bluuebunny/crossref_metadata_2025 huggingface dataset:
Adoption of new HIV treatment guidelines and drug substitutions within first‐line as a measure of quality of care in rural Lesotho: health centers and hospitals compared
Authors: Labhardt Niklaus D. , Sello Motlalepula , Lejone Thabo , Ehmer Jochen , Mokhantso Mohlaba , Lynen Lutgarde , Pfeiffer Karolin
Published: July 2012

Objective  In 2007, Lesotho launched new national antiretroviral treatment (ART) guidelines, prioritising tenofovir and zidovudine over stavudine as a backbone together with lamivudine. We compared the rate of adoption of these new guidelines and substitution of first‐line drugs by health centers (HC) and hospitals in two catchment areas in rural Lesotho.

Methods  Retrospective cohort analysis. Patients aged ≥16 years were stratified into a HC‐ and a hospital‐group. Main outcome variables: Type of backbone at ART‐initiation (i), substitutions within first line (ii) and type of backbone among patients retained by December 2010 (iii). A multiple logistic regression model including HC vs. hospital, patient characteristics (sex, age, WHO‐stage, baseline CD4‐count, concurrent pregnancy, concurrent tuberculosis treatment) and year of ART‐start, was used.

Results  Of 3936 adult patients initiated on ART between 2007 and 2010, 1971 started at hospitals and 1965 at HCs. Hospitals were more likely to follow the new guidelines as measured by prescription of backbones without stavudine (Odds‐ratio 1.55; 95%CI: 1.32–1.81) and had a higher rate of drug substitutions while on first‐line ART (2.39; 1.83–3.13). By December 2010, patients followed at health centres were more likely to still receive stavudine (2.28; 1.83–2.84).

Conclusions  Health centers took longer to adopt the new guidelines and substituted drugs less frequently. Decentralised ART‐programmes need close support, supervision and mentoring to absorb new guidelines and to adhere to them.
Allergy to beer in LTP‐sensitized patients: beers are not all the same
Authors: Quercia O. , Zoccatelli G. , Stefanini G. F. , Mistrello G. , Amato S. , Bolla M. , Emiliani F. , Asero R.
Published: July 2012

Background

Most cases of beer allergy reported so far have been associated with hypersensitivity to the non‐specific lipid transfer protein (LTP). In view of the marked differences in brewing processes we assessed IgE reactivity as well as tolerance to many different beers in an allergic patient.

Methods

A 45 year‐old man hypersensitive to grass pollen, cat dander and Alternaria tenuis with a history of urticaria and dyspnoea after drinking beer and a weak skin reactivity to commercial corn extract was studied. The patient underwent SPT with 36 different brands of beer and an open challenge with those scoring negative was performed. An immunoblot analysis was carried out using 2 SPT‐positive beers, 2 SPT‐negative beers, and barley, wheat, and maize extracts using both patient's serum and a maize LTP‐specific in‐house developed polyclonal antibody from rabbit. Further, the immune reactive LTP of one beer was separated by HPLC and the chromatogram was compared to that of purified maize LTP.

Results

Beer SPT scored positive in 30/36 cases. The immunoblot analysis showed IgE reactivity at about 10 kDa against the two SPT‐positive beers and against maize with both patient's serum and the polyclonal anti‐LTP rabbit serum, whereas the two SPT‐negative beers, and barley extract scored negative. The immunodetected protein co‐migrated with maize LTP.

Conclusion

In beer‐allergic patients the diagnostic workup may point to the detection of some tolerated products that can be consumed risk‐free.
Towards global consensus on outcome measures for atopic eczema research: results of the HOME II meeting
Authors: Schmitt Jochen , Spuls Phyllis , Boers Maarten , Thomas Kim , Chalmers Joanne , Roekevisch Evelien , Schram Mandy , Allsopp Richard , Aoki Valeria , Apfelbacher Christian , Bruijnzeel‐Koomen Carla , Bruin‐Weller Marjolein , Charman Carolyn , Cohen Arnon , Dohil Magdalene , Flohr Carsten , Furue Masutaka , Gieler Uwe , Hooft Lotty , Humphreys Rosemary , Ishii Henrique Akira , Katayama Ichiro , Kouwenhoven Willem , Langan Sinéad , Lewis‐Jones Sue , Merhand Stephanie , Murota Hiroyuki , Murrell Dedee F. , Nankervis Helen , Ohya Yukihiro , Oranje Arnold , Otsuka Hiromi , Paul Carle , Rosenbluth Yael , Saeki Hidehisa , Schuttelaar Marie‐Louise , Stalder Jean‐Francois , Svensson Åke , Takaoka Roberto , Wahlgren Carl‐Fredrik , Weidinger Stephan , Wollenberg Andreas , Williams Hywel
Published: July 2012

The use of nonstandardized and inadequately validated outcome measures in atopic eczema trials is a major obstacle to practising evidence‐based dermatology. The Harmonising Outcome Measures for Eczema (HOME) initiative is an international multiprofessional group dedicated to atopic eczema outcomes research. In June 2011, the HOME initiative conducted a consensus study involving 43 individuals from 10 countries, representing different stakeholders (patients, clinicians, methodologists, pharmaceutical industry) to determine core outcome domains for atopic eczema trials, to define quality criteria for atopic eczema outcome measures and to prioritize topics for atopic eczema outcomes research. Delegates were given evidence‐based information, followed by structured group discussion and anonymous consensus voting. Consensus was achieved to include clinical signs, symptoms, long‐term control of flares and quality of life into the core set of outcome domains for atopic eczema trials. The HOME initiative strongly recommends including and reporting these core outcome domains as primary or secondary endpoints in all future atopic eczema trials. Measures of these core outcome domains need to be valid, sensitive to change and feasible. Prioritized topics of the HOME initiative are the identification/development of the most appropriate instruments for the four core outcome domains. HOME is open to anyone with an interest in atopic eczema outcomes research.
Co‐factor‐enhanced food allergy
Authors: Cardona V. , Luengo O. , Garriga T. , Labrador‐Horrillo M. , Sala‐Cunill A. , Izquierdo A. , Soto L. , Guilarte M.
Published: July 2012

Background

Alcohol, exercise or non‐steroidal anti‐inflamatory drugs (NSAID) are frequently mentioned as amplifiers of food allergic reactions but only individual cases or small series have been previously published.

Methods

Descriptive study including 74 cases of suspected co‐factor enhanced food allergy, assessed by skin‐prick tests, specific IgE and oral challenges.

Results

Anaphylaxis accounted for 85.1% of reactions. In 99% of cases culprit food allergens were plant‐derived, mainly vegetables and cereals. NSAID were involved in 58%, exercise in 52.7% and alcohol in 12.2%. Lipid transfer protein was the most frequently involved allergen.

Conclusions

Co‐factor enhanced food allergy should be considered when assessing food, alcohol, exercise and NSAID allergic reactions.
The interaction between Lyn and FcεRIβ is indispensable for FcεRI‐mediated human mast cell activation
Authors: Okayama Y. , Kashiwakura J.‐I. , Matsuda A. , Sasaki‐Sakamoto T. , Nunomura S. , Yokoi N. , Ebihara N. , Kuroda K. , Ohmori K. , Saito H. , Ra C.
Published: July 2012

Background

FcεRIβ reportedly functions as an amplifier of the FcεRIγ‐mediated activation signal using a reconstitution system. However, the amplification mechanisms in human mast cells (MCs) are poorly understood. We previously reported the hyperexpression of FcεRIβ of MCs in giant papillae from vernal keratoconjunctivitis patients, compared with that in conjunctivae from nonallergic conjunctivitis patients. Elucidation of the molecular mechanisms of the amplification induced by FcεRIβ should provide new targets for novel therapeutic interventions. The aim is to understand in greater details the function of FcεRIβ in human MC FcεRI expression and signaling.

Methods

FcεRIβ and Lyn expression was reduced using a lentiviral shRNA silencing technique. Localization of Lyn and FcεRIβ in cultured MCs was examined by confocal microscopic analysis. Mediators were measured by ELISAs.

Results

The diminution of FcεRIβ significantly downregulated cell surface FcεRI expression and FcεRI‐mediated mediator release/production. The downregulation of FcεRI‐mediated degranulation was not only due to the decrease in FcεRI expression. The diminution of FcεRIβ inhibited the redistribution of Lyn within the cell membrane following IgE sensitization. The diminution of Lyn in MCs significantly downregulated FcεRI‐mediated degranulation. The recombinant cell‐penetrating forms of phosphorylated FcεRIβ immunoreceptor tyrosine‐based activation motif (ITAM) for intracellular delivery disturbed the interaction between Lyn and phosphorylated endogenous FcεRIβ ITAM, resulted in inhibiting IgE‐dependent histamine release from MCs in vitro and from giant papillae specimens ex vivo.

Conclusion

The interaction between Lyn and FcεRIβ is indispensable for FcεRI‐mediated human MC activation, and specific inhibition of the interaction may represent a new therapeutic strategy for the treatment of human allergic diseases.
Pulse transit time as a quick predictor of a successful axillary brachial plexus block
Authors: KORTEKAAS M. C. , NIEHOF S. P. , VAN VELZEN M. H. N. , GALVIN E. M. , HUYGEN F. J. P. M. , STOLKER R. J.
Published: July 2012

Background

It can take up to 30 min to determine whether or not axillary block has been successful. Pulse transit time (PTT) is the time between the R‐wave on electrocardiography (ECG) and the arrival of the resulting pressure pulse wave in the fingertip measured with photoplethysmography. It provides information about arterial resistance. Axillary block affects vasomotor tone causing loss of sympathetic vasoconstriction resulting in an increased PTT. Early objective assessment of a block can improve efficacy of operating room time and minimize patient's fear of possible conversion to general anesthesia. This study explores whether PTT can objectively, reliably and quickly predict a successful axillary block.

Methods

Forty patients undergoing hand surgery under axillary block were included. A three‐lead ECG and photoplethysmographic sensors were placed on both index fingers. Measurements were made from 2 min before until 30 min after induction of the block or less if the patient was transferred for operation. Afterwards, PTT was calculated as the time between the R‐wave on ECG and a reference point on the photoplethysmogram. To assess the change in PTT caused by the block, the PTT difference between the control and blocked arm was calculated. Sensitivity and specificity of PTT difference were calculated using receiver operating characteristic analysis.

Results

In a successful block, the mean PTT difference significantly increased after 3 min by 12 (standard error of the mean 3.9) ms, sensitivity 87% and specificity 71% (area under the curve 0.87, P = 0.004).

Conclusions

PTT is a reliable, quick and objective method to assess whether axillary block is going to be successful or not.
Temperature efficiency for dormancy release in apricot varies when applied at different amounts of chill accumulation
Authors: Campoy J. A. , Ruiz D. , Nortes M. D. , Egea J.
Published: July 2012

Our aim was to assess the possible differential effect of increasing temperatures due to global warming on dormancy progression in apricot. The effect of a range of chilling temperatures on vegetative and reproductive bud dormancy progression in excised shoots was examined during two seasons. Temperature treatments were applied in different dormant stages to evaluate the possible interaction of date × temperature for dormancy release in apricot. During sampling, chill accumulated in the field ranged from 0 to 49 chill portions (CPs), corresponding to 0–100% of the chilling requirement (CR) of the apricot selection Z505‐2. Forcing conditions were applied after a 60‐day chill treatment on each sampling date, and rate to budbreak (1/mean time to bud break: MTB−1) was established in vegetative (terminal and lateral) and reproductive buds to determine depth of dormancy. Results showed that the stage of dormancy has a strong influence on the effect of different temperatures on dormancy progression in apricot. For the first time, a non‐linear effect of different chilling temperatures during the dormancy cycle in apricot was obtained, especially in the superior range of temperatures traditionally considered to release dormancy. Thus, introduction of this differential effect could help to improve the models to estimate dormancy release in the context of climate change.
Response pattern of amino compounds in phloem and xylem of trees to soil drought depends on drought intensity and root symbiosis
Authors: Liu X.‐P. , Gong C.‐M. , Fan Y.‐Y. , Eiblmeier M. , Zhao Z. , Han G. , Rennenberg H.
Published: July 2012

This study aimed to identify drought‐mediated differences in amino nitrogen (N) composition and content of xylem and phloem in trees having different symbiotic N2‐fixing bacteria. Under controlled water availability, 1‐year‐old seedlings ofRobinia pseudoacacia(nodules withRhizobium),Hippophae rhamnoides(symbiosis withFrankia) andBuddleja alternifolia(no such root symbiosis) were exposed to control, medium drought and severe drought, corresponding soil water content of 70–75%, 45–50% and 30–35% of field capacity, respectively. Composition and content of amino compounds in xylem sap and phloem exudates were analysed as a measure of N nutrition. Drought strongly reduced biomass accumulation in all species, but amino N content in xylem and phloem remained unaffected only inR. pseudoacacia. InH. rhamnoidesandB. alternifolia, amino N in phloem remained constant, but increased in xylem of both species in response to drought. There were differences in composition of amino compounds in xylem and phloem of the three species in response to drought. Proline concentrations in long‐distance transport pathways of all three species were very low, below the limit of detection in phloem ofH. rhamnoidesand in phloem and xylem ofB. alternifolia. Apparently, drought‐mediated changes in N composition were much more connected with species‐specific changes in C:N ratios. Irrespective of soil water content, the two species with root symbioses did not show similar features for the different types of symbiosis, neither in N composition nor in N content. There was no immediate correlation between symbiotic N fixation and drought‐mediated changes in amino N in the transport pathways.
Relationships among the perceived health status, family support and life satisfaction of older Korean adults
Authors: Kim Sook‐Young , Sok Sohyune R
Published: July 2012

The objective of this study was to examine the perceived health status, family support and life satisfaction of older Korean adults and the relationships among them. This study was designed to be a descriptive correlation study using questionnaire. Subjects were 246 older people who were over 65 years of age in Seoul and Daegu metropolitan city, Korea. Measures were the Cornell Medical Index‐Simple Korean Form to measure the perceived health status, the Family Support Instrument to measure the family support and the Standard Life Satisfaction Instrument for Korean people to measure the life satisfaction. Perceived health state was worse as average 3.3, family support was good as average 3.4 and life satisfaction was low as average 3.1. There were statistically significant positive correlations among perceived health state, family support and life satisfaction and between family support and life satisfaction. The predictors of life satisfaction in elderly were family support, age, monthly allowance and perceived health state. These factors explained 37.5% of the total variance. The major influencing factor was family support. This cross‐sectional study provides preliminary evidence that to develop nursing strategy to increase family support of older Korean adults is needed.
Medication errors: Perspectives of newly graduated and experienced nurses
Authors: Unver Vesile , Tastan Sevinc , Akbayrak Nalan
Published: July 2012

This study investigated the perspectives of newly graduated and experienced nurses concerning medication errors. This is a descriptive cross‐sectional study conducted in a military education and research hospital in Turkey, which was performed between July and August 2009. Totally, 169 nurses were involved in this study: 87 were new graduates and 82 were experienced nurses. The Modified Gladstone's Scale of Medication Errors was used to collect data on rates, causes and reporting of medication errors. The two highest perceived causes of medication errors were nurse exhaustion and nurse distraction. Most medication errors were preventable errors. The reasons for error occurrence and failure to inform co‐workers of medical errors were examined.

Implications: Training nurses to understand the causes of medication errors and related prevention methods should be provided to newly graduated nurses, and continuous training should be provided.
Maternal ventilation and sedation for H1N1 influenza resulting in fetal bladder rupture and urinary ascites
Authors: Chaudhari Tejasvi , Robertson Meiri , Ellwood David , Simpson Erroll , Kecskes Zsuzsoka , Kent Alison L
Published: July 2012

Urinary ascites in a newborn infant is unusual and most commonly results from bladder perforation following umbilical arterial catheterisation or obstructive uropathy. The following report describes a case of fetal bladder rupture with urinary ascites in a mother ventilated and sedated with narcotics and benzodiazepines for H1N1 influenza. This was associated with a unique biochemical profile of hyponatraemia and elevated serum urea and creatinine characteristic of urinary autodialysis in the neonate.
Can an athlete have too much ticker? Hypertrophic cardiomyopathy in young athletes
Authors: Fitzgerald Nicholas M , Sherwood Megan , Fitzgerald Dominic A
Published: July 2012

Sudden cardiac death (SCD) is an uncommon but devastating potential consequence of participation in competitive sport. It is seen in adolescent and young adult athletes. The most common cause of this, hypertrophic cardiomyopathy (HCM), is a genetic disorder responsible for more than a third of cases and is manageable. Screening is undertaken for HCM, using differing strategies in Europe and North America. Screening and early diagnosis have reduced the mortality rate but has come at a significant economic cost. The evidence and relevant arguments for and against screening are presented together with management strategies as reflected by an illustrative case.
Ecophysiology of embryo development and seed germination of the European woodland herbaceous perennial Corydalis cava (L.) Schweigg. & Körte subsp. cava (Fumariaceae)
Authors: MONDONI ANDREA , ORSENIGO SIMONE , ROSSI GRAZIANO
Published: July 2012

In this study we examined the germination ecology with special reference to the temperature requirements for embryo development and germination of Corydalis cava subsp. cava, under both outdoor and laboratory conditions. Corydalis cava is a spring flowering woodland tuberous geophyte widely distributed across Europe. Germination phenology, including embryo development and radicle and cotyledon emergence, was investigated in a population growing in northern Italy. Immediately after harvest, seeds of C. cava were sown both in the laboratory under simulated seasonal temperatures and naturally. Embryos, undifferentiated at the time of seed dispersal, grew during summer and autumn conditions, culminating in radicle emergence in winter, when temperatures fell to ca 5°C. Cotyledon emergence also occurred at ca 5°C, but first emergence was delayed until late winter and early spring. Laboratory experiments showed that high (summer) followed by medium (autumn) and low temperatures (winter) are needed for physiological dormancy loss, embryo development and germination respectively. Unlike seeds of C. cava that germinated in winter, in other Corydalis species radicle emergence occurred in autumn (C. flavula) or did not depend on a period of high summer temperature to break dormancy (C. solida). Our results suggest that subtle differences in dormancy and germination behavior between Corydalis species could be related to differences in their geographical distribution.
Genetic diversity and conservation ofIpomoea microdactyla(Convolvulaceae): an endemic vine from the Bahamas, Cuba, and southeastern Florida
Authors: Geiger John H. , Meerow Alan W. , Lewis Carl , Oviedo Ramona , Francisco‐Ortega Javier
Published: July 2012

Ipomoea microdactylaGriseb. (Convolvulaceae) is restricted to the Bahamian archipelago, Cuba, and southeastern Florida. The species is listed as a state endangered species in Florida, where it is mostly restricted to the hyperfragmented pine rockland of Miami‐Dade County. Using seven DNA microsatellite loci, we assessed levels of genetic diversity for 12 populations of this species from Andros Island in the Bahamas (six sites), Cuba (one site), and Florida (five sites). We found significantly greater mean numbers of alleles, and higher mean values for both observed and expected heterozygosity in populations from the continuous forest on Andros than those from the habitat fragments in Florida. It is unknown if these patterns of genetic diversity in the Florida populations are the result of habitat fragmentation or founder effects. The population from Cuba exhibited relatively high levels of genetic variation, suggesting that this island is a major center of diversity and dispersal for this species. It appears that hybrid introgression forI. carolinaalleles withinI. microdactylaindividuals occurred at a single site on Andros Island. Overall, the mean inbreeding coefficient value was 0.089, suggesting low levels of inbreeding. The highest inbreeding coefficient values were mostly recorded in Florida. Two groups were revealed, one containing the populations from Florida, and the second one encompassing those from the Bahamas and Cuba. Our results highlight the negative genetic consequences of habitat fragmentation and support initiatives recently established to establish corridors to connect the remnants of the pine forest of the Miami‐Dade County.
Spatially explicit benefit–cost analysis of fire management for greenhouse gas abatement
Authors: HECKBERT SCOTT , RUSSELL‐SMITH JEREMY , REESON ANDREW , DAVIES JOCELYN , JAMES GLENN , MEYER CARL
Published: July 2012

This paper examines the economic potential for fire management to provide offsets to carbon markets in the savannas of northern Australia. Long‐term field trials in Australia's savannas have quantified greenhouse gas (GHG) emissions abatement resulting from improved fire management. However, little is known about the economic potential of fire management projects or the locations where projects might be economically viable for providing GHG offsets. A benefit–cost analysis of fire management for GHG offsets is presented here, which includes spatially explicit estimates for GHG abatement under three assumptions of management efficacy (conservative, empirically based, upper potential). The total supply of GHG abatement is estimated under different prices and management efficacy assumptions, and areas that pass the benefit–cost analysis are identified. At the Australian Government's carbon price of A$23 per metric tonne of carbon dioxide equivalents (CO2‐e), fire management would be economically viable across 51 million hectares, all within the higher monsoonal rainfall regions of northern Australia, abating 1.6 million tonnes of CO2‐e per year. These estimates suggest that fire management projects can contribute to GHG abatement targets and be financially viable across large areas of northern Australia. Additional benefits are anticipated from these projects for biodiversity conservation, livelihoods for indigenous Australians and economic development in remote regions.
Fetal heart rate patterns related to neonatal brain damage and neonatal death in placental abruption
Authors: Takano Yuuki , Furukawa Seishi , Ohashi Masanao , Michikata Kaori , Sameshima Hiroshi , Ikenoue Tsuyomu
Published: July 2012

Aim:  The aim of this study was to determine the correlation between non‐reassuring fetal heart rate (NRFHR) patterns and poor neonatal outcome in placental abruption.

Material and Methods:  A retrospective study was performed involving 83 placental abruptions with a live fetus at one tertiary and one secondary hospital in Miyazaki prefecture, Japan. We examined the correlation among NRFHR, umbilical arterial blood gas status, and neonatal poor outcomes, including neonatal death (ND) and cerebral palsy (CP).

Results:  A total of 83 cases were divided into bradycardia (n = 27), recurrent late deceleration (rLD, n = 29), severe variable deceleration or prolonged deceleration (sVD/PD, n = 8), and other cases (n = 19). In the bradycardia group, the incidence of low umbilical artery (UA) pH (<7.0) was 59% and the average UA pH was 6.96 ± 0.22. Among these cases, 10 showed severe bradycardia (less than 80 b.p.m.) and an average UA pH of 6.85 ± 0.24, and four cases resulted in poor outcome (three CP and one ND). In the rLD group, the incidence of low UA pH (<7.0) was 7% and the average UA pH was 7.24 ± 0.12. In this group, a 40‐week‐old fetus with umbilical phlebitis had a lower UA pH (6.92) and developed CP. In the sVD/PD group, there were no cases of a low UA pH (<7.0) and the average UA pH was 7.30 ± 0.04. In this group, a 31‐week‐old boy with a UA pH of 7.36 developed CP (PVL). The remaining 19 cases had no CP.

Conclusion:  Poor neonatal outcome of placental abruption is closely related to NRFHR, especially the degree of bradycardia. In the rLD and sVD/PD groups, risk factors, such as prematurity and fetal inflammation, co‐existed.
Pyomayoma during pregnancy: A case report and review of the literature
Authors: Kobayashi Fumimasa , Kondoh Eiji , Hamanishi Junzo , Kawamura Yosuke , Tatsumi Keiji , Konishi Ikuo
Published: July 2012

Pyomyoma (suppurative leiomyoma) is a rare but serious complication of uterine leiomyomas. Although the management of leiomyomas during pregnancy is usually expectant, prompt surgical intervention is mandatory for pyomyoma. We present a case of pyomyoma with peritonitis that necessitated myomectomy at 21 weeks of gestation in a 28‐year‐old nullipara in which the pregnancy continued to successful delivery at 37 weeks of gestation. Perinatal and neonatal outcomes in pregnancies complicated with pyomyoma may be improved by prompt surgical intervention even in the early second trimester. A brief review of the literature regarding pyomyoma associated with pregnancy is also described.
Expression of angiogenic chemokines in ovarian clear cell carcinoma
Authors: Quattrocchi Livia , Sisson Melanie , Green Andrew , Martin Stewart G. , Durrant Lindy , Deen Suha
Published: July 2012

Aims:  The aim of this study was to assess the expression of angiogenic chemokines (CXCR4/CXCL12) and the vascular endothelial growth factor in ovarian clear cell carcinoma, comparing levels against those in ovarian high‐grade serous carcinoma.

Material and Methods:  Tissue microarray samples from 136 cases of epithelial ovarian carcinoma (108 high‐grade serous carcinoma and 28 clear cell carcinoma) were reviewed with World Health Organization histological criteria strictly applied to categorize cases according to histological subtype. Only cases without prior exposure to chemotherapy were included. Sections were stained with vascular endothelial growth factor, CXCR4, CXCL12 and assessed using conventional histological scoring (H‐scoring).

Results:  Patients with clear cell carcinoma presented at an early stage of the disease (74% stage 1 and 2) and had a significantly better progression‐free (P = 0.042) survival than those with high‐grade serous carcinoma. Low expression profile of the tested markers was seen in cases of clear cell carcinoma contrary to that seen in high‐grade serous carcinoma.

Conclusion:  The current study reports, for the first time, the difference in expression of a set of angiogeneic prognostic markers between clear cell carcinoma and high‐grade serous carcinoma, offering a possible explanation for the apparent chemotherapy resistance. These results are relevant for the design of future clinical studies of first‐line treatment for patients with ovarian clear cell carcinoma.
Association of maternal periodontal health with adverse pregnancy outcome
Authors: Kumar Ashok , Basra Minu , Begum Nargis , Rani Vigya , Prasad Sudha , Lamba Arundeep Kaur , Verma Mahesh , Agarwal Sarita , Sharma Shashi
Published: July 2012

Aim:  The present study aims to determine the association of periodontal disease (identified early in pregnancy) and adverse pregnancy outcomes in a North Indian population.

Material and Methods:  A total of 340 primigravida women, aged 20–35 years with single live pregnancy were recruited at 14–20 weeks period of gestation from the antenatal clinic. These women had undergone periodontal examination at time of recruitment. The pregnancy outcomes were recorded.

Results:  Out of 340 primigravida women, 147 (43.23%) women had gingivitis and 61 (17.94%) women had periodontitis. Periodontitis was found to be significantly associated with pre‐eclampsia, intrauterine growth restriction, preterm delivery, and low birthweight with odds ratios (95% confidence interval) of 7.48 (2.72–22.42), 3.35 (1.20–9.55), 2.72 (1.30–5.68) and 3.03 (1.53–5.97), respectively.

Conclusions:  The study shows a significant association between periodontitis (but not with gingivitis) and adverse pregnancy outcomes. Maternal periodontitis is associated with an increased risk of pre‐eclampsia, intrauterine growth restriction, preterm delivery and low birthweight infants.
Modified vaginal dilation rat model for postpartum stress urinary incontinence
Authors: Huang Jian , Cheng Mingjun , Ding Yan , Chen Limei , Hua Keqin
Published: July 2012

Aim:  The aim of this study was to develop a modified rat model for postpartum stress urinary incontinence (SUI) which can be easily established and which will steadily evaluate urodynamic changes.

Material and Methods:  A urinary catheter was placed into the vaginas of rats (n = 40) and the balloon was inflated for 8 h to simulate labor. A whisker was inserted into the nostril to induce sneezing. The urodynamic changes induced by vaginal dilation or sneezing were observed by measurement of leak point pressure (LPP), and maximum bladder volume. Serum lactose dehydrogenase (LDH) and creatine kinase (CK) were tested, and the mRNA expression of caspase‐3 in pubococcygeus muscle tissue was measured to show the effect of muscle injury in SUI.

Results:  After 8 h of balloon vaginal dilation, a rat model of postpartum SUI was established with a success rate of 72.5% (29/40). By sneeze assay, SUI was noted in 100% (5/5), 80% (4/5), 60% (3/5), 60% (3/5) and 40% (2/5) of experimental rats on day 1, 7, 14, 28 and 56, respectively. No SUI was found in the control group (n = 10). The level of serum LDH and CK in these 29 experimental rats initially increased, peaked on day 7, and finally decreased toward normal values. Compared with control rats, the differences were significant (P < 0.05). The expression of the caspase‐3 gene in pubococcygeal muscle of experimental rats peaked on day 1 and decreased thereafter, while no such change was seen in the control group, and the difference was significant (P < 0.05).

Conclusion:  Eight hours of vaginal balloon dilation resulted in SUI in this rat model. The alterations in serum LDH and CK, and in the muscle's apoptotic genes mimic those observed in human postpartum SUI patients. It can therefore be considered as a useful animal model for the study on the pathogenesis of postpartum SUI.
Effect of raloxifene and atorvastatin in atherosclerotic process in ovariectomized rats
Authors: Çetinkaya Demir Bilge , Uyar Yıldız , Özbilgin Kemal , Köse Can
Published: July 2012

Aim:  The goal of this study was to investigate the combined effects of raloxifene and atorvastatin in aged ovariectomized rats during endothelial dysfunction and atherosclerotic process.

Material and Methods:  This study was conducted on 28 Wistar albino female rats randomly divided into four groups. All groups were ovariectomized and one group was kept as the control group (OVX). For four weeks, the remaining three groups were treated with the statin atorvastatin (OVX+AV), the selective estrogen receptor modulator raloxifene (OVX+RL), and both atorvastatin and raloxifene (OVX+RL+AV), respectively. At the end of the treatment period, all rats were sacrificed and thoracic aortas excised, and endothelial cells were immunohistochemically stained for markers in the atherosclerotic process, such as inducible nitric oxide synthase (iNOS), endothelial nitric oxide synthase (eNOS), endothelin‐1 (ET‐1), monocyte chemotactic protein‐1 (MCP‐1), and tumor necrosis factor alpha (TNF‐α).

Results:  Compared to the ovariectomized group, the iNOS level was significantly increased in the OVX+RL group (P = 0.002), but contrarily decreased in the groups OVX+AV (P = 0.002) and OVX+RL+AV (P = 0.002). eNOS levels in the groups OVX+AV (P = 0.002) and OVX+RL+AV (P = 0.002) were significantly lower than that in the OVX group. When compared to the OVX group, significant reductions in ET‐1 and TNF‐α levels were found in all treatment groups. A significant decrement in MCP‐1 level was found in the OVX+AV group (P = 0.002).

Conclusion:  In aged ovariectomized rats, the administration of both raloxifene and atorvastatin significantly decreased the levels of ET‐1 and TNF‐α on endothelial cells. Combined treatment with these drugs shortly after menopause might play a potential preventive role in the early stages of atherosclerosis development.
Bilateral ovarian involvement: A rare presentation of disseminated multiple myeloma
Authors: Kazeminezhad Behrang , Zare‐mirzaie Ali , Mirafsharieh Abbas , Soleimantabar Hussein , Zahedifard Sara
Published: July 2012

Extramedullary spread of multiple myeloma is extremely rare. This paper reports a case of bilateral ovarian involvement in plasma cell myeloma. The patient was a 48‐year‐old Persian woman who experienced constitutional symptoms, bone pain and flashing for one year. Her condition showed multiple myeloma with lytic lesions of the skull, plasma cell infiltration in bone marrow and positive light chain lambda type in serum. Workup showed huge bilateral ovarian masses, and ovarian metastasis from plasma cell myeloma was confirmed after pathologic assessment. Multiple myeloma spread to ovary is rare and according to our knowledge, this is the fourth reported case of bilateral ovarian involvement in extramedullary multiple myeloma.
MicroRNA‐132 regulates recognition memory and synaptic plasticity in the perirhinal cortex
Authors: Scott Helen L. , Tamagnini Francesco , Narduzzo Katherine E. , Howarth Joanna L. , Lee Youn‐Bok , Wong Liang‐Fong , Brown Malcolm W. , Warburton Elizabeth C. , Bashir Zafar I. , Uney James B.
Published: July 2012

Evidence suggests that the acquisition of recognition memory depends upon CREB‐dependent long‐lasting changes in synaptic plasticity in the perirhinal cortex.The CREB‐responsive microRNA miR‐132 has been shown to regulate synaptic transmission and we set out to investigate a role for this microRNA in recognition memory and its underlying plasticity mechanisms. To this end we mediated the specific overexpression of miR‐132 selectively in the rat perirhinal cortex and demonstrated impairment in short‐term recognition memory. This functional deficit was associated with a reduction in both long‐term depression and long‐term potentiation. These results confirm that microRNAs are key coordinators of the intracellular pathways that mediate experience‐dependent changes in the brain. In addition, these results demonstrate a role for miR‐132 in the neuronal mechanisms underlying the formation of short‐term recognition memory.
Changes in the microbial community structure of bacteria, archaea and fungi in response to elevated CO2 and warming in an Australian native grassland soil
Authors: Hayden Helen L. , Mele Pauline M. , Bougoure Damian S. , Allan Claire Y. , Norng Sorn , Piceno Yvette M. , Brodie Eoin L. , DeSantis Todd Z. , Andersen Gary L. , Williams Amity L. , Hovenden Mark J.
Published: July 2012

The microbial community structure of bacteria, archaea and fungi is described in an Australian native grassland soil after more than 5 years exposure to different atmospheric CO2 concentrations ([CO2]) (ambient, + 550 ppm) and temperatures (ambient, + 2°C) under different plant functional types (C
3 and C
4 grasses) and at two soil depths (0–5 cm and 5–10 cm). Archaeal community diversity was influenced by elevated [CO2], while under warming archaeal 16S rRNA gene copy numbers increased for C
4 plant Themeda triandra and decreased for the C
3 plant community (P < 0.05). Fungal community diversity resulted in three groups based upon elevated [CO2], elevated [CO2] plus warming and ambient [CO2]. Overall bacterial community diversity was influenced primarily by depth. Specific bacterial taxa changed in richness and relative abundance in response to climate change factors when assessed by a high‐resolution 16S rRNA microarray (PhyloChip). Operational taxonomic unit signal intensities increased under elevated [CO2] for both Firmicutes and Bacteroidetes, and increased under warming for Actinobacteria and Alphaproteobacteria. For the interaction of elevated [CO2] and warming there were 103 significant operational taxonomic units (P < 0.01) representing 15 phyla and 30 classes. The majority of these operational taxonomic units increased in abundance for elevated [CO2] plus warming plots, while abundance declined in warmed or elevated [CO2] plots. Bacterial abundance (16S rRNA gene copy number) was significantly different for the interaction of elevated [CO2] and depth (P < 0.05) with decreased abundance under elevated [CO2] at 5–10 cm, and for Firmicutes under elevated [CO2] (P < 0.05). Bacteria, archaea and fungi in soil responded differently to elevated [CO2], warming and their interaction. Taxa identified as significantly climate‐responsive could show differing trends in the direction of response (‘+’ or ‘−’) under elevated CO2 or warming, which could then not be used to predict their interactive effects supporting the need to investigate interactive effects for climate change. The approach of focusing on specific taxonomic groups provides greater potential for understanding complex microbial community changes in ecosystems under climate change.
Private duty nurses in Greek hospitals: a literature review
Authors: Papageorgiou D. , Fouka G. , Plakas S. , Kelesi M. , Fasoi G. , Vardaki Z.
Published: July 2012

PAPAGEORGIOU D., FOUKA G., PLAKAS S., KELESI M., FASOI G. & VARDAKI Z. (2012) Private duty nurses in Greek hospitals: a literature review. International Nursing Review

Aim:  The study aims to provide an overview of the practice of private duty nurses in Greek hospitals.

Background:  For several decades, it has been a necessity for some hospital patients to hire private duty nurses (PDNs) to counterbalance the inadequacies of hospital infrastructures. In the current economic crisis in Greece, the majority of patients will not be able to afford to pay for private nursing care.

Methods:  Databases such as PubMed, CINAHL, ScienceDirect, Wiley Online Library, Google Scholar and national sources were searched for relevant literature through a range of keywords. Information gathered was evaluated for relevance and grouped on a thematic basis.

Findings:  Five articles met the inclusion criteria. Nearly 90% of PDNs have secondary levels of education or below. Approximately 15% of patients use PDNs at night due to nurse shortages and inability of their families to stay with them. Fifty per cent of the relatives reported being very unsatisfied with PDN services, while the cost for the use of a PDN is rather high.

Conclusion:  The existence of private duty nursing has been largely responsible for protecting healthcare authorities from the need to develop effective care infrastructures. In the current economic climate, nursing and healthcare authorities must staff wards appropriately for safe, free and efficient care for all patients. Effective utilization of the national nursing and healthcare workforce – including PDNs with appropriate qualifications – and matching demand with the necessary skills is essential.
Valuing Lives and Allocating Resources: A Defense of the Modified Youngest First Principle of Scarce Resource Distribution
Authors: Tallman Ruth
Published: July 2012

In this paper, I argue that the ‘modified youngest first’ principle provides a morally appropriate criterion for making decisions regarding the distribution of scarce medical resources, and that it is morally preferable to the simple ‘youngest first’ principle. Based on the complete lives system's goal of maximizing complete lives rather than individual life episodes, I argue that essential to the value we see in complete lives is the first person value attributed by the experiencer of that life. For a life to be ‘complete’ or ‘incomplete,’ the subject of that life must be able to understand the concept of a complete life, to have started goals and projects, and to know what it would be for that life to be complete. As the very young are not able to do this, it can reasonably be said that their characteristically human lives have not yet begun, giving those accepting a complete lives approach good reason to accept the modified youngest first principle over a simple ‘youngest first’ approach.
‘One Can Always Say No.’ Enriching the Bioethical Debate on Antisocial Behaviour, Neurobiology and Prevention: Views of Juvenile Delinquents
Authors: Horstkötter Dorothee , Berghmans Ron , Feron Frans , De Wert Guido
Published: July 2012

Genomic and neuro‐scientific research into the causes and course of antisocial behaviour triggers bioethical debate. Often, these new developments are met with reservation, and possible drawbacks and negative side‐effects are pointed out. This article reflects on these scientific developments and the bioethical debate by means of an exploration of the perspectives of one important stakeholder group: juveniles convicted of a serious crime who stay in a juvenile justice institution. The views of juveniles are particularly interesting, as possible applications of current and future scientific findings are considered to be most effective if applied early in life. Based on their statements we come to the following provisional conclusions. Concerns about labelling and stigmatization are recognized and widely shared. Possible effects on one's identity are acknowledged too. Yet, a possible biological underpinning of one's antisocial behaviour is not considered to result in the development of a criminal identity. Nonetheless, psychopharmacological interventions are experienced as endangering one's current self. Concerns regarding the refusal of responsibility and the blaming of one's genes or brain can be put into perspective. Instead, participants emphasize the motive of own choice as underlying their criminal behaviour. Moreover, bioethical debate should pay attention to the role of parents of children at risk and the parent‐child relationship in families at‐risk. We argue that the short‐term and long‐term interests of children at risk, as well as their interests and those of society at large, may conflict. In order to deal appropriately with newly arising dilemmas, a normative framework needs to be developed.
Competence and Ability
Authors: Vogelstein Eric
Published: July 2012

It is nearly universally thought that the kind of decision‐making competence that gives one a strong prima facie right to make one's own medical decisions essentially involves having an ability (or abilities) of some sort, or having a certain level or degree of ability (or abilities). When put under philosophical scrutiny, however, this kind of theory does not hold up. I will argue that being competent does not essentially involve abilities, and I will propose and defend a theory of decision‐making competence according to which one is competent only if one possesses a certain kind of rationality in making treatment decisions.
The Principle of Procreative Beneficence: Old Arguments and A New Challenge
Authors: Hotke Andrew
Published: July 2012

In the last ten years, there have been a number of attempts to refute Julian Savulescu's Principle of Procreative Beneficence; a principle which claims that parents have a moral obligation to have the best child that they can possibly have. So far, no arguments against this principle have succeeded at refuting it. This paper tries to explain the shortcomings of some of the more notable arguments against this principle. I attempt to break down the argument for the principle and in doing so, I explain what is needed to properly refute it. This helps me show how and why the arguments of Rebecca Bennett, Sarah Stoller and others fail to refute the principle. Afterwards, I offer a new challenge to the principle. I attack what I understand to be a fundamental premise of the argument, a premise which has been overlooked in the literature written about this principle. I argue that there is no reason to suppose, as Savulescu does, that morality requires us to do what we have most reason to do. If we reject this premise, as I believe we have reason to do, the argument for Procreative Beneficence fails.
Eugenic Selection Benefits Embryos
Authors: Walker Mark
Published: July 2012

The primary question to be addressed here is whether pre‐implantation genetic diagnosis (PGD), used for both negative and positive trait selection, benefits potential supernumerary embryos. The phrase ‘potential supernumerary embryos’ is used to indicate that PGD is typically performed on a set of embryos, only some of which will be implanted. Prior to any testing, each embryo in the set is potentially supernumerary in the sense that it may not be selected for implantation. Those embryos that are not selected, and hence destroyed or frozen, are ‘actually supernumerary’. The argument to be advanced is hypothetical: If embryos may be said to benefit or be harmed by our actions, then PGD used to select for an embryo or embryos with the highest expected Wellbeing benefits potential supernumerary embryos. The argument shows that the ‘non‐identity’ problem is not sufficient to show that eugenic selection does not benefit supernumerary embryos.
Foreign Language Exposure, Cultural Threat, and Opposition to Immigration
Authors: Newman Benjamin J. , Hartman Todd K. , Taber Charles S.
Published: July 2012

In the present article, we extend the notion of cultural threat posed by immigrants beyond its current conceptualization as symbolic, collective‐level threats to American culture and identity. Instead, we argue that routine encounters with non‐English‐speaking immigrants cause many individuals to feel threatened because of real barriers to interpersonal communication and exchange. We draw upon survey and experimental data to demonstrate that local contact with immigrants who speak little to no English, as well as incidental exposure to the Spanish language, heighten feelings of cultural threat, which increases anti‐immigrant sentiment and policy preferences.
Online course design: a statistics course example
Authors: Gazioğlu Suzan
Published: July 2012

Classroom‐based learning has great value, but online classes are becoming quite popular in the academic world because of the tremendous opportunities they offer. This article outlines the author's journey through the planning, development and execution of an online statistics course.
Using the coefficient of determination R2 to test the significance of multiple linear regression
Authors: Quinino Roberto C. , Reis Edna A. , Bessegato Lupércio F.
Published: July 2012

This article proposes the use of the coefficient of determination as a statistic for hypothesis testing in multiple linear regression based on distributions acquired by beta sampling.