bluuebunny/crossref_metadata_2025 huggingface dataset:
Minimally Invasive Percutaneous Iliac Screws
Authors: Wang Michael Y. , Williams Seth , Mummaneni Praveen V. , Sherman Jonathan D.
Published: September 2012

Summary of Background Data:

Percutaneous pedicle screws have become accepted as an effective method for segmental fixation in a variety of settings. However, fixation to the pelvis, which offers unique biomechanical advantages, had remained elusive from a minimally invasive approach.

Objective:

To ascertain the safety of percutaneous iliac screws implanted placement using fluoroscopic guidance.

Methods:

In an effort to verify the accuracy of a fluoroscopically guided technique for safe iliosacral screw placement, we reviewed the imaging results from 24 consecutive patients undergoing this procedure. Percutaneous iliac screw placement was accomplished using primarily x-ray–guided screw insertion (obturator outlet view technique) without frameless image-guidance and with limited exposure of bony landmarks or tactile feedback. Indications for surgery included infection, neoplasia, trauma, and deformity. All patients underwent early postoperative computed tomography scanning to determine the accuracy of screw positioning.

Results:

A total of 24 patients had 47 screws placed for fixation at the lumbosacral junction. No cases required abortion of the procedure or conversion to an open operation. All of the percutaneous screws were placed appropriately as verified by postoperative computed tomography scanning with 3-dimensional reconstruction. There were no hardware-related complications. However, one 75-year-old patient suffering a sacral fracture died of medical comorbidities on postoperative day 10.

Conclusions:

A minimally invasive technique for iliac screw placement can be performed safely with a low likelihood of bony violation. This technique offers the unique biomechanical advantages of iliac fixation without the soft-tissue exposure traditionally needed for safe hardware insertion. The technique relies on high-quality intraoperative fluoroscopic imaging.
DNA-based species detection capabilities using laser transmission spectroscopy
Authors: Mahon A. R. , Barnes M. A. , Li F. , Egan S. P. , Tanner C. E. , Ruggiero S. T. , Feder J. L. , Lodge D. M.
Published: September 2012

Early detection of invasive species is critical for effective biocontrol to mitigate potential ecological and economic damage. Laser transmission spectroscopy (LTS) is a powerful solution offering real-time, DNA-based species detection in the field. LTS can measure the size, shape and number of nanoparticles in a solution and was used here to detect size shifts resulting from hybridization of the polymerase chain reaction product to nanoparticles functionalized with species-specific oligonucleotide probes or with the species-specific oligonucleotide probes alone. We carried out a series of DNA detection experiments using the invasive freshwater quagga mussel (Dreissena bugensis) to evaluate the capability of the LTS platform for invasive species detection. Specifically, we tested LTS sensitivity to (i) DNA concentrations of a single target species, (ii) the presence of a target species within a mixed sample of other closely related species, (iii) species-specific functionalized nanoparticles versus species-specific oligonucleotide probes alone, and (iv) amplified DNA fragments versus unamplified genomic DNA. We demonstrate that LTS is a highly sensitive technique for rapid target species detection, with detection limits in the picomolar range, capable of successful identification in multispecies samples containing target and non-target species DNA. These results indicate that the LTS DNA detection platform will be useful for field application of target species. Additionally, we find that LTS detection is effective with species-specific oligonucleotide tags alone or when they are attached to polystyrene nanobeads and with both amplified and unamplified DNA, indicating that the technique may also have versatility for broader applications.
Laparoscopic Transvesical Resection of an En Bloc Bladder Cuff and Distal Ureter during Nephroureterectomy
Authors: Giannakopoulos Stilianos , Toufas George , Dimitriadis Charalampos , Giannopoulos Stavros , Kalaitzis Christos , Bantis Athanasios , Patris Emmanuel , Touloupidis Stavros
Published: September 2012

Objective. The most appropriate technique for excising the distal ureter and bladder cuff during laparoscopic nephroureterectomy is still debated. We report our experience with a pure laparoscopic transvesical method that duplicates the long-standing open transvesical approach.Materials and Methods. Seven men and three women diagnosed with upper tract transitional cell carcinoma were treated with this procedure. Three intravesical ports were inserted, and pneumovesicum was established at 12 mmHg. Transvesical laparoscopic circumferential detachment of the bladder cuff and en bloc mobilization of the last centimeters of the distal ureter were performed, followed by the closure of the bladder defect. Subsequently, a nephrectomy was performed either laparoscopically or using an open flank approach.Results. The median age was 68.5 years. The procedure was completed uneventfully in all cases. The median operating time for distal ureter excision was 82.5 minutes (range 55–120). No complications directly related to the pneumovesicum method were recorded. The median follow-up period was 31 months (range 12–55). During the follow-up period, two patients (20%) died from the disease, and a bladder tumor developed in three cases (30%).Conclusion. The laparoscopic transvesical resection of the en bloc bladder cuff and distal ureter is a reliable, effective, and oncologically safe technique, at least in the midterm.
Nonlinear Forced Response of Electromechanical Integrated Toroidal Drive to Coupled Excitation
Authors: Xu Lizhong , Wang Fen
Published: September 2012

The electric excitation and the parameter excitation from mesh stiffness fluctuation are analyzed. The forced response equations of the drive system to the coupled excitations are presented. For the exciting frequencies far from and near natural frequencies, the forced responses of the drive system to the coupled excitations are investigated. Results show that the nonlinear forced responses of the drive system to the coupled excitations change periodically and unsteadily; the time period of the nonlinear forced responses depends on the frequencies of the electric excitation, the mesh parameter excitation, and the nonlinear natural frequencies of the drive system; in order to improve the dynamics performance of the drive system, the frequencies of the electric excitations should not be taken as integral multiple of the mesh parameter exciting frequency.
In Vivo Function of Tryptophans in the Arabidopsis UV-B Photoreceptor UVR8
Authors: O’Hara Andrew , Jenkins Gareth I.
Published: September 2012

Arabidopsis thaliana UV RESISTANCE LOCUS8 (UVR8) is a photoreceptor specifically for UV-B light that initiates photomorphogenic responses in plants. UV-B exposure causes rapid conversion of UVR8 from dimer to monomer, accumulation in the nucleus, and interaction with CONSTITUTIVELY PHOTOMORPHOGENIC1 (COP1), which functions with UVR8 in UV-B responses. Studies in yeast and with purified UVR8 implicate several tryptophan amino acids in UV-B photoreception. However, their roles in UV-B responses in plants, and the functional significance of all 14 UVR8 tryptophans, are not known. Here we report the functions of the UVR8 tryptophans in vivo. Three tryptophans in the β-propeller core are important in maintaining structural stability and function of UVR8. However, mutation of three other core tryptophans and four at the dimeric interface has no apparent effect on function in vivo. Mutation of three tryptophans implicated in UV-B photoreception, W233, W285, and W337, impairs photomorphogenic responses to different extents. W285 is essential for UVR8 function in plants, whereas W233 is important but not essential for function, and W337 has a lesser role. Ala mutants of these tryptophans appear monomeric and constitutively bind COP1 in plants, but their responses indicate that monomer formation and COP1 binding are not sufficient for UVR8 function.
Analysis of HLA‐G Polymorphisms in Couples with Implantation Failure
Authors: Nardi Fabiola da Silva , Slowik Renata , Wowk Pryscilla Fanini , da Silva José Samuel , Gelmini Geórgia Fernanda , Michelon Tatiana Ferreira , Neumann Jorge , Bicalho Maria da Graça
Published: September 2012

Problem

HLA‐G expression is related as an immune modulator of fetal–maternal tolerance, and its levels was correlated with pregnancy outcome. In a case–control study, we investigate the association between the genetic variability of the HLA‐G gene and serum levels of soluble HLA‐G in cases of embryo implantation failure.

Method of Study

Forty couples with at least two unsuccessful fresh embryo transfers (implantation failure; IF) and 83 fertile couples with at least two successful pregnancies was genotyped by sequencing‐based typing. HLA‐G alleles were defined by nucleotide sequence variations at exon 2, 3, and 4, and the quantification of soluble HLA‐G (sHLA‐G) was performed by ELISA.

Results

There was a significant difference between the HLA‐G allelic distributions between IF couples and the control couples. The HLA‐G*01:03:01 allele was increased in the IF couples. There were no significant differences in the serum levels of sHLA‐G in the IF and control groups.

Conclusion

The results suggest that the distribution of HLA‐G products may play a significant role in the modulation of maternal–fetal immune response.
Early risk predictors for impaired numerical skills in 5‐year‐old children born before 32 weeks of gestation
Authors: Kiechl‐Kohlendorfer Ursula , Ralser Elisabeth , Pupp Peglow Ulrike , Pehboeck‐Walser Nicola , Fussenegger Barbara
Published: September 2012

Aim

To unravel risk predictors for impaired numerical skills at 5 years of age in a population‐based cohort of very preterm infants.

Methods

Between January 2003 and August 2006, we prospectively enrolled all infants born in Tyrol with <32 weeks of gestation. A total of 161 of 223 preterm infants (participation rate 72.2%) had a detailed examination at 5 years of age including cognitive assessment (Hannover‐Wechsler Intelligence Test for preschool children, third edition (HAWIVA‐III) or Snijders‐Oomen Nonverbal Intelligence Test (SON‐R)). In 135 children, numerical abilities were assessed with the dyscalculia test TEDI‐MATH. The association between pre‐ and postnatal factors and impaired numerical skills was analyzed by means of logistic regression analysis.

Results

Dyscalculia test showed delayed numerical skills (TEDI‐MATH Sum T‐score <40) in 27 of 135 children tested (20.0%). In half of the children tested, delayed numerical abilities were related to lower IQ scores. Smoking in pregnancy, intracerebral haemorrhage and chronic lung disease were predictive of delayed numerical skills at 5 years of age in the multivariate analysis.

Conclusion

This study identified risk predictors for impaired numerical skills in preterm infants. Our data support the role of both pre‐ and perinatal factors in the evolution of mathematical deficits.
Pleural function and lymphatics
Authors: Negrini D. , Moriondo A.
Published: September 2012

The pleural space plays an important role in respiratory function as the negative intrapleural pressure regimen ensures lung expansion and in the mean time maintains the tight mechanical coupling between the lung and the chest wall. The efficiency of the lung–chest wall coupling depends upon pleural liquid volume, which in turn reflects the balance between the filtration of fluid into and its egress out of the cavity. While filtration occurs through a single mechanism passively driving fluid from the interstitium of the parietal pleura into the cavity, several mechanisms may co‐operate to remove pleural fluid. Among these, the pleural lymphatic system emerges as the most important one in quantitative terms and the only one able to cope with variable pleural fluid volume and drainage requirements. In this review, we present a detailed account of the actual knowledge on: (a) the complex morphology of the pleural lymphatic system, (b) the mechanism supporting pleural lymph formation and propulsion, (c) the dependence of pleural lymphatic function upon local tissue mechanics and (d) the effect of lymphatic inefficiency in the development of clinically severe pleural and, more in general, respiratory pathologies.
Effective treatment of mouse experimental colitis by alpha 2 integrin antibody: comparison with alpha 4 antibody and conventional therapy
Authors: Gillberg L. , Berg S. , de Verdier P. J. , Lindbom L. , Werr J. , Hellström P. M.
Published: September 2012

Aim

To compare the therapeutic effect of α2 and α4 integrin‐blocking antibodies to conventional inflammatory bowel disease drugs methotrexate, 5‐aminosalicylic acid and azathioprine in the dextran sulphate sodium mouse colitis model.

Methods

Colitis was induced in balb/c mice with 2.5–3.0% dextran sulphate sodium. Treatment was given daily for 7 days after the onset of colitis, by rectal installation. Clinical signs of disease were assessed daily using a disease activity index. After 19 days, all animals were killed and colon samples collected for histological grading and mRNA/protein analysis. All treatment groups were compared with an untreated control group and a treatment group receiving dextran sulphate sodium alone to monitor the potential degree of clinical remission.

Results

Treatment with anti‐α2 antibodies and methotrexate reduced the body weight loss. At the end of treatment, anti‐α2 antibodies reduced rectal bleeding, while methotrexate reduced the disease activity index score. Histological evaluation showed that anti‐α2 antibodies, methotrexate, 5‐aminosalicylic acid and azathioprine treatment reduced the acute inflammation; methotrexate was the only treatment with effect on the crypt score. Compared with the dextran sulphate sodium alone group, the methotrexate group showed down‐regulation of IL‐1β at the mRNA level, while the anti‐α2 antibody group displayed decreased protein expression of iNOS and IL‐1β.

Conclusions

Specific blocking of extravascular trafficking of leucocytes with α2‐antibodies could be a new beneficial drug target in inflammatory bowel disease.
The effects of varying acidity on Helicobacter pylori growth and the bactericidal efficacy of ampicillin
Authors: Marcus E. A. , Inatomi N. , Nagami G. T. , Sachs G. , Scott D. R.
Published: September 2012

Background

Penicillins inhibit cell wall synthesis; therefore, Helicobacter pylori must be dividing for this class of antibiotics to be effective in eradication therapy. Identifying growth responses to varying medium pH may allow design of more effective treatment regimens.

Aim

To determine the effects of acidity on bacterial growth and the bactericidal efficacy of ampicillin.

Methods

H. pylori were incubated in dialysis chambers suspended in 1.5‐L of media at various pHs with 5 mM urea, with or without ampicillin, for 4, 8 or 16 h, thus mimicking unbuffered gastric juice. Changes in gene expression, viability and survival were determined.

Results

At pH 3.0, but not at pH 4.5 or 7.4, there was decreased expression of ~400 genes, including many cell envelope biosynthesis, cell division and penicillin‐binding protein genes. Ampicillin was bactericidal at pH 4.5 and 7.4, but not at pH 3.0.

Conclusions

Ampicillin is bactericidal at pH 4.5 and 7.4, but not at pH 3.0, due to decreased expression of cell envelope and division genes with loss of cell division at pH 3.0. Therefore, at pH 3.0, the likely pH at the gastric surface, the bacteria are nondividing and persist with ampicillin treatment. A more effective inhibitor of acid secretion that maintains gastric pH near neutrality for 24 h/day should enhance the efficacy of amoxicillin, improving triple therapy and likely even allowing dual amoxicillin‐based therapy for H. pylori eradication.
Fragile X‐associated tremor/ataxia syndrome (FXTAS) in grey zone carriers
Authors: Liu Y , Winarni TI , Zhang L , Tassone F , Hagerman RJ
Published: September 2012

The grey zone (GZ; 45–54 CGG repeats in the FMR1 gene) is considered a normal allele; however, several studies have found a high frequency of GZ in movement disordered populations. Here, we describe neurological features of fragile X‐associated tremor/ataxia syndrome (FXTAS) in two carriers of GZ alleles, although FXTAS has been defined as occurring only in premutation carriers (55–200 CGG repeats). Both patients had family members who had premutation and were diagnosed with FXTAS. The presence of relatively high GZ alleles with elevated fragile X mental retardation 1 mRNA (FMR1‐mRNA) combined with a family history of FXTAS that may represent a facilitating genetic background for FXTAS are the factors that led to the presence of FXTAS in these individuals with a GZ allele. Further research into clinical involvement of GZ alleles is recommended and the definition of FXTAS may require revision.
Invasion success and impact of an invasive fish, round goby, in Great Lakes tributaries
Authors: Kornis Matthew S. , Sharma Sapna , Jake Vander Zanden M.
Published: September 2012

Aim

Environmental and biological characteristics interact in complex ways to determine ecosystem susceptibility to invasive species, and a greater understanding of their relative roles in invader spread and impact is needed. We evaluated relationships between environmental characteristics, biodiversity of indigenous species, and the abundance and ecological impact of an invasive fish, round goby (Neogobius melanostomus).

Location

Tributaries to Lake Michigan, WI, USA.

Methods

We assessed the distribution and abundance of round gobies and native fishes in tributaries via electrofishing. We compared fish community composition and diversity in streams with (n = 30) and without (n = 52) round gobies and examined how trends in round goby abundance from 2007 to 2010 correlated with changes in abundance of five native benthic fishes. We used redundancy analysis to determine how indigenous stream communities related to environmental characteristics and round goby abundance.

Results

Round goby abundance was best explained by environmental characteristics, with watershed area and temperature explaining 22.4% of the variation. Species richness and Shannon diversity only explained 6.9% of the variation in round goby abundance and only an additional 2.3% after considering environmental characteristics. Round goby abundance was not a significant predictor of fish community composition, which was best explained by seven environmental variables (30.3% of the variation). Invaded communities had significantly higher indigenous species richness than uninvaded communities (8.38 vs. 6.54). Round goby abundance was low compared with estimates from other studies, but showed an increasing trend in many tributaries (average 10.8‐fold increase from 2007 to 2010). Surprisingly, there were no temporal trends in native benthic fish abundance despite increases in round goby abundance.

Main conclusions

Environmental characteristics favouring high fish diversity (e.g. resource availability and warm water temperature) were positively associated with round goby abundance. However, round goby density and impact are relatively low in most tributaries at present, emphasizing the importance of considering heterogeneity in an invader's abundance when assessing invasion success.
A direct comparison of the pharmacodynamic properties of insulin detemir and neutral protamine lispro insulin in patients with type 1 diabetes
Authors: Korsatko S. , Glettler K. , Olsen K. J. , Wutte A. , Bock G. , Koehler G. , Mader J. K. , Semlitsch B. , Pieber T. R.
Published: September 2012

Aims

To compare the pharmacodynamic properties of insulin detemir (detemir) and neutral protamine lispro (NPL) insulin using a euglycaemic glucose clamp.

Methods

In a double‐blind, crossover study, 30 patients with C‐peptide negative type 1 diabetes were randomly assigned to a single dose (0.4 U/kg) of detemir and NPL. Plasma glucose (PG) was normalized with a variable insulin infusion and then decreased stepwise, followed by a euglycaemic clamp at 5.5 mmol/l over 32 h. Duration of action was defined as time from dosing until PG exceeded 8.3 mmol/l for at least 30 min.

Results

Duration of action was similar for detemir [23.0 (range 2.25–32) h] and NPL [22.0 (9.5–32) h], p = 0.55. Using glucose infusion rate (GIR) parameters, detemir showed a flatter pharmacodynamic profile versus NPL: area under the curve, AUCGIR(0–32) = 1326 vs. 1841 mg/kg, p < 0.01 (detemir vs. NPL, respectively); AUCGIR(0–12) = 784 vs. 1392 mg/kg, p < 0.05; AUCGIR(12–32) = 455 vs. 274 mg/kg, p = 0.051; GIRlate(12–32)/GIRearly(0–12) ratio = 0.33 vs. 0.04, p < 0.001. Detemir also showed a lower and later peak of action than NPL [GIRmax 2.0 vs. 3.2 mg/kg/min, p < 0.01; Tmax 9.1 (95% confidence interval: 3.0–14.7) vs. 7.0 h (1.8–15.2)].

Conclusions

Detemir and NPL had similar duration of action of approximately 24 h in patients with type 1 diabetes. Compared with NPL, detemir had a flatter profile with a more even distribution of metabolic effect over 24 h.
Oxidized LDL Receptor 1 gene polymorphism in patients with Metabolic Syndrome
Authors: Palmieri Vincenzo O. , Coppola Brigida , Grattagliano Ignazio , Casieri Valentina , Cardinale Giovanna , Portincasa Piero , Palasciano Giuseppe , Di Serio Francesca
Published: September 2012

Eur J Clin Invest 2012

Aims  The lectin‐like oxidized low‐density lipoprotein receptor‐1 (LOX‐1), encoded by the OLR1 gene, has been implicated in the pathogenesis of atherosclerosis. We therefore evaluated the genotyping of OLR1 gene in a sample of 55 patients with Metabolic Syndrome, a clinical condition characterized by a high cardiovascular risk.

Methods and Patients  The genotyping of the LOX‐1 was performed by polymerase chain reaction (PCR) analysis of the IVS4‐14 A>G OLR1 polymorphism embedded within the OLR1 Linkage Disequilibrium block. Patients were assessed for routine serum parameters, microalbuminuria, insulin resistance (HOMA) and oxidative stress (thiobarbituric acid reactive substances, TBARs and thioredoxin).

Results  The allele or genotype distribution of the OLR1 IVS4‐14 A>G was not statistically different between MS and controls subjects. A positive association was found between IVS4‐14 GG genotype, microalbuminuria and fasting glycaemia as well as a higher frequency of type 2 diabetes, elevated microalbuminuria, fasting serum glucose and HOMA index in the same subjects. Thioredoxin values were higher in patients with MS but did not differ in relation to OLR1 IVS4‐14 A>G genotype. The TBARs/Cholesterol ratio was higher in MS both in IVS4‐14 GG and in IVS4‐14 AG.

Conclusion  IVS4‐14 GG genotype seems to be related to glucose metabolism disturbance, elevated insulin level and lipid peroxidation in patients with MS.
Methanotrophy in a Paleoproterozoic oil field ecosystem, Zaonega Formation, Karelia, Russia
Authors: Qu Y. , Črne A. E. , Lepland A. , van Zuilen M. A.
Published: September 2012

Organic carbon rich rocks in the c. 2.0 Ga Zaonega Formation (ZF), Karelia, Russia, preserve isotopic characteristics of a Paleoproterozoic ecosystem and record some of the oldest known oil generation and migration. Isotopic data derived from drill core material from the ZF show a shift in δ13Corg from c. −25‰ in the lower part of the succession to c. −40‰ in the upper part. This stratigraphic shift is a primary feature and cannot be explained by oil migration, maturation effects, or metamorphic overprints. The shift toward 13C‐depleted organic matter (δ13Corg < −25‰) broadly coincides with lithological evidence for the generation of oil and gas in the underlying sediments and seepage onto the sea floor. We propose that the availability of thermogenic CH4 triggered the activity of methanotrophic organisms, resulting in the production of anomalously 13C‐depleted biomass. The stratigraphic shift in δ13Corg records the change from CO2‐fixing autotrophic biomass to biomass containing a significant contribution from methanotrophy. It has been suggested recently that this shift in δ13Corg reflects global forcing and progressive oxidation of the Earth. However, the lithologic indication for local thermogenic CH4, sourced within the oil field, is consistent with basinal methanotrophy. This indicates that regional/basinal processes can also explain the δ13Corg negative isotopic shift observed in the ZF.
Prothrombotic state and impaired fibrinolysis in bullous pemphigoid, the most frequent autoimmune blistering disease
Authors: Marzano A V , Tedeschi A , Polloni I , Crosti C , Cugno M
Published: September 2012

Bullous pemphigoid (BP) is a potentially life-threatening autoimmune blistering disease that is burdened with an increased risk of cardiovascular events. In BP, there is an interplay between inflammation and coagulation both locally, which contributes to skin damage, and systemically, which leads to a prothrombotic state. Fibrinolysis is an important defence mechanism against thrombosis, but has only been studied locally in BP and no systemic data are available. The aim of this observational study was to evaluate systemic fibrinolysis and coagulation activation in patients with BP. We measured parameters of fibrinolysis and coagulation by immunoenzymatic methods in plasma from 20 patients with BP in an active phase and during remission after corticosteroid treatment. The controls were 20 age- and sex-matched healthy subjects. Plasma levels of plasminogen activator inhibitor type 1 (PAI-1) antigen, PAI-1 activity and tissue plasminogen activator (t-PA) antigen were significantly higher in the BP patients with active disease than in healthy controls (P = 0·0001 for all), as were the plasma levels of the fibrin fragment d-dimer and prothrombin fragment F1+2 (P = 0·0001 for both). During remission after treatment, levels of PAI-1 antigen and PAI-1 activity decreased significantly (P = 0·008 and P = 0·006, respectively), and there was also a significant decrease in plasma levels of d-dimer (P = 0·0001) and F1+2 (P = 0·0001). Fibrinolysis is inhibited in patients with active BP, due mainly to an increase in plasma levels of PAI-1. Corticosteroids not only induce the regression of BP lesions, but also reduce the inhibition of fibrinolysis, which may contribute to decreasing thrombotic risk.
Stable isotope analysis of archaeological oak charcoal from eastern Anatolia as a marker of mid‐Holocene climate change
Authors: Masi A. , Sadori L. , Baneschi I. , Siani A. M. , Zanchetta G.
Published: September 2012

Comparison between modern trees and archaeological charred wood is an under‐explored method to study climate change, which may help to infer past environmental changes. The stable carbon content of deciduous oak charcoals was analysed for five periods covering more than a 1000 years (3350–2000 BC) at the site of Arslantepe, Turkey, together with modern deciduous oak specimens from five rare arboreal patches still present in the area (17–64 km from the site). In studies of past climate change it is difficult to distinguish human‐induced changes from independent variations, such as the impact of past populations on the landscape and their relationship with climate changes in the mid‐Holocene. Archaeology can evaluate climate signals preserved in fossil plants in light of past human life. This paper will contribute to understanding environmental changes that can be attributed to climate variation and those linked to human activities. We compared 13C/12C of modern and fossil oaks in order to correlate the 13C‐content to environmental features of Arslantepe, both today and between 3350 and 2000 BC. At present, this area is semi‐arid. The results show important similarities to palaeoenvironmental records for the rest of the Near East. The climate trend can be divided in three main phases: instability phase from ca. 3200 to 2900 BC; a phase of relative stability (until 2350 BC); and a final increase in aridity. The comparison of Δ13C values between fossil and modern plants shows that present climate is more arid than that between the end of the fourth and the whole third millennium BC.
Stress and coping styles in Japanese nursing students
Authors: Yamashita Kanae , Saito Miwa , Takao Toshihiro
Published: September 2012

The objective of this investigation was to examine the stress and coping styles in Japanese nursing students. The principal measures of the stress and coping styles were the General Health Questionnaire (GHQ)‐12 and Brief Coping Orientations to Problems Experienced scale. In a cross‐sectional analysis, 1324 students completed the anonymous self‐administered questionnaires including the scales earlier. Feeling stress, living with family, not eating breakfast every day, having no regular exercise and poor sleep were associated with GHQ responder (psychological distressed group). The most commonly reported source of stress was taking examinations, followed by relationships with friends, engaging in clinical practice and presenting reports. The three most common coping styles adopted by the nursing students were acceptance, self‐distraction and using instrumental support. By logistic regression analysis of coping styles with GHQ responder, self‐blame, active coping, acceptance and behavioural disengagement were highly associated with GHQ responder. The nursing school educators as well as students should be aware of stress management strategies (e.g. using active coping and avoiding self‐blame) that may help prevent depression.
The effect of individual training and counselling programme for patients with myocardial infarction over patients’ quality of life
Authors: Uysal Hilal , Özcan Şeyda
Published: September 2012

The aim of the present study was to identify the effect of individual training and counselling programme for patients having experienced myocardial infarction over patients’ quality of life. The sample was composed of 90 patients, 45 in the intervention and 45 in the control group, selected by sequential sampling from patients who had myocardial infarction for the first time. Data were collected between April and November 2008 by means of patient information form, Myocardial Infarction Dimensional Assessment Scale MIDAS, and Short Form SF‐36. In the intervention group, more improvement was observed in comparison with the control group in terms of quitting smoking, physical activity, body mass index, waist circumference (mean differences P = 0.000). A significant difference was observed in the third month of evaluation of both MIDAS and SF‐36 quality of life scales in comparison with the baseline values (P ≤ 0.000). The results indicated that individual training and counselling provided to patients having experienced acute myocardial infarction lead to improvement in quality of life and decrease risk factors by increasing behaviours that protect cardiac health. Such educational programmes should be applied to patients with acute myocardial infarction prior to discharge.
Home environmental and health‐related factors among home fallers and recurrent fallers in community dwelling older Korean women
Authors: Lim Young Mi , Sung Mi Hae
Published: September 2012

The purpose of the study was to determine home environmental and health‐related factors among home fallers and recurrent fallers in community dwelling older Korean women. The study population included 438 older women aged 65 years and over. Measures included a checklist of home environments and health‐related items. Risk indicators for accidental falls and recurrent falling were analysed using logistic regression. Logistic regression analysis revealed that chronic disease (odds ratio (OR) = 2.02, P = 0.007), poor night light (OR = 1.97, P = 0.032) and obstacle of door sill (OR = 1.76, P = 0.021) were predictors of accidental falls, and physical inactivity (OR = 2.34, P = 0.018) and slippery floor in the bathroom (OR = 0.41, P = 0.034) were predictors of recurrent falling. The findings have implications for strategies and suggest the need to modify home environmental context in systematic and consistent ways and the need to maintain physical activities to prevent falls and recurrent falling.
Attitudes ofTurkish midwives and nurses working at hospitals towards people living with human immunodeficiency virus/acquired immune deficiency syndrome
Authors: Akgun Kostak Melahat , Unsar Serap , Kurt Seda , Erol Ozgul
Published: September 2012

Health professionals caring for people living with human immunodeficiency virus (HIV)/acquired immune deficiency syndrome (AIDS) show poor or negative attitudes because of fear of contagion. Therefore, it is important to know the attitudes of midwives' and nurses' towards people living withHIV/AIDS. The aim of this descriptive and cross‐sectional study is to assess the attitudes of Turkish midwives and nurses working at hospitals to people living withHIV/AIDSand to identify factors that affect these attitudes. A group of 46 midwives and 192 nurses working in hospitals were included in the study. Data were collected throughAIDS AttitudeScale. Age, professional experience, number of children and marital status influenced the attitudes of the participants towards people living withHIV/AIDS. We concluded that higher level of education appear to positively influence the attitudes of the participants.Education programmes including evidence‐based nursing implications might be planned to improve positive attitudes and to prevent stigmatization of people living withHIV/AIDS.
Integrating the online nursing evidence‐based information resources for evidence‐based nursing study in China
Authors: He Mengxue , Hu Yan
Published: September 2012

At present Chinese nurses could not get the up‐to‐date and high‐quality evidences efficiently and conveniently due to language barrier and other practical difficulties. This program built a Chinese website of integrated evidence‐based network information resources for EBN studies. Researchers hope to provide practical guidance and advice for nurses in non‐English‐speaking countries..
Intraspecific variation in life history traits of Viola brevistipulata (Violaceae) in Hokkaido
Authors: Hayamizu Masato , Hosokawa Ichijitsu , Kimura Osamu , Ohara Masashi
Published: September 2012

Intraspecific life‐history variations of Viola brevistipulata var. brevistipulata were examined with special reference to reproductive features based on quantitative and qualitative monitoring of chasmogamous (CH) and cleistogamous (CL) flowers. We selected 10 populations in southwestern Hokkaido in common deciduous forests, and marked 40–70 individual plants at each population. Marked individuals were monitored every 1–2 weeks. The expression of CH and CL flowers was distinct among the populations. That is, there were populations consisting of plants with only CH flowers, while other populations produced CL flowers after CH flowers with greater shoot longevity This phenomenon was observed even in populations located at the same site. The results suggest that V. brevistipulata var. brevistipulata shows distinct life‐history variations among the populations.
Single‐incision versus conventional laparoscopic cholecystectomy: a meta‐analysis
Authors: Wang Zhanhui , Huang Xinyu , Zheng Qi
Published: September 2012

Background

Conventional laparoscopic cholecystectomy (CLC) is now accepted as the gold standard surgical treatment for gallbladder stone disease. Single‐incision laparoscopic technology has recently been introduced into laparoscopic clinical practice in order to reduce the invasiveness of this procedure. A meta‐analysis of randomized clinical trials (RCTs) was performed to compare single‐incision laparoscopic cholecystectomy (SICL) and CLC.

Methods

Medline, Embase, ISI Web of Knowledge CPCI‐S and the Cochrane Library were searched and the methodological quality of the included trials was evaluated. Outcomes evaluated were adverse events, conversion rate, post‐operative hospital stay, blood loss, post‐operative pain, total wound length, operative time and wound satisfaction score. Results were pooled in meta‐analyses as odds ratio and weighted mean differences (WMD).

Results

Five RCTs on 264 patients qualified for the meta‐analysis, 139 being allocated to SILC and 125 to CLC. There was no significant difference between SICL and CLC for adverse events, conversion rate, post‐operative hospital stay, blood loss, post‐operative pain and total wound length; however, operative time was significantly longer in SICL than in CLC (WMD 7.72 (95% confidence interval (CI): 1.38–14.07) min; P = 0.02, χ2 P = 0.02, I2 = 69%). Furthermore, wound satisfaction score was significantly higher in SICL than in CLC (WMD 1.40 (95% CI: 1.19–1.61) min; P < 0.00001, χ2 P = 0.19, I2 = 42%).

Conclusion

SILC may be superior to CLC in terms of cosmetic outcome, but not in operative time. Currently, SILC is a safe procedure for proper patients in experienced surgeons.
Secluded and restrained patients' perceptions of their treatment
Authors: Soininen Päivi , Välimäki Maritta , Noda Toshie , Puukka Pauli , Korkeila Jyrki , Joffe Grigori , Putkonen Hanna
Published: September 2012

Though some empirical and anecdotal accounts can be located in the extant literature, it remains the case that little is known about how secluded/restrained (S/R) patients perceive their overall treatment. The purpose of this study was to explore patients' perceptions of their hospital treatment measured after S/R. The data were collected with a Secluded and Restrained Patients' Perceptions of their Treatment (S/R‐PPT) questionnaire from S/R patients aged 18–65 years. Ninety completed questionnaires were analysed. Patients perceived that they received enough attention from staff, and they were able to voice their opinions, but their opinions were not taken into account. Patients denied the necessity and beneficence of S/R. Women and older patients were more critical than men and younger patients regarding the use of restrictions. There were also statistically‐significant differences in responses among patients at different hospitals. It is concluded that patients' opinions need more attention in treatment decisions. To achieve this, psychiatric treatment needs genuine dialogue between patients and staff, and individual care should have alternatives and no routine decisions. Therefore, the treatment culture must improve towards involving patients in treatment planning, and giving them a say when S/R is considered.
Reflective practice groups for nurses: A consultation liaison psychiatry nursing initiative: Part 1 – the model
Authors: Dawber Chris
Published: September 2012

In the present study, we outline the evolution of a process‐focused reflective practice group (RPG) model for nurses working in clinical settings. The groups were initiated at Redcliffe and Caboolture hospitals by the consultation liaison psychiatry nurse and author. An associated article provides an evaluation of these RPG. The literature review identifies the key themes and theories on which the model is based, and the article outlines the process and practicalities of facilitating RPG in critical care, midwifery, and oncology specialties over a 3‐year period. The model proposes that the effectiveness and sustainability of RPG arises from adequate preparation and engagement with prospective participants. Group rules, based on principles of confidentially, supportiveness, and diversity, were collaboratively developed for each group. Facilitation utilized a group‐as‐a‐whole approach to manage process and stimulate reflection. While the purpose of RPG was a reflection on interpersonal aspects of nursing, contextual workplace issues were frequently raised in groups. Acknowledgement and containment of such issues were necessary to maintain clinical focus. The literature highlights facilitator credibility and style as crucial factors in the overall success of RPG, and it is proposed that reflective practice as a process‐focused model for groups succeeds when nurse facilitators are trained in group process and receive concurrent supervision.
Restraint use in acute and extended mental health services for older persons
Authors: Gerace Adam , Mosel Krista , Oster Candice , Muir‐Cochrane Eimear
Published: September 2012

Restraint of older persons in inpatient and residential care is used to control aggression, and prevent falls and other adverse outcomes. Initiatives to reduce these practices are being implemented worldwide. However, there has been little examination of restraint practice in psychiatric services for older persons. This paper reports a retrospective comparative analysis of restraint use in three acute and two extended care psychiatric inpatient wards in Australia. The analysis involved examination of restraint incidents and comparison of restrained and non‐restrained patients. There was significant variation in restraint use between wards. On one acute ward, 12.74% of patients were restrained, although restraint use declined during the data collection period. Patients with dementia were restrained at higher rates than patients with other diagnoses, and restrained patients stayed in hospital for a longer duration. Restraint occurred early in admission, and few differences emerged between those restrained once or multiple times. Mechanical restraint was more prevalent than physical restraint, with restraint predominantly used to manage aggression and falls. Findings provide new data on restraint in older persons' psychiatric services. Greater conceptual understandings of behaviours associated with dementia and the unique needs of patients with these disorders may assist in reducing restraint use in these settings.
The inpatient psychiatric unit as both a safe and unsafe place: Implications for absconding
Authors: Muir‐Cochrane Eimear , Oster Candice , Grotto Jessica , Gerace Adam , Jones Julia
Published: September 2012

Absconding from acute psychiatric inpatient units is a significant issue with serious social, economic, and emotional costs. A qualitative study was undertaken to explore the experiences of people (n = 12) who had been held involuntarily under the local mental health act in an Australian inpatient psychiatric unit, and who had absconded (or attempted to abscond) during this time. The aim of the study was to explore why people abscond from psychiatric inpatient units, drawing on published work from health geography on the significance of the person–place encounter, and in particular the concept of ‘therapeutic landscapes’. The findings show that the inpatient unit is perceived as a safe or unsafe place, dependent on the dialectical relationship between the physical, individual, social, and symbolic aspects of the unit. Consumers absconded when the unit was perceived as unsafe. Forming a therapeutic relationship with staff, familiarity with the unit, a comfortable environment, and positive experiences with other consumers all supported perceptions that the unit was safe, decreasing the likelihood of absconding. Findings extend existing work on the person–place encounter within psychiatric inpatient units, and bring new knowledge about the reasons why consumers abscond. Implications for practice are discussed.
Post‐partum blues among Korean mothers: A structural equation modelling approach
Authors: Chung Sung Suk , Yoo Il Young , Joung Kyoung Hwa
Published: September 2012

The objective of this study was to propose the post‐partum blues (PPB) model and to estimate the effects of self‐esteem, social support, antenatal depression, and stressful events during pregnancy on PPB. Data were collected from 249 women post‐partum during their stay in the maternity units of three hospitals in Korea using a self‐administered questionnaire. A structural equation modelling approach using the Analysis of Moments Structure program was used to identify the direct and indirect effects of the variables on PPB. The full model had a good fit and accounted for 70.3% of the variance of PPB. Antenatal depression and stressful events during pregnancy had strong direct effects on PPB. Household income showed indirect effects on PPB via self‐esteem and antenatal depression. Social support indirectly affected PPB via self‐esteem, antenatal depression, and stressful events during pregnancy.
Beyond Depoliticization? Caste, NGOs and Dalit Land Rights in Maharashtra, India
Authors: Waghmore Suryakant
Published: September 2012

In India, Dalit mobilization for land rights and the cultivation of gaairan (grazing lands) in the last decade has attracted the attention of international civil society actors who participate in such mobilization through local non‐governmental organizations (NGOs). This article contextualizes the debate on the growth and role of NGOs by presenting the politics of formation and working of a funding‐driven network of NGOs on Dalit rights and livelihoods in India. It cautions against exaggerating the role of international civil society actors in local democratization processes, and also argues that the feared depoliticizing of public interests as a result of INGO involvement is misplaced in the case of Dalit politics.
Social network influences on smoking, drinking and drug use in secondary school: centrifugal and centripetal forces
Authors: Fletcher Adam , Bonell Chris
Published: September 2012

We explore how school experiences and social networks structure young people’s substance use in different institutional contexts. The concepts of ‘selection’ and ‘influence’ are situated within the context of bounded agency, counter‐school cultures and Bourdieusian notions of capital. We employed individual and group interviews, network‐mapping, and observations at two contrasting English secondary schools. Both schools were characterised by extended social network structures that appeared to influence patterns of substance use, although the mechanisms via which this occurred varied according to school context. At Grange House school (suburban context) a minority of students from disadvantaged families were alienated by the attainment‐focused regime, marginalised by a strong peer‐led centrifugal force pushing them outwards, and substance use was an alternative source of bonding and identity for these students. In contrast, at North Street a centripetal force operated whereby the majority of students were pulled towards highly‐visible, normative markers of ‘safe’, ‘road culture’, such as cannabis use and gang‐involvement, as they attempted to fit in and survive in an inner‐city school environment. We conclude that health inequalities may be reproduced through these distinctive centrifugal and centripetal forces in different institutional contexts, and this should be the focus of quantitative examination in the UK and elsewhere.
The craft of intensive care medicine
Authors: Carmel Simon
Published: September 2012

The practice of medicine is often represented as a dualism: is medicine a ‘science’ or an ‘art’? This dualism has been long‐lasting, with evident appeal for the medical profession. It also appears to have been rhetorically powerful, for example in enabling clinicians to resist the encroachment of ‘scientific’ evidence‐based medicine into core areas of medical work such as individual clinical judgement. In this article I want to make the case for a more valid conceptualisation of medical practice: that it is a ‘craft’ activity. The case I make is founded on a theoretical synthesis of the concept of craft, combined with an analysis of ethnographic observations of routine medical practice in intensive care. For this context the craft aspects of medical work can be seen in how biomedical and other types of knowledge are used in practice, the embodied skills and practical judgement of practitioners and the technological and material environment. These aspects are brought together in two conceptual dimensions for ‘craft’: first, the application of knowledge; second, interaction with the material world. Some practical and political implications of a ‘craft’ metaphor for medical practice are noted.