of these dolphins also carried time–depth recorders, nine of which were recovered with a combined total of 477 h of dive data. The movement data suggested that the dolphins associate with areas of relatively high biological productivity. Dolphins close to shore moved along the continental slope, while some dolphins traveled farther offshore along thermocline “ridges.” Tracking and tagging multiple dolphins demonstrated the dynamic nature of dolphin herds, which change size and membership over the course of a day. At night, the dolphins traveled more slowly but dove deeper and longer, with more rapid ascents and descents than during daylight hours. These nighttime dive characteristics support the hypothesis suggested by some food habit studies that spotted dolphins are nocturnal feeders. Comparison of dive data with acoustic backscatter data indicates that spotted dolphins typically begin and end nighttime feeding activities with dusk and dawn diving bouts that track the vertical migration of organisms associated with the deep scattering layer.
Do sampling method and sample size affect basic measures of dolphin sociality?
Authors: Gibson Quincy Anne , Mann Janet
Published: January 2009

Abstract

Although the fission–fusion social patterns of bottlenose dolphins have been described, defining and measuring sociality is difficult. No study to date has investigated how much data are necessary to accurately depict social patterns in a fission–fusion species and whether this amount differs depending on the measure used. Using the long‐term Shark Bay bottlenose dolphin study we examined four different measures of sociality for mothers and dependent calves (n= 89). Our objectives were to determine (1) the amount of observation time necessary to accurately depict sociality using these measures, (2) correlations among these measures, and (3) if sampling method affects the validity of sociality measurements. A minimum of 10 h and 5 h of observations, respectively, were necessary to accurately capture calf associate numbers and percent time alone. A pairwise comparison of calf sociality measurements from focal and survey data found that calves spent from 0% to 70.2% of their time alone in focal data, but these same calves spent only 0%–7.7% alone in survey data. These findings indicate that (1) results differ depending on the type of sampling method and (2) the amount of observation time necessary to adequately capture individual variation differs depending on the measure of sociality.
Transmission loss patterns from acoustic harassment and deterrent devices do not always follow geometrical spreading predictions
Authors: Shapiro Ari D. , Tougaard Jakob , Jørgensen Poul Boel , Kyhn Line A. , Balle Jeppe Dalgaard , Bernardez Cristina , Fjälling Arne , Karlsen Junita , Wahlberg Magnus
Published: January 2009

Abstract

Acoustic harassment and deterrent devices have become increasingly popular mitigation tools for negotiating the impacts of marine mammals on fisheries. The rationale for their variable effectiveness remains unexplained, but high variability in the surrounding acoustic field may be relevant. In the present study, the sound fields of one acoustic harassment device and three acoustic deterrent devices were measured at three study sites along the Scandinavian coast. Superimposed onto an overall trend of decreasing sound exposure levels with increasing range were large local variations in the sound level for all sources in each of the environments. This variability was likely caused by source directionality, inter‐ping source level variation and multipath interference. Rapid and unpredictable variations in the sound level as a function of range deviated from expectations derived from spherical and cylindrical spreading models and conflicted with the classic concept of concentric zones of increasing disturbance with decreasing range. Under such conditions, animals may encounter difficulties when trying to determine the direction to and location of a sound source, which may complicate or jeopardize avoidance responses.
Confirmed expression of MHC class I and class II genes in the New Zealand endemic Hector's dolphin (Cephalorhynchus hectori)
Authors: Heimeier Dorothea , Baker C. Scott , Russell Kirsty , Duignan Pádraig J. , Hutt Alistair , Stone Gregory S.
Published: January 2009

Abstract

We provide the first description and confirmation of expression for three Major Histocompatibility Complex (MHC) genes (DQA, DQB, and class I) in the New Zealand endemic Hector's dolphin (Cephalorhynchus hectori). Sequences were derived from cDNA generated from peripheral blood leukocyte mRNA collected during a temporary live capture of two Hector's dolphins. The complete exons 2 and 3 of DQA, DQB, and class I were amplified from cDNA to confirm their expression. The same primers proved reliable for amplification from genomic DNA. Locus identity was supported by phylogenetic relationships to MHC molecules from other closely related species. No evidence was found for duplication of DQ loci, but cloning of amplified exon 2 of the class I gene indicated duplication or triplication of this locus. However, the expression of multiple class I loci was uncertain as only one allele could be detected from clones of cDNA. Balancing selection was indicated by a significantly greater ratio of nonsynonymous to synonymous substitutions at all three loci and by the apparent transspecific sharing of alleles for DQA and DQB.
Do monk seals exert top‐down pressure in subphotic ecosystems?
Authors: Parrish Frank A.
Published: January 2009

Abstract

Patterns of subphotic fish assemblages on seamounts in the Northwestern Hawaiian Islands were identified and compared for potential structuring influences, including the bottom‐up effects of regional oceanic productivity and top‐down predation pressure exerted by visiting monk seals (Monachus schauinslandi). Patterns in fish size, density, and biomass were evaluated at the deep extreme (350–500 m) of the seals feeding range to avoid confounding effects of diverse shallow habitats (e.g., coral reefs). Fish number and size were used to calculate biomass density of the seamount fish assemblages that were then compared to the independent variables of summit depth, substrate type, relief, oceanic productivity, distance to seal colonies, and seal colony population. Only the variables of distance to seal colony and seal colony population were retained in a multiple regression model that explained 31% of the variance. Despite the presence of obvious regional differences in oceanic productivity, the overall patterns in the subphotic fish assemblages are better explained by the top‐down hypothesis of predation pressure from monk seals.
Shiism in the Modern Context: From Religious Quietism to Political Activism
Authors: Brunner Rainer
Published: January 2009

The intention of this article is twofold. The first part tries to elucidate some characteristics of Shiism by briefly describing the background of this basic sectarian rift within Islam and its consequences for the Shiite worldview. The second part is a stocktaking of the situation of Shiites in the contemporary Muslim world and the role of Shiism in today's political landscape in the Middle East and beyond. Apart from Iran and the revolution of 1979 which has proved to be the decisive watershed in Islamic sectarianism, four regions are dealt with in particular: Iraq, the Arabian Peninsula, Lebanon, and Pakistan. In conclusion, the transition from quietism to activism will be illustrated by several key concepts of classical Shiism and their modern implementation.
Evaluation and performance characteristics of the coagulation system: ACL TOP analyzer – HemosIL reagents
Authors: MILOS M. , HERAK D. , KURIC L. , HORVAT I. , ZADRO R.
Published: January 2009

ACL TOP is a fully automated coagulation analyzer, designed for simultaneous measurement of routine and special coagulation parameters. We evaluated analytical and technical performance characteristics of the coagulation system composed of the ACL TOP analyzer and HemosIL reagent group for the determination of routine clotting (PT, APTT, fibrinogen, FVII, and FVIII), chromogenic (protein C) and immunological assays (FXIII antigen). Within run and between run CVs ranged from 0.9% to 7.7% and from 2.0% to 14.8% respectively. The obtained CVs for imprecision of calibration curves were <5% for PT and <7% for fibrinogen. The method comparison study showed good correlation between results obtained on the ACL TOP and BCS/BCT analyzers, with correlation co‐efficients ranging from 0.709 to 0.955, but with significantly different results for PT INR, APTT, fibrinogen and protein C, and wide dispersion of differences observed in difference plots for most assays. Despite good correlation and agreement for FVIII, problems in measuring FVIII<10% were encountered. The effective throughput for the ACL TOP and BCS was 151 and 212 PT/APTT/fibrinogen tests per hour, respectively. Although the ACL TOP is designed to run multiple assays on a large number of samples, software limitations make the instrument suitable rather for mid‐sized laboratories.
Can automated blood film analysis replace the manual differential? An evaluation of the CellaVision DM96 automated image analysis system
Authors: BRIGGS C. , LONGAIR I. , SLAVIK M. , THWAITE K. , MILLS R. , THAVARAJA V. , FOSTER A. , ROMANIN D. , MACHIN S. J.
Published: January 2009

Automation of differentials is desirable for economic and time‐saving reasons. Over the last 20 years, automated imaging processes have started to be introduced where stained blood films are scanned by a computer‐driven microscope and leucocytes classified; however, early methods were slow and had difficulty in classifying abnormal cells. More recently the CellaVision™ DM96 (CellaVision AB, Lund, Sweden) has been introduced with added features such as continuous loading of slides and a faster throughput than previous instruments. The accuracy of CellaVisionTM DM96 has been evaluated by comparing results to reference manual differentials. Results from different operators using the DM96 were compared with their own manual differential and to a 400‐cell reference manual differential. Precision of the instrument was compared to the manual differential. The preclassification accuracy of the DM96 was 89.2%. Precision was similar to that of the 100‐cell manual differential. The DM96 was faster than the manual method, even after reclassification by a laboratory scientist of any cells wrongly categorized by the instrument. The DM96 accuracy in morphological classification of leucocytes and red blood cells; depends upon both blood pathology and experience of the laboratory scientist using the instrument. For some cell types and operators, DM96 accuracy was better than the individual’s 100 cell manual differential.
Reticulated platelets and thrombopoietin in schistosomiasis patients
Authors: KÖPKE‐AGUIAR L. A. , DE LEON C. P. , SHIGUEOKA D. C. , LOURENÇO D. M. , KOUYOMDJIAN M. , BORGES D. R.
Published: January 2009

Schistosomiasis mansoni is a non‐cirrhotic liver disease. In cirrhosis patients with portal hypertension, a decreased number of reticulated platelets associated with increased thrombopoietin serum levels were reported. We previously reported a 120/nl platelet cutoff level as a marker of clinically significant portal hypertension in schistosomiasis patients. To evaluate reticulated platelet counts and thrombopoietin serum levels (TPO) in schistosomiasis patients and correlate them with portal hypertension markers. Thirty‐three schistosomiasis patients without co‐morbidities were endoscopically classified as those with (n = 19) or without (n = 14) clinically significant portal hypertension. Flow cytometric determination of reticulated platelets was performed using CD41 antibody and thiazol orange. Ultrasonographic examinations were performed according to the Niamey protocol. TPO and hyaluronic acid serum levels were determined in duplicate using ELISA methods. The platelet number of 120/nl discriminates the two groups with 100% accuracy and 100% positive and negative predictive values, and correlates with spleen length and portal and splenic vein diameters. Differences in reticulated platelets and hyaluronic acid serum levels between both groups were significant (P = 0.025 and 0.012, respectively), but thrombopoietin serum levels were not (P = 0.769). Schistosomiasis patients with portal hypertension have increased reticulated platelets associated with normal TPO serum levels.