bluuebunny/crossref_metadata_2025 huggingface dataset:
Predictors of elective pregnancy termination among women diagnosed with HIV during pregnancy in two regions of China, 2004–2010
Authors: Liang K , Meyers K , Zeng W , Gui X
Published: November 2012

Please cite this paper as: Liang K, Meyers K, Zeng W, Gui X. Predictors of elective pregnancy termination among women diagnosed with HIV during pregnancy in two regions of China, 2004–2010. BJOG 2013;120:1207–1214.

Objective  To document the rates of abortion among women diagnosed with HIV during pregnancy in two regions of China, and to investigate the sociodemographic factors associated with women’s decisions to terminate their pregnancy.

Design  Prospective cohort study.

Setting  Three central Chinese provinces (Hubei, Hebei and Shanxi) and Yining, Xinjiang.

Population  Women diagnosed with HIV during pregnancy, 2004–2010.

Methods  Of 798 HIV‐infected pregnant women identified through routine screening of pregnant women via antenatal care between 2004 and 2010, 499 women made decisions about the outcome of pregnancy. Chi‐squared test was used to describe the characteristics of women who chose to terminate their pregnancies. Logistic regression models were used to identify potential predictors for pregnancy outcome for one cohort of women in central China and a second cohort of women in Yining, Xinjiang.

Main outcome measures  Pregnancy outcome, trends of elective pregnancy termination.

Results  In the central China cohort, 76 of 161 pregnancies (47.2%) were terminated. In Yining, the proportion was significantly less, at only 61 of 338 (18.0%). Factors associated with pregnancy termination included unmarried marital status, already having one or more children and earlier trimester of pregnancy at the time of diagnosis.

Conclusions  The rate of pregnancy termination in these cohorts of HIV‐infected women appears to be higher than the rate in the general population of women in China. More work needs to be carried out to decrease the social stigma related to HIV and to convey clear messages about the effectiveness of prevention of mother to child transmission to women and their families. The significantly lower rate of pregnancy termination in Yining relative to central China is probably a result of the cultural and religious reservations towards pregnancy termination. Healthcare workers providing services to HIV‐infected pregnant women need to be sensitive to cultural factors influencing women’s decisions with regard to pregnancy termination.
The effect of a counselling intervention on weight changes during and after pregnancy: a randomised trial
Authors: Althuizen E , van der Wijden CL , van Mechelen W , Seidell JC , van Poppel MNM
Published: November 2012

Objectives  To evaluate the effects of a counselling intervention on excessive weight gain during pregnancy and postpartum weight retention.

Design  The New Life(style) study was a randomised trial with a control group (n = 113) and an intervention group (n = 106).

Setting  Midwife practices in the Netherlands.

Population  Women with a healthy pregnancy, expecting their first baby.

Methods  The intervention consisted of four face‐to‐face counselling sessions about weight, physical activity and diet during pregnancy, and one session by telephone after delivery.

Main outcome measures  Weight was objectively assessed at 15, 25 and 35 weeks of gestation, and again at 8, 26 and 52 weeks postpartum. In regression models, the intervention effect on gestational weight gain and postpartum weight retention was assessed.

Results  Women gained on average 11.3 kg (SD 3.7 kg) from early to late pregnancy. Women were 1.0 kg (SD 5.3 kg) lighter at 52 weeks postpartum compared with early pregnancy. The intervention had no effect on gestational weight gain (B = −0.05; 95% CI −1.10 to 1.00) or postpartum weight (B = 0.94; 95% CI −2.41 to 0.53) in the total study group. In a subgroup of overweight and obese women (n = 47), a favourable trend on all outcomes was observed, but none of the differences were statistically significant.

Conclusion  The lifestyle counselling intervention evaluated in this study did not have an effect on excessive weight gain or postpartum weight retention. Our findings for overweight and obese women need to be confirmed in a larger, well‐designed randomised trial.
Prevalence and risk factors for pelvic organ prolapse 20 years after childbirth: a national cohort study in singleton primiparae after vaginal or caesarean delivery
Authors: Gyhagen M , Bullarbo M , Nielsen TF , Milsom I
Published: November 2012

Please cite this paper as: Gyhagen M, Bullarbo M, Nielsen T, Milsom I. Prevalence and risk factors for pelvic organ prolapse 20 years after childbirth: a national cohort study in singleton primiparae after vaginal or caesarean delivery. BJOG 2012; DOI : 10.1111/1471‐0528.12020.

Objective  To investigate prevalence and risk factors for symptomatic pelvic organ prolapse (sPOP) and sPOP concomitant with urinary incontinence (UI) in women 20 years after one vaginal delivery or one caesarean delivery.

Design  Registry‐based national cohort study.

Setting  Women who returned a postal questionnaire in 2008 (response rate 65.2%).

Population  Singleton primiparae with a birth in 1985–88 and no further births (n = 5236).

Methods  The SWEPOP study used validated questionnaires about sPOP and UI.

Main outcome measures  Prevalence rate and risk of sPOP with or without concomitant UI.

Results  Prevalence of sPOP was higher after vaginal delivery compared with caesarean section (14.6 versus 6.3%, odds ratio [OR] 2.55; 95% confidence interval [95% CI] 1.98–3.28) but was not increased after acute compared with elective caesarean section. Episiotomy, vacuum extraction and second‐degree or more laceration were not associated with increased risk of sPOP compared with spontaneous vaginal delivery. Symptomatic POP increased 3% (OR 1.03; 95% CI 1.01–1.05) with each unit increase of current BMI and by 3% (OR 1.03; 95% CI 1.02–1.05) for each 100 g increase of infant birthweight. Mothers ≤160 cm who delivered a child with birthweight ≥4000 g had a doubled prevalence of sPOP compared with short mothers who delivered an infant weighing <4000 g (24.2 versus 13.4%, OR 2.06; 95% CI 1.19–3.55). Women with sPOP had UI and UI > 10 years more often than women without prolapse.

Conclusion  The prevalence of sPOP was doubled after vaginal delivery compared with caesarean section, two decades after one birth. Infant birthweight and current BMI were risk factors for sPOP after vaginal delivery.
The link between perceived HRM practices, performance and well‐being: the moderating effect of trust in the employer
Authors: Alfes Kerstin , Shantz Amanda , Truss Catherine
Published: November 2012

The present study examines the interaction between perceived HRM practices and trust in the employer on employee performance and well‐being. Specifically, the study tests whether trust in the employer moderates the relationships between perceptions of HRM practices and task performance (as rated by employees’ supervisors), organisational citizenship behaviour, turnover intentions and employee well‐being. Support was found for the majority of the hypotheses using data from 613 employees and their line managers in a service sector organisation in the UK. Trust in the employer moderates the relationships between perceived HRM practices and task performance, turnover intentions and individual well‐being, but not organisational citizenship behaviour. Implications of the findings for organisations and future research are discussed.
A new propensity to trust scale and its relationship with individual well‐being: implications for HRM policies and practices
Authors: Ashleigh Melanie J. , Higgs Malcolm , Dulewicz Vic
Published: November 2012

In the on‐going debate around HRM and performance, there is an argument that greater attention should be paid to understanding the role that employee attitudes, attributes and behaviours play. Emerging research suggests that trust and well‐being are two aspects that could contribute to this debate. Research has shown some relationships between trust and well‐being. However, this has tended to omit consideration of an individual's propensity to trust due to lack of suitable measures. This paper explores the relationships between propensity to trust and well‐being by means of a study of 458 managers using a newly developed instrument to assess propensity and established well‐being scales. Analyses of the results demonstrate a reliable measure of propensity and a range of positive relationships. The potential implications for HR policies and practices of a measure of propensity are discussed. In particular, application in the areas of selection and development are highlighted.
Association of statin use with peripheral neuropathy in the US population 40 years of age or older (美国40岁及以上人群的他汀使用情况与周围神经病变的关系)
Authors: Tierney Edward F. , Thurman David J. , Beckles Gloria L. , Cadwell Betsy L.
Published: November 2012

Background

Peripheral neuropathy is a serious complication of diabetes and several conditions that may lead to the loss of lower extremity function and even amputations. Since the introduction of statins, their use has increased markedly. Recent reports suggest a role for statins in the development of peripheral neuropathy. The aims of the present study were to assess the association between statin use and peripheral neuropathy, and to determine whether this association varied by diabetes status.

Methods

Data from the lower extremity examination supplement of the 1999–2004 National Health and Nutrition Examination Survey were used.

Results

The overall prevalence of statin use was 15% and the prevalence of peripheral neuropathy was 14.9%. The prevalence of peripheral neuropathy was significantly higher among those who used statins compared with those who did not (23.5% vs 13.5%, respectively; P < 0.01). Multivariate logistic regression revealed that statin use (adjusted odds ratio 1.3; 95% confidence interval 1.1–1.6; Wald P = 0.04) was significantly associated with peripheral neuropathy, controlling for diabetes status, age, gender, race, height, weight, blood lead levels, poverty, glycohemoglobin, use of vitamin B12, alcohol abuse, hypertension, and non‐high‐density lipoprotein–cholesterol. Diabetes status, age, gender, height, weight, blood lead levels, poverty, and glycohemoglobin were also significantly associated with peripheral neuropathy. We found no effect modification between statin use and diabetes status, race, gender, age, vitamin B12, blood lead levels, or alcohol abuse.

Conclusions

In the present cross‐sectional study, we found a modest association between peripheral neuropathy and statin use. Prospective studies are required to determine the causal direction.
Hypertension Management: Rationale for Triple Therapy Based on Mechanisms of Action
Authors: Neutel Joel M. , Smith David H. G.
Published: November 2012

An estimated 25% of patients will require 3 antihypertensive agents to achieve blood pressure (BP) control; combination therapy is thus an important strategy in hypertension treatment. This review discusses the triple‐therapy combination of an angiotensin receptor blocker (ARB) or direct renin antagonist (DRI) with a calcium channel blocker (CCB) and a diuretic, with a focus on mechanisms of action. Multiple physiologic pathways contribute to hypertension. Combining antihypertensive agents not only better targets the underlying pathways, but also helps blunt compensatory responses that may be triggered by single‐agent therapy. DRIs and ARBs target the renin–angiotensin–aldosterone system (RAAS) at the initial and final steps, respectively, and both classes lower BP by reducing the effects of angiotensin‐2; however, ARBs may trigger a compensatory increase in renin activity. Dihydropyridine CCBs target L‐type calcium channels and lower BP through potent vasodilation, but can trigger compensatory activation of the sympathetic nervous system (SNS) and RAAS. Thiazide diuretics lower BP initially through sodium depletion and plasma volume reduction, followed by total peripheral resistance reduction, but can also trigger compensatory activation of the SNS and RAAS. The combination of an agent targeting the RAAS with a CCB and diuretic is rational, and triple combinations of valsartan/amlodipine/hydrochlorothiazide, olmesartan/amlodipine/hydrochlorothiazide, and aliskiren/amlodipine/hydrochlorothiazide have demonstrated greater effectiveness compared with their respective dual‐component combinations. In addition, single‐pill, fixed‐dose combinations can address barriers to BP control including clinical inertia and poor adherence. Fixed‐dose antihypertensive combination products capitalize on complementary mechanisms of action and have been shown to result in improved BP control.
Modulation of methuselah expression targeted to Drosophila insulin‐producing cells extends life and enhances oxidative stress resistance
Authors: Gimenez Luis E. D. , Ghildyal Parakashtha , Fischer Kathleen E. , Hu Hongxiang , Ja William W. , Eaton Benjamin A. , Wu Yimin , Austad Steven N. , Ranjan Ravi
Published: November 2012

Ubiquitously reduced signaling via Methuselah (MTH), a G‐protein‐coupled receptor (GPCR) required for neurosecretion, has previously been reported to extend life and enhance stress resistance in flies. Whether these effects are due to reduced MTH signalling in specific tissues remains unknown. We determined that reduced expression of mth targeted to the insulin‐producing cells (IPCs) of the fly brain was sufficient to extend life and enhance oxidative stress resistance. Paradoxically, we discovered that overexpression of mth targeted to the same cells has similar phenotypic effects to reduced expression due to MTH's interaction with β‐arrestin, which uncouples GPCRs from their G‐proteins. We confirmed the functional relationship between MTH and β‐arrestin by finding that IPC‐targeted overexpression of β‐arrestin alone mimics the longevity phenotype of reduced MTH signaling. As reduced MTH signaling also inhibits insulin secretion from the IPCs, the most parsimonious mechanistic explanation of its longevity and stress‐resistance enhancement might be through reduced insulin/IGF signaling (IIS). However, examination of phenotypic features of long‐lived IPC‐mth modulated flies as well as several downstream IIS targets implicates enhanced activity of the JNK stress‐resistance pathway more directly than insulin signaling in the longevity and stress‐resistance phenotypes.
Earnings management of initial public offering firms: evidence from regulation changes in China
Authors: Liu Jianlei , Uchida Konari , Gao Ruidong
Published: November 2012

Discretionary current accruals of Chinese initial public offering (IPO) firms decreased after the abolition of fixed‐price offering systems that directly linked offering price to reported earnings. Results suggest IPO firms that decrease managerial ownership manage earnings upward during the fixed‐price offering period, but this relationship disappeared after the introduction of a book‐building system. We also find that bank debt is negatively related to discretionary current accruals during the fixed‐price offering period, but no relation exists for the book‐building period. Leverage has a significant positive relationship with earnings management. However, this finding is potentially attributable to nonoffering price objectives or endogeneity biases.
Root discolouration following short‐term application of steroid medicaments containing clindamycin, doxycycline or demeclocycline
Authors: Chen Belinda Kuan‐Jung , George Roy , Walsh Laurence James
Published: November 2012

Discolouration of teeth following application of intra‐canal antibiotic pastes is a clinical concern. This laboratory study compared the extent of tooth discolouration from three antibiotic pastes over 4 weeks. A total of 120 root samples were prepared and the canals filled with either Ledermix (demeclocyline), Odontopaste (clindamycin) or DoxyPaste (doxycycline). Roots were photographed before and 2 or 4 weeks after incubation at 37°C and 100% humidity in complete darkness in opaque containers. Digital images were standardised and assessed for changes in luminosity. Ledermix paste caused the most discolouration of the three, at both 2 and 4 weeks. There was no significant difference between DoxyPaste and Odontopaste at 2 weeks, whereas at 4 weeks, DoxyPaste caused a greater decrease in luminosity (P < 0.05), darkening more over the second 2‐week interval than treatment with Odontopaste (P < 0.05). Under zero light conditions, staining with Ledermix can still occur; indicating non‐light‐based chemical reactions in the staining process. Doxycycline containing intra‐canal medicaments caused less staining despite being a tetracycline‐based medicament.
Adrenomedullin attenuates vascular calcification in fructose‐induced insulin resistance rats
Authors: Zhou Y.‐B. , Gao Q. , Li P. , Han Y. , Zhang F. , Qi Y.‐F. , Tang C.‐S. , Gao X.‐Y. , Zhu G.‐Q.
Published: November 2012

Aim

To determine the therapeutic effects of adrenomedullin (ADM) on vascular calcification and related molecular mechanism in fructose‐induced insulin resistance rats.

Methods

Rats received ordinary drinking water or 10% fructose in drinking water for 12 weeks and subcutaneous injection of normal saline or ADM (3.6 μg kg−1) twice a day for the last 4 weeks. Levels of ADM, calcitonin receptor‐like receptors (CRLR), receptor activity‐modifying proteins (RAMP) as well as calcium content, alkaline phosphatase (ALP) activity, osteoblastic and contractile smooth muscle markers in aortic media were measured.

Results

The levels of ADM, CRLR, RAMP2 and RAMP3 in aortic media were increased in fructose‐fed rats. ADM treatment attenuated the fructose‐induced insulin resistance, increased blood pressure, fasting glucose, insulin, triglycerides and cholesterol levels. It improved VSMCs proliferation and disordered arrangement and hyperplasia of elastic fibres in fructose‐fed rats. Calcium deposits, calcium content and ALP activity in the aortic media were increased in fructose‐fed rats, which were attenuated by ADM treatment. The osteoblastic markers such as osteopontin (OPN), bone morphogenetic protein 2 (BMP2) proteins and core binding factor alpha‐1 (Cbfα‐1) protein and mRNA expressions were increased in fructose‐fed rats. ADM treatment increased the OPN protein expression, but reduced the BMP2 protein, Cbfα‐1 protein and mRNA expression. Contractile smooth muscle markers such as α‐actin and smooth muscle 22α (SM‐22α) were downregulated in fructose‐fed rats, which were recovered by ADM treatment.

Conclusion

Administration of ADM attenuates insulin resistance, calcium deposition and osteogenic transdifferentiation in aortic media in fructose‐fed rats.
Head and eye movements affect object processing in 4‐month‐old infants more than an artificial orientation cue
Authors: Wahl Sebastian , Michel Christine , Pauen Sabina , Hoehl Stefanie
Published: November 2012

This study investigates the effects of attention‐guiding stimuli on 4‐month‐old infants' object processing. In the human head condition, infants saw a person turning her head and eye gaze towards or away from objects. When presented with the objects again, infants showed increased attention in terms of longer looking time measured by eye tracking and an increasedNc amplitude measured by event‐related potentials (ERP) for the previously uncued objects versus the cued objects. This suggests that the uncued objects were previously processed less effectively and appeared more novel to the infants. In a second condition, a car instead of a human head turned towards or away from objects. Eye‐tracking results did not reveal any significant difference in infants' looking time.ERPs indicated only a marginally significant effect in late slow‐wave activity associated with memory encoding for the uncued objects. We conclude that human head orientation and gaze direction affect infants' object‐directed attention, whereas movement and orientation of a car have only limited influence on infants' object processing.
The Kids' Empathic Development Scale (KEDS): A multi‐dimensional measure of empathy in primary school‐aged children
Authors: Reid Corinne , Davis Helen , Horlin Chiara , Anderson Mike , Baughman Natalie , Campbell Catherine
Published: November 2012

Empathy is an essential building block for successful interpersonal relationships. Atypical empathic development is implicated in a range of developmental psychopathologies. However, assessment of empathy in children is constrained by a lack of suitable measurement instruments. This article outlines the development of the Kids' Empathic Development Scale (KEDS) designed to assess some of the core affective, cognitive and behavioural components of empathy concurrently. The KEDS assesses responses to picture scenarios depicting a range of individual and interpersonal situations differing in social complexity. Results from 220 children indicate the KEDS measures three related but distinct aspects of empathy that are also related to existing measures of empathy and cognitive development. Scores on the KEDS show age and some gender‐related differences in the expected direction.
Hydrogen water consumption prevents osteopenia in ovariectomized rats
Authors: Guo Ji‐Dong , Li Li , Shi Ya‐Min , Wang Hua‐Dong , Hou Shu‐Xun
Published: November 2012

Background and Purpose

Accumulating evidence indicates an important role of oxidative stress in the progression of osteoporosis. Recently, it was demonstrated that hydrogen gas, as a novel antioxidant, could selectively reduce hydroxyl radicals and peroxynitrite anion to exert potent therapeutic antioxidant activity. The aim of the present work was to investigate the effect of hydrogen water (HW) consumption on ovariectomy‐induced osteoporosis.

Experimental Approach

Ovariectomized rats were fed with HW (1.3 ± 0.2 mg·L−1) for 3 months. Then, blood was collected and femur and vertebrae were removed for evaluation of the effect of HW on bone.

Key Results

HW consumption in ovariectomized rats had no significant effect on oestrogen production, but prevented the reduction of bone mass including bone mineral content and bone mineral density in femur and vertebrae, and preserved mechanical strength including ultimate load, stiffness, and energy, and bone structure including trabecular bone volume fraction, trabecular number, and trabecular thickness in femur, and preserved mechanical strength including ultimate load and stiffness, and bone structure including trabecular bone volume fraction and trabecular number in vertebrae. In addition, treatment with HW abated oxidative stress and suppressed IL‐6 and TNF‐α mRNA expressions in femur of ovariectomized rats; treatment with HW increased femur endothelial NOS activity and enhanced circulating NO level in ovariectomized rats.

Conclusions and Implications

HW consumption prevents osteopenia in ovariectomized rats possibly through the ablation of oxidative stress induced by oestrogen withdrawal.
Cannabidiolic acid prevents vomiting in Suncus murinus and nausea‐induced behaviour in rats by enhancing 5‐HT1A receptor activation
Authors: Bolognini D , Rock EM , Cluny NL , Cascio MG , Limebeer CL , Duncan M , Stott CG , Javid FA , Parker LA , Pertwee RG
Published: November 2012

Background and Purpose

To evaluate the ability of cannabidiolic acid (CBDA) to reduce nausea and vomiting and enhance 5‐HT1A receptor activation in animal models.

Experimental Approach

We investigated the effect of CBDA on (i) lithium chloride (LiCl)‐induced conditioned gaping to a flavour (nausea‐induced behaviour) or a context (model of anticipatory nausea) in rats; (ii) saccharin palatability in rats; (iii) motion‐, LiCl‐ or cisplatin‐induced vomiting in house musk shrews (Suncus murinus); and (iv) rat brainstem 5‐HT1A receptor activation by 8‐hydroxy‐2‐(di‐n‐propylamino)tetralin (8‐OH‐DPAT) and mouse whole brain CB1 receptor activation by CP55940, using [35S]GTPγS‐binding assays.

Key Results

In shrews, CBDA (0.1 and/or 0.5 mg·kg−1 i.p.) reduced toxin‐ and motion‐induced vomiting, and increased the onset latency of the first motion‐induced emetic episode. In rats, CBDA (0.01 and 0.1 mg·kg−1 i.p.) suppressed LiCl‐ and context‐induced conditioned gaping, effects that were blocked by the 5‐HT1A receptor antagonist, WAY100635 (0.1 mg·kg−1 i.p.), and, at 0.01 mg·kg−1 i.p., enhanced saccharin palatability. CBDA‐induced suppression of LiCl‐induced conditioned gaping was unaffected by the CB1 receptor antagonist, SR141716A (1 mg·kg−1 i.p.). In vitro, CBDA (0.1–100 nM) increased the Emax of 8‐OH‐DPAT.

Conclusions and Implications

Compared with cannabidiol, CBDA displays significantly greater potency at inhibiting vomiting in shrews and nausea in rats, and at enhancing 5‐HT1A receptor activation, an action that accounts for its ability to attenuate conditioned gaping in rats. Consequently, CBDA shows promise as a treatment for nausea and vomiting, including anticipatory nausea for which no specific therapy is currently available.
Caregiving, single parents and cumulative stresses when caring for a child with cancer
Authors: Granek L. , Rosenberg‐Yunger Z. R. S. , Dix D. , Klaassen R. J. , Sung L. , Cairney J. , Klassen A. F.
Published: November 2012

Background

Single parents whose children have cancer are a marginalized group who report less family centred care, and therefore, less quality cancer care for their children. As such, the aims of this study were to explore how single parents of children with cancer describe their caregiving experiences and to understand their contextual life stressors.

Methods

A constructivist grounded theory method was used. Qualitative interviews with 29 single parents of children with cancer who were at least 6 months post‐diagnosis were recruited between November 2009 and April 2011 from four hospitals across Canada. Line‐by‐line coding was used to establish codes and themes and constant comparison was used to establish relationships among emerging codes and conceptual themes.

Results

The first set of findings report on caregiving duties including: emotional tasks, informational tasks and physical tasks. The second set of findings report on the contextual picture of parent's lives including their living conditions, their physical and mental health and their family histories of disruption, trauma and disease.

Conclusions

Single parents caring for children with cancer were found to experience several cumulative stressors in addition to the current strain of caring for a child with cancer. The synergy of these cumulative stresses with the added strain of caregiving for a child with cancer may have long‐term health and financial implications for parents. Broad‐based policy interventions should focus on relieving the chronic strains associated with being a single parent of a child with cancer.
Tackling child health inequalities due to deprivation: using health equity audit to improve and monitor access to a community paediatric service
Authors: Maharaj V. , Rahman F. , Adamson L.
Published: November 2012

Background

Deprived children constitute a large population with high levels of ill health, and difficulty with access to healthcare contributes to their poor health outcomes. There is debate on how best to engage deprived families and the literature on differential access to paediatric care based on deprivation is limited.

Aims

To demonstrate that community paediatrics can contribute to reduction of health inequalities by providing services that are accessible to and preferentially used by children whose health is likely to be affected by deprivation.

To provide a template for others to improve and monitor equity in their services.

Method

Long‐term service reconfiguration and health equity audit. We used routinely collected activity data and the Indices of Multiple Deprivation to construct equity profiles of the children using our service, and compared these with the profile of the population aged 0–16 years in the geographical area covered by the service.

Results

The new patient contact rate for the most deprived children in the population was more than three times that of the least deprived [odds ratio (OR) 3.29, 95% confidence interval (CI) 2.76–3.93]. Deprived children were more than twice as likely to require multi‐agency meetings as part of their medical care (OR 2.28, 95% CI 1.94–2.69). Seventy per cent (3693/5312) of our total contacts were with children in the two most deprived quintiles. There was a marked socio‐economic gradient in all types of contact.

Conclusions

The model of care used by our community paediatric service successfully engages deprived families, thereby reducing health inequalities due to poor access. Key features are multi‐agency working, removing barriers to access, raising staff awareness and use of health equity audit. Our findings provide support for tackling health inequalities via health services that are available to all, but capable of responding proportionately according to level of need, a model recently described as proportionate universalism.
Specific patterns of allergic sensitization in early childhood and asthma & rhinitis risk
Authors: Stoltz D. J. , Jackson D. J. , Evans M. D. , Gangnon R. E. , Tisler C. J. , Gern J. E. , Lemanske R. F.
Published: November 2012

Background

Specific patterns of allergic sensitization as well as quantification of the in vitro IgE response in early life may provide relevant clinical insight into future rhinitis and asthma risk.

Objective

To define relationships among established sensitization to particular aeroallergens, quantitative analyses of allergen‐specific IgE levels, pet exposure and sensitization, and asthma and rhinitis risk.

Methods

Children at high‐risk for the development of asthma and allergic diseases were enrolled at birth into the Childhood Origins of ASThma (COAST) study. Allergen‐specific IgE was assessed at ages 1, 3, 6, and 9 years by fluoroenzyme immunoassay (Unicap® 100; Pharmacia Diagnostics). Current asthma and rhinitis were diagnosed at age 6 and 8 years.

Results

Sensitization to dog was strongly associated with increased asthma risk (P < 0.0001). Sensitization to perennial compared with seasonal allergens was more strongly associated with asthma risk, while sensitization to seasonal allergens was more closely associated with rhinitis risk. Increased levels of specific IgE to perennial allergens were associated with an increased asthma risk (P = 0.05), while any detectable level of IgE to seasonal allergens was associated with increased rhinitis risk (P = 0.0009). While dog and cat sensitization were both independently associated with increased asthma and rhinitis risk, dog exposure at birth was associated with a reduced risk of asthma, regardless of dog sensitization status during the first 6 years of life (P = 0.05).

Conclusions and Clinical Relevance

Analysing specific patterns of an individual's allergic sensitization profile reveals additional relevant associations with asthma and rhinitis risk as opposed to the information gained from characterizing an individual as ‘atopic’ by the presence of any demonstrable sensitization alone. Furthermore, protective mechanisms of dog exposure with regards to asthma risk appear to be unrelated to the prevention of sensitization.
The association of cerebral palsy with birth asphyxia: a definitional quagmire
Authors: ELLENBERG JONAS H , NELSON KARIN B
Published: November 2012

Aim  The aim of this study was to investigate whether current literature provides a useful body of evidence reflecting the proportion of cerebral palsy (CP) that is attributable to birth asphyxia.

Method  We identified 23 studies conducted between 1986 and 2010 that provided data on intrapartum risks of CP.

Results  The proportion of CP with birth asphyxia as a precursor (case exposure rate) varied from less than 3% to over 50% in the 23 studies reviewed. The studies were heterogeneous in many regards, including the definitions for birth asphyxia and the outcome of CP.

Interpretations  Current data do not support the belief, widely held in the medical and legal communities, that birth asphyxia can be recognized reliably and specifically, or that much of CP is due to birth asphyxia. The very high case exposure rates linking birth asphyxia to CP can probably be attributed to several factors: the fact that the clinical picture at birth cannot specifically identify birth asphyxia; the definition of CP employed; and confusion of proximal effects – results – with causes. Further research is needed.
NMR structure and dynamics of the C‐terminal domain of R‐type lectin from the earthworm Lumbricus terrestris
Authors: Hemmi Hikaru , Kuno Atsushi , Hirabayashi Jun
Published: November 2012

The C‐terminal domain (Ch; C‐half) of the R‐type earthworm 29‐kDa lectin (EW29), isolated from the earthworm Lumbricus terrestris, has two sugar‐binding sites, in subdomains α and γ, and the protein uses the two sugar‐binding sites for its function as a single domain‐type haemagglutinin. Our previous NMR titration experiments showed that the α sugar‐binding site is a high‐affinity site and the γ sugar‐binding site is a low‐affinity site. However, it remains unclear why the α sugar‐binding site of EW29Ch binds to lactose much more strongly because the crystal structure of lactose‐bound EW29Ch showed that the interaction between the α sugar‐binding site and lactose was almost same as that between the γ sugar‐binding site and lactose. In the present study, we have determined the NMR structure of EW29Ch in the sugar‐free state and performed 15N relaxation experiments for EW29Ch in both the sugar‐free state and the lactose‐bound states. The conformation of EW29Ch in the sugar‐free state was similar to that of EW29Ch in complex with lactose. Conformational changes upon binding of lactose were observed only for the α sugar‐binding site. By contrast, the 15N relaxation experiments revealed a conformational exchange at the α sugar‐binding site in the sugar‐free state, which was suppressed in the lactose‐bound state. The conformational exchange phenomenon observed for the α sugar‐binding site was not observed for the γ sugar‐binding site. Differences in the conformational change and the backbone dynamics between subdomains α and γ may be associated with the difference of the sugar‐binding modes between the two sugar‐binding sites.

Database

Structural data for the NMR structure of EW29Ch in the sugar‐free state have been deposited in the Protein Data Bank database under accession number 2RST.
Folding and dimerization kinetics of bone morphogenetic protein‐2, a member of the transforming growth factor‐β family
Authors: Vallejo Luis F. , Rinas Ursula
Published: November 2012

The kinetics of folding and dimerization of bone morphogenetic protein‐2 (BMP‐2), a disulfide‐connected, homodimeric cystine‐knot protein and a member of the transforming growth factor‐β superfamily, was analyzed under a variety of different conditions. Refolding and dimerization of BMP‐2 were extremely slow under all conditions studied, and could be described by consecutive first‐order reactions involving at least one long‐lived intermediate. The rate constants vary from ∼ 0.2 × 10−5 to ∼ 3.5 × 10−5 s−1, and were strongly dependent on temperature, redox conditions, and the presence of stabilizing or destabilizing ions. In particular, the combined impact of ionic strength and redox conditions on the rates indicates that electrostatic interactions control thiol–disulfide exchange reactions on the path from the unfolded and reduced monomers to the disulfide‐connected growth factor in a rate‐determining way.

Structured digital abstract

BMP‐2 and BMP‐2bind by cross-linking study (View interaction)
Structural characterization of the second intra‐discal loop of the photoreceptor tetraspanin RDS
Authors: Chakraborty Dibyendu , Rodgers Karla K. , Conley Shannon M. , Naash Muna I.
Published: November 2012

Vertebrate photoreceptors contain a unique tetraspanin protein known as ‘retinal degeneration slow’ (RDS). Mutations in the RDS gene have been identified in a variety of human retinal degenerative diseases, and more than 70% of these mutations are located in the second intra‐discal (D2) loop, highlighting the importance of this region. Here we examined the conformational and thermal stability properties of the D2 loop of RDS, as well as interactions with ROM–1, a non‐glycosylated homolog of RDS. The RDS D2 loop was expressed in Escherichia coli as a fusion protein with maltose binding protein (MBP). The fusion protein, referred to as MBP–D2, was purified to homogeneity. Circular dichroism spectroscopy showed that the wild‐type (WT) D2 loop consists of approximately 21% α–helix, approximately 20% β–sheet and approximately 59% random coil. D2 loop fusion proteins carrying disease‐causing mutations in RDS (e.g. R172W, C214S, N244H/K) were also examined, and conformational changes were observed (compared to wild‐type D2). In particular, the C150S, C214S and N244H proteins showed significant reductions in α–helicity. However, the thermal stability of the mutants was unchanged compared to wild‐type, and all the mutants were capable of interacting with ROM–1, indicating that this functional aspect of the isolated D2 loop remained intact in the mutants despite the observed conformational changes. An I–TASSER model of the RDS D2 loop predicted a structure consistent with the circular dichroism experiments and the structure of the conserved region of the D2 loop of other tetraspanin family members. These results provide significant insight into the mechanism of RDS complex formation and the disease process underlying RDS‐associated retinal degeneration.
Sea ice phenology and timing of primary production pulses in the Arctic Ocean
Authors: Ji Rubao , Jin Meibing , Varpe Øystein
Published: November 2012

Arctic organisms are adapted to the strong seasonality of environmental forcing. A small timing mismatch between biological processes and the environment could potentially have significant consequences for the entire food web. Climate warming causes shrinking ice coverage and earlier ice retreat in the Arctic, which is likely to change the timing of primary production. In this study, we test predictions on the interactions among sea ice phenology and production timing of ice algae and pelagic phytoplankton. We do so using the following (1) a synthesis of available satellite observation data; and (2) the application of a coupled ice‐ocean ecosystem model. The data and model results suggest that, over a large portion of the Arctic marginal seas, the timing variability in ice retreat at a specific location has a strong impact on the timing variability in pelagic phytoplankton peaks, but weak or no impact on the timing of ice‐algae peaks in those regions. The model predicts latitudinal and regional differences in the timing of ice algae biomass peak (varying from April to May) and the time lags between ice algae and pelagic phytoplankton peaks (varying from 45 to 90 days). The correlation between the time lag and ice retreat is significant in areas where ice retreat has no significant impact on ice‐algae peak timing, suggesting that changes in pelagic phytoplankton peak timing control the variability in time lags. Phenological variability in primary production is likely to have consequences for higher trophic levels, particularly for the zooplankton grazers, whose main food source is composed of the dually pulsed algae production of the Arctic.
Above‐ and belowground linkages in Sphagnum peatland: climate warming affects plant‐microbial interactions
Authors: Jassey Vincent EJ , Chiapusio Geneviève , Binet Philippe , Buttler Alexandre , Laggoun‐Défarge Fatima , Delarue Frédéric , Bernard Nadine , Mitchell Edward AD , Toussaint Marie‐Laure , Francez André‐Jean , Gilbert Daniel
Published: November 2012

Peatlands contain approximately one third of all soil organic carbon (SOC). Warming can alter above‐ and belowground linkages that regulate soil organic carbon dynamics and C‐balance in peatlands. Here we examine the multiyear impact of in situ experimental warming on the microbial food web, vegetation, and their feedbacks with soil chemistry. We provide evidence of both positive and negative impacts of warming on specific microbial functional groups, leading to destabilization of the microbial food web. We observed a strong reduction (70%) in the biomass of top‐predators (testate amoebae) in warmed plots. Such a loss caused a shortening of microbial food chains, which in turn stimulated microbial activity, leading to slight increases in levels of nutrients and labile C in water. We further show that warming altered the regulatory role of Sphagnum‐polyphenols on microbial community structure with a potential inhibition of top predators. In addition, warming caused a decrease in Sphagnum cover and an increase in vascular plant cover. Using structural equation modelling, we show that changes in the microbial food web affected the relationships between plants, soil water chemistry, and microbial communities. These results suggest that warming will destabilize C and nutrient recycling of peatlands via changes in above‐ and belowground linkages, and therefore, the microbial food web associated with mosses will feedback positively to global warming by destabilizing the carbon cycle. This study confirms that microbial food webs thus constitute a key element in the functioning of peatland ecosystems. Their study can help understand how mosses, as ecosystem engineers, tightly regulate biogeochemical cycling and climate feedback in peatlands
The oral health of HIV‐infected Brazilian children
Authors: de Aguiar Ribeiro Apoena , Portela Maristela Barbosa , de Souza Ivete Pomarico Ribeiro
Published: November 2012

Background

The number of HIV‐infected people has increased almost continuously. Paediatric dentists should be concerned about the oral findings in HIV‐infected children and their aetiologic factors, to promote adequate treatment.

Aim

To present the oral health aspects of Brazilian HIV‐infected children and to verify the aetiological factors.

Design

A cross‐sectional study was conducted with HIV‐infected children. During the medical appointments, children were submitted to visual‐tactile exams of oral soft tissues and teeth. All parents answered questions in a structured interview. Data were analysed using the SPSS, release 10.0 (Chicago, IL, USA).

Results

Of the 57 children examined, 39 (69.6%) presented one or more oral soft tissue manifestations. More than a half suffered from gingivitis and only 12.5% had no visible dental biofilm. A high prevalence of dental surfaces with active carious lesions was observed; mean DMFS‐m and dmfs‐m scores were 5.41 ± 5.61 and 16.77 ± 19.52, respectively. Caries activity and gingivitis were correlated with the presence of mature dental biofilm.

Conclusions

Prevalence of soft tissue lesions, dental caries and gingivitis in HIV‐infected children was high and correlated to lack of satisfactory oral hygiene habits, suggesting the need of therapeutic programmes that allow these children to recover their oral health.
Characterization of serine proteases of Lumbriculus variegatus and their role in regeneration
Authors: Tweeten Kay A. , Reiner Anne
Published: November 2012

Serine proteases, ubiquitous enzymes known to function in digestion and immune protection in both vertebrates and invertebrates and implicated in regeneration in some species, were investigated in the California blackworm, Lumbriculus variegatus. Several serine proteases, rather than a single enzyme with broad specificity, were present in tissue extracts from the worms. Extracts were treated with a fluorescein‐labeled peptide chloromethyl ketone that specifically binds to trypsin/thrombin‐like proteases. Denaturing gel electrophoresis of labeled extracts showed several serine proteases with their molecular weight ranging 28,000–38,000 daltons. The trypsin/thrombin‐like activity was localized, using the fluorescein‐conjugated reagent, to the pharynx and digestive tract of L. variegatus. Movement of cells labeled by the reagent into regenerating tissues suggests that some differentiated endodermal tissues were used for reformation of digestive structures during regeneration in L. variegatus. The types of serine proteases in the extracts were further characterized by inhibitor studies. Presence of plasmin‐like activity was indicated by degradation of fibrin by tissue homogenates from the worms and the inhibitory effect of aprotinin on enzymes in these extracts. The ability of L. variegatus extracts to generate clots when incubated with rabbit plasma and partial inhibition of extract activity by phenylmethylsulfonyl fluoride and hirudin indicated presence of thrombin‐like activity. Consistent with the detection of trypsin, chymotrypsin, and plasmin‐like enzymes in the extracts was partial inhibition of L. variegatus serine protease activity by aminoethyl benzenesulfonyl fluoride and soybean trypsin inhibitor. Selective inhibition of chymotrypsin‐like activity by N‐tosyl‐l‐phenylalanine chloromethyl ketone and chymostatin as well as trypsin‐like activity by N‐tosyl‐l‐lysine chloromethyl ketone was observed. A potential role during regeneration for serine proteases is suggested by blockage of formation of head and tail structures by aminoethyl benzenesulfonyl fluoride, an inhibitor of these proteases.
Phylogenetic and mixed Yule‐coalescent analyses reveal cryptic lineages within two South American marine snails of the genus Crepipatella (Gastropoda: Calyptraeidae)
Authors: Nuñez José J. , Vejar‐Pardo Andrés , Guzmán Benjamín E. , Barriga Elías H. , Gallardo Carlos S.
Published: November 2012

The presence of sibling species within the marine gastropod genus Crepipatella has complicated the taxonomy of members of the group. Since the establishment of the genus, 15 species have been described, but recent studies have indicated that there are only five valid species, two of which inhabit the coasts of Chile, namely C. dilatata and C. fecunda. The two species are morphologically indistinguishable as adults, but can be differentiated on the basis of their encapsulated developmental stages. The primary aim of this study was to reconstruct phylogeny within the genus, and to establish species limits of C. dilatata and C. fecunda, using mitochondrial DNA data. To this end, we used maximum parsimony, maximum likelihood, and Bayesian inference to reconstruct phylogenies using 589 bp of the cytochrome oxidase I (COI) gene. The mtDNA phylogenies were then used as input in a general mixed Yule‐coalescent (GMYC) analysis to estimate species boundaries. In addition, quarter likelihood mapping was used to test a posteriori the confidence of inner branch patterns in the phylogenetic tree. Both DNA tree‐based and GMYC methods provide support for five isolated lineages within this species complex. Our data also suggest that Late Pleistocene and Holocene fragmentation and subsequent range expansion events may have shaped contemporary genetic patterns of Crepipatella in South America.