bluuebunny/crossref_metadata_2025 huggingface dataset:
The effects of beeswax coating on quality of Kashar cheese during ripening
Authors: Yilmaz Fırat , Dagdemir Elif
Published: August 2012

The aim of this study was to evaluate the effects of the application of beeswax coating on the microbiological, physicochemical and sensory properties of Kashar cheese during ripening (120 day). Kashar cheeses were coated with two different thickness of beeswax (single‐layer coating, BW1, and double‐layer coating, BW2). For comparison, vacuum packaged (VP) and without packaging material (control) were also studied. Generally, no differences were found in total aerobic mesophilic bacteria, LAB on M‐17 agar, coliform bacteria and S. aureus counts among cheeses. Microbiological analyses also showed the beeswax‐coated cheeses presented a decrease of 2.5 logarithmic units on mould counts compared to control at 120th day. The control cheese had significantly (P < 0.05) higher dry matter, fat and protein contents, followed by BW1. However, the coating reduced formation of a thick crust layer by delaying moisture loss. At the end of 120‐day storage period, no significant differences in pH and acidity values were observed among the cheeses studied. Compared to other cheeses, control and BW1 cheeses had higher levels of WSN and ripening index in the end of storage. In the result of sensory analysis, while cheese BW1 and control were more preferred by the panellists, cheese VP received the lowest scores.
Effect of extraction conditions on hemicellulose yields and optimisation for industrial processes
Authors: Yılmaz Celebioglu Hilal , Cekmecelioglu Deniz , Dervisoglu Muhammet , Kahyaoglu Talip
Published: August 2012

Hemicellulose is a valuable component of agro‐food industrial wastes and used in various areas such as drug manufacture and food industry for encapsulation and emulsification. In this study, effects of raw material type, particle size, and extraction conditions (alkaline concentration, temperature, time) and methods (direct alkaline extraction, alkaline extraction after component removal and acidic extraction method) on hemicellulose yields were investigated. Sugar beet pulp and corn wastes were used as raw material. The alkaline method resulted in 40.2% pure extracts, while the acidic method gave only 27.4% purity in the same extraction conditions. The optimal extraction conditions were found as 30 °C temperature, 10% alkali (NaOH) and 24 h time (64.3%). It was also observed that removal of constituents such as fat, protein, starch and soluble sugar increased the purity of hemicellulose from 40.2% to 58.2% at the same conditions. The results indicated that using both low alkaline concentration and low temperature allows to recover higher‐quality extracts.
Effects of overexpression of the alcohol acetyltransferase‐encoding gene ATF1 and disruption of the esterase‐encoding gene IAH1 on the flavour profiles of Chinese yellow rice wine
Authors: Zhang Jian‐Wei , Zhang Cui‐Ying , Dai Long‐hai , Dong Jian , Liu Yu‐Lan , Guo Xue‐wu , Xiao Dong‐Guang
Published: August 2012

Alcohol acetyltransferase (AATase), which is mainly encoded by ATF1, is one of the most important enzymes for acetate ester synthesis. On the other hand, isoamyl acetate is degraded into a higher alcohol under the catalysis of IAH1‐encoded esterase. In this study, Chinese Saccharomyces cerevisiae was used as the parent strain to construct an ATF1 overexpression and IAH1 disruption mutant. The results show that after 5 days of pre‐fermentation, the concentrations of ethyl acetate, isoamyl acetate and isobutyl acetate in the yellow rice wines fermented with EY1 (pUC‐PIAK) increased to 468.94 mg L−1 (which is approximately 22‐fold higher than that of the parent cell RY1), 99.86 and 7.69 mg L−1 respectively. Meanwhile, isoamyl alcohol production was reduced to 56.37 mg L−1 (which is approximately 50% of that produced by the parent strain RY1). Therefore, ATF1 overexpression and IAH1 disruption can significantly increase acetate esters contents and reduce isoamyl alcohol content in Chinese yellow rice wine, thereby paving the way for breeding an excellent yeast strain for high‐quality Chinese yellow rice wine production.
Self‐transcendence in cognitively intact nursing‐home patients: a resource for well‐being
Authors: Haugan Gørill , Rannestad Toril , Hammervold Randi , Garåsen Helge , Espnes Geir Arild
Published: August 2012

Aim

This article reports an empirical study of self‐transcendence in cognitively intact nursing‐home patients. The aim was to investigate the interrelationships between self‐transcendence and nursing‐home patients' physical, social, emotional and functional well‐being.

Background

Finding new and alternative approaches to increase well‐being among nursing‐home patients is highly warranted. Self‐transcendence is considered a developmental process of maturity in adulthood and a vital resource for well‐being at the end of life, thus self‐transcendence could be a useful approach.

Design

Cross‐sectional

Method

The self‐transcendence scale and the Functional Assessment of Cancer Therapy General (FACT‐G) Quality of Life questionnaire were used. A sample of 202 cognitively intact nursing‐home patients in Mid‐Norway was selected to respond to the instruments in 2008 and 2009. Analysis was applied by means of LISREL 8·8 Structural Equation Modelling.

Results

A two‐factor construct of self‐transcendence showed that intrapersonal self‐transcendence directly affected functional well‐being and indirectly influenced physical, emotional and functional well‐being. Interpersonal self‐transcendence directly affected social and emotional well‐being. Additionally important influences were disclosed from functional to emotional and from emotional to physical well‐being.

Conclusion

Finding nursing interventions to enhance both intrapersonal and interpersonal self‐transcendence might benefit nursing‐home patients' overall well‐being. In a holistic perspective of body‐mind‐spirit, this research generates new‐research questions about the pathways between the different dimensions of well‐being in nursing‐home patients, which is important to holistic nursing practice.
Challenges for institutional elder care in Slovenian nursing homes
Authors: Habjanič Ana , Saarnio Reetta , Elo Satu , Turk Dušanka Mičetić , Isola Arja
Published: August 2012

Aims and objectives.  To investigate deficiencies in the institutional elder care that is being offered to residents of nursing homes in Slovenia.

Background.  Public criticism of the provision of elder care in nursing homes is growing all over the world, including in Slovenia. Many studies on this issue have been conducted, but seldom have assessed different viewpoints simultaneously.

Design.  A qualitative research design that involved individual unstructured interviews was used in 2007. The participants (n = 48) comprised 16 residents, 16 relatives and 16 members of the nursing staff from four nursing homes in Slovenia.

Methods.  The data generated were subjected to qualitative content analysis.

Results.  The major themes that emerged from this analysis were neglect, unprofessional communication, uncomfortable physical environment and inadequate administration.

Conclusions.  The participants of the study identified issues in institutional elder care in Slovenia that have also been highlighted by international research. Due to staff shortages, low motivation, insufficient communication skills and inexperience, members of the nursing staff reported that they were not in a position to offer the best possible quality of care.

Relevance to clinical practice.  To improve the living environment in nursing homes, it is important to consider the opinions of all those who are involved closely in institutional elder care. Correction of deficiencies should be a priority and should result in more engagement with residents.
Couples’ postpartum health status
Authors: Fang Li , Hung Chich‐Hsiu
Published: August 2012

Aims and objectives.  This study was conducted in Taiwan on couples for a month in the postpartum period to investigate the correlated factors that affect their health status.

Background.  Most studies have focused on the postpartum health status of mothers, but few of them mention about the postpartum health status of fathers.

Design.  A cross‐sectional design.

Methods.  This study was carried out on a cross‐section of couples, and the data were collected through telephone interviews conducted by a research assistant using structured questionnaires. A total of 201 couples who had given birth to a healthy single baby at a medical centre in southern Taiwan were recruited between 1 August 2007–31 November 2007.

Results.  The two most important factors correlated with mothers’ health statuses, during the month‐long postpartum period, were mothers’ educational and postpartum stress levels. The result also showed that baby’s Apgar score at the first minute was the main factor related to father’s health status during the month‐long postpartum period.

Conclusions.  Educational programmes should incorporate factors that affect couples’ health status during the one month postpartum period to promote postnatal couples’ health.

Relevance to clinical practice.  To improve the couples’ health status during the one month postpartum period, we need to strengthen the stress‐coping skills of mothers and provide them with coping resources to support their maternal roles, to provide social support to fathers and to incorporate issues of marital intimacy and parental attachment into the couples’ educational programmes. Also, a father’s presence at his infant’s birth is encouraged to enhance parental attachment.
Neonatal nurses’ perspectives of family‐centred care: a qualitative study
Authors: Trajkovski Suza , Schmied Virginia , Vickers Margaret , Jackson Debra
Published: August 2012

Aims and objectives.  The aim of this study is to explore neonatal nurses’ perspectives of their role in facilitating family centred care in the neonatal intensive care unit.

Background.  The philosophy of family centred care focuses on the health and wellbeing of the newborn and their family, through the development of a respectful partnership between the health care professional and the infant’s parents. Many studies report family centred care in the context of paediatric care; however, few studies explore neonatal nurses’ perspective of family centred care in the context of neonatal care.

Design.  Qualitative interpretative approach.

Methods.  Four focus groups and five individual face‐to‐face interviews were conducted with neonatal intensive care nurses (total n = 33) currently practicing in a tertiary Neonatal Intensive Care Unit in Australia. Each focus group and face to face interview was audio‐taped and transcribed. Data was analysed using thematic analysis.

Results.  Four dominant themes emerged from the data: (1) Getting to know parents and their wishes (2) Involving family in the day to day care (3) Finding a ‘happy’ medium (4) Transitioning support across the continuum.

Conclusion.  These findings revealed a general understanding of family centred care principles. Nurses reported the potential benefits and challenges of adopting a family centred care approach to deliver optimal care for neonates and their families. The study highlighted that nurses need ongoing organisation support, guidance and further education to assist them in delivering family centred care effectively.

Relevance to clinical practice.  Family centred care is a central tenet underpinning neonatal care. Understanding neonatal nurses’ perspectives will be useful when developing strategies to strengthen family centred care in the neonatal intensive care unit, and potentially improve neonatal care and family outcomes.
The effects of uncoated paper on skin moisture and transepidermal water loss in bedridden patients
Authors: Shin Yong Soon , Kim Hyun Jung , Moon Nam‐Kyung , Ahn Young Hee , Kim Kyoung‐Ok
Published: August 2012

Aims and objectives.  The aims of this study were to measure skin moisture and transepidermal water loss after application of uncoated paper and to compare skin moisture and transepidermal water loss after use of uncoated paper and disposable underpads.

Study design.  The study was a cross‐over, prospective, open‐labeled, randomized trial.

Sample and setting.  Bedridden patients aged ≥18 years at a medical center in Korea were included. Treatment order was randomly assigned using block randomization, with a block size of 4 and an assignment rate of one‐by‐one.

Methods.  Skin moisture was measured using a Corneometer 825 and transepidermal water loss was measured using a Tewameter 300.

Results.  Skin moisture after application of an uncoated paper was significantly lower than observed after application of a disposable underpad (mean 40·6 and SD 13·1 vs. mean 64·6 and SD 23·7, p < 0·001). Transepidermal water loss also showed greater health scores after using uncoated paper (mean 11·1 and SD 5·7 g/m2/hour) than after applying a disposable underpad (mean 23·2 and SD 11·1 g/m2/hour, p < 0·001). There were no statistical between‐group differences in room temperature, relative humidity, and body temperature.

Conclusion.  We found that uncoated paper was helpful in avoiding excessive moisture without adverse effects.

Relevance to clinical practice.  As indicated by the results of this study, uncoated paper can be applied to bed‐ridden patients who required incontinence care. Nurses may consider using uncoated paper as one of nursing methods in the routine care of bed‐ridden patients for moisture control.
Burden and coping strategies experienced by caregivers of persons with schizophrenia in the community
Authors: Tan Sharon CH , Yeoh Ai Lean , Choo Irene BK , Huang Adeline PH , Ong Seng Hong , Ismail Hafizah , Ang Pei Pei , Chan Yiong Huak
Published: August 2012

Aims and objectives.  Examined the levels of burden and the coping strategies experienced by caregivers of persons with schizophrenia in the community. It aims (1) to provide mental healthcare professionals with more information about caregiver stressors and (2) to recommend more effective community resources and support.

Background.  A caregiver’s burden increases due to negative coping skills and lack of resources. However, insufficient studies of caregiver burden and coping skills accentuate the already inadequate understanding of the field. This lack of understanding often leads to frequent readmission of patients when caregivers give up their care‐giving responsibilities.

Design.  Descriptive and quantitative methods.

Methods.  Convenience sampling method was used at three outpatient clinics on 150 caregivers. The Burden Assessment Scale measured care‐giving burden. The Family Crisis‐Oriented Personal Scales examined the coping strategies.

Results.  Findings reveal that 31·3% caregivers felt distress and 33·3% found stigma upsetting. Only 14·7% sought help from healthcare workers and 49·3% were interested to know more. Nevertheless, 24·7% verbalized sufficient social support.

Conclusions.  Results demonstrated a high burden on caregivers because of many factors such as other commitments, lack of resources, insufficient financial support, education level and ageing. This study found that long‐term caregivers suffer more than short‐term ones, which is contrary to Seng’s study (2005). Burden increases further for those having to cope with both work and care giving at the same time.

Relevance to clinical practice.  It is critical to improve and increase services and resources to support care giving. It is also essential to educate and ensure that the people affected know how to leverage the available resources. It is important to improve and increase our services and resources. It is also essential to educate and ensure the people concerned know how to make use of them. It also essential to educate and ensure the people concerned know how to make use of them.
Nursing practice in a post‐Soviet country from the perspectives of Armenian nurses: a qualitative exploratory study
Authors: Poghosyan Lusine , Poghosyan Hermine , Berlin Kristen , Truzyan Nune , Danielyan Lusine , Khourshudyan Kristine
Published: August 2012

Aims and objectives.  The purpose of this qualitative descriptive study was to explore the views of head and staff nurses about nursing practice in the hospitals of Armenia.

Background.  Armenia inherited its nursing frameworks from the Soviet Union. After the Soviet collapse, many changes took place to reform nursing. However, to date little has been systematically documented about nursing practice in Armenia.

Design.  Qualitative descriptive design was implemented.

Methods.  Three major hospitals in Yerevan, the capital city of Armenia, participated in the study. Purposeful sampling was used. Forty‐three nurses participated, 29 staff and fourteen head nurses. Data were collected through five focus groups comprised of seven to ten participants. A focus group guide was developed. The researcher facilitated the discussions in Armenian, which were audio taped. The research assistant took notes. Data were transcribed and translated into English, imported into atlas.ti 6.1 qualitative software, and analysed by three authors.

Results.  Five themes were extracted. Lack of role clarity theme was identified from the head nurse data. The practice environment theme was identified from the staff nurse data. Nursing education, value, respect and appreciation of nursing, and becoming a nurse were common themes identified from both head and staff nurse data. Head nurses lack autonomy, do not have clear roles and are burdened with documentation. Staff nurses practice in challenging work environments with inadequate staffing and demanding workloads. All nurses reported the need to improve nursing education.

Conclusions.  This is the first study conducted in Armenia exploring nursing practice in the hospitals from the nurses’ perspectives. Nurses face challenges that may impact their wellbeing and patient care.

Relevance to clinical practice.  Understanding challenges nursing practice faces in the hospitals in Armenia will help administrators and care providers to take actions to improve nursing practice and subsequently patient care.
Comparison of nurse practitioners’ perceptions of required competencies and self‐evaluated competencies in Taiwan
Authors: Chang I‐Wen , Shyu Yea‐Ing , Tsay Pei‐Kwei , Tang Woung‐Ru
Published: August 2012

Aims and objectives.  This paper is a report of a study conducted to investigate differences between nurse practitioners’ perceptions of the importance of required competencies and their self‐evaluated existing competencies, and the main factors influencing these differences.

Background.  The difference between nurse practitioners’ perceptions of required competencies and their existing competencies has never been investigated. Therefore, it is still uncertain whether these two competencies differ.

Design.  A nationwide survey study was authorised by the Department of Health (DOH) in Taiwan.

Methods.  For this nationwide survey study, the Questionnaire of Competencies in the Nurse Practitioner’s Role was mailed to all nurse practitioners who qualified for the first annual national NP licence exam in Taiwan. Of 582 questionnaires distributed, 374 valid questionnaires were returned for a response rate of 64·2%.

Results.  The scores for required competencies were all higher than existing competencies. The competencies with largest differences were (in increasing order) clinical research, direct care, and leadership and reform. The competencies with smallest differences were (in ascending order) medical assistance, communication and coordination, and ethical decision‐making. Differences in the total score between required and existing competencies were significantly influenced by nurse practitioners’ age, seniority as nurse practitioner, whether the nurse practitioners’ institution had a nurse practitioner advancement system, and the number of patients under their care.

Conclusions.  Nurse practitioners’ perceptions of the importance of their expected role competencies were significantly greater in most cases than their actual competencies.

Relevance to clinical practice.  These findings could serve as a reference to improve cultivation of the NP system in Taiwan, to strengthen professional competencies in NP training programs.
A likelihood‐based comparison of population histories in a parasitoid guild
Authors: Lohse Konrad , Barton Nicholas H. , Melika George , Stone Graham N.
Published: August 2012

Little is known about the stability of trophic relationships in complex natural communities over evolutionary timescales. Here, we use sequence data from 18 nuclear loci to reconstruct and compare the intraspecific histories of major Pleistocene refugial populations in the Middle East, the Balkans and Iberia in a guild of four Chalcid parasitoids (Cecidostiba fungosa, Cecidostiba semifascia, Hobbya stenonota and Mesopolobus amaenus) all attacking Cynipid oak galls. We develop a likelihood method to numerically estimate models of divergence between three populations from multilocus data. We investigate the power of this framework on simulated data, and—using triplet alignments of intronic loci—quantify the support for all possible divergence relationships between refugial populations in the four parasitoids. Although an East to West order of population divergence has highest support in all but one species, we cannot rule out alternative population tree topologies. Comparing the estimated times of population splits between species, we find that one species, M. amaenus, has a significantly older history than the rest of the guild and must have arrived in central Europe at least one glacial cycle prior to other guild members. This suggests that although all four species may share a common origin in the East, they expanded westwards into Europe at different times.
Patterns and persistence of larval retention and connectivity in a marine fish metapopulation
Authors: Saenz‐Agudelo Pablo , Jones Geoffrey P. , Thorrold Simon R. , Planes Serge
Published: August 2012

Connectivity, the demographic linking of local populations through the dispersal of individuals, is one of the most poorly understood processes in population dynamics, yet has profound implications for conservation and harvest strategies. For marine species with pelagic larvae, direct estimation of connectivity remains logistically challenging and has mostly been limited to single snapshots in time. Here, we document seasonal and interannual patterns of larval dispersal in a metapopulation of the coral reef fish Amphiprion polymnus. A 3‐year record of larval trajectories within and among nine discrete local populations from an area of approximately 35 km was established by determining the natal origin of settled juveniles through DNA parentage analysis. We found that spatial patterns of both self‐recruitment and connectivity were remarkably consistent over time, with a low level of self‐recruitment at the scale of individual sites. Connectivity among sites was common and multidirectional in all years and was not significantly influenced by seasonal variability of predominant surface current directions. However, approximately 75% of the sampled juveniles could not be assigned to parents within the study area, indicating high levels of immigrations from sources outside the study area. The data support predictions that the magnitude and temporal stability of larval connectivity decreases significantly with increasing distance between subpopulations, but increases with the size of subpopulations. Given the considerable effort needed to directly measure larval exchange, the consistent patterns suggest snapshot parentage analyses can provide useful dispersal estimates to inform spatial management decisions.
Speciation history of three closely related oak gall wasps, Andricus mukaigawae,A. kashiwaphilus, and A. pseudoflos (Hymenoptera: Cynipidae) inferred from nuclear and mitochondrial DNA sequences
Authors: Wachi Nakatada , Abe Yoshihisa , Inomata Nobuyuki , Szmidt Alfred Edward , Tachida Hidenori
Published: August 2012

The Andricus mukaigawae complex of oak gall wasps is composed of cyclically parthenogenetic species: A. mukaigawae and Andricus kashiwaphilus, and a parthenogenetic species, Andricus pseudoflos. The component species differ in life history, host plant, karyotype, and asexual gall shape, although little difference is found in the external morphology of asexual adults. To understand the speciation history of this species complex, DNA sequences of one mitochondrial region and nine nuclear gene regions were investigated. The genetic relationship among the species suggested that a loss of sex occurred after host shift. Unexpectedly, two or three distinct groups in the parthenogenetic species, A. pseudoflos, were revealed by both mitochondrial and nuclear DNA data. Gene flow in nuclear genes from the species not infected by Wolbachia (A. kashiwaphilus) to the species infected by it (A. mukaigawae) was suggested by a method based on coalescent simulations. On the other hand, gene flow in mitochondrial genes was suggested to be in the opposite direction. These findings indicate possible involvement of Wolbachia infection in the speciation process of the A. mukaigawae complex.
Distribution and speciation of Mn in hydrated roots of cowpea at levels inhibiting root growth
Authors: Kopittke Peter M. , Lombi Enzo , McKenna Brigid A. , Wang Peng , Donner Erica , Webb Richard I. , Blamey F. Pax C. , de Jonge Martin D. , Paterson David , Howard Daryl L. , Menzies Neal W.
Published: August 2012

The phytotoxicity of Mn is important globally due to its increased solubility in acid or waterlogged soils. Short‐term (≤24 h) solution culture studies with 150 µM Mn were conducted to investigate the in situ distribution and speciation of Mn in apical tissues of hydrated roots of cowpea [Vigna unguiculata (L.) Walp. cv. Red Caloona] using synchrotron‐based techniques. Accumulation of Mn was rapid; exposure to 150 µM Mn for only 5 min resulting in substantial Mn accumulation in the root cap and associated mucigel. The highest tissue concentrations of Mn were in the root cap, with linear combination fitting of the data suggesting that ≥80% of this Mn(II) was associated with citrate. Interestingly, although the primary site of Mn toxicity is typically the shoots, concentrations of Mn in the stele of the root were not noticeably higher than in the surrounding cortical tissues in the short‐term (≤24 h). The data provided here from the in situ analyses of hydrated roots exposed to excess Mn are, to our knowledge, the first of this type to be reported for Mn and provide important information regarding plant responses to high Mn in the rooting environment.
Effect of Electrical Conductivity and Silicate on Infection of Basil with Colletotrichum gloeosporioides in Soilless Culture
Authors: Cogliati Ettore Erik , Gilardi Giovanna , Gullino Maria Lodovica , Garibaldi Angelo
Published: August 2012

The aim of this study was to evaluate the effect of potassium silicate administration and of electrical conductivity of nutrient solution in three experiments against Colletotrichum gloeosporioides infection on basil (Ocimum basilicum L. cv Genovese Gigante) grown in a closed soilless system. Potassium silicate was added at 100 mg/l of nutrient solution at three different levels of electrical conductivity: 1.5–1.6 mS/cm (E.C.1), 3–3.2 mS/cm (E.C.2, 0.70 g/l NaCl) and 4–4.2 mS/cm (E.C.3, 0.95 g/l NaCl). Basil plants were inoculated with C. gloeosporioides spores 21–31 days after sowing or placing the pots on the channels, applying 5 ml of conidial suspension to each treatment. The increased electrical conductivity of the nutrient solution generally reduced the incidence and severity of the disease, with the highest electrical conductivity (E.C.3) providing the best results. The addition of potassium silicate to the different nutrient solutions showed a significant reduction in both incidence and severity of the disease compared to a solution without silicate and the best results were given by the addition of silicate with the highest electrical conductivity (E.C.3) in all the trials carried out. The combination of high electrical conductivity and potassium silicate supplied gave good results. The possibility and benefits of applying Si amendments in practice are examined.
Transcription regulatory mechanism of Pitx in the papilla‐forming region in the ascidian, Halocynthia roretzi, implies conserved involvement of Otx as the upstream gene in the adhesive organ development of chordates
Authors: Yoshida Keita , Ueno Motoko , Niwano Tomoko , Saiga Hidetoshi
Published: August 2012

Pitx genes play important roles in a variety of developmental processes in vertebrates. In an ascidian species, Halocynthia roretzi, Hr‐Pitx, the only Pitx gene of this species, has been reported to be expressed in the left epidermis at the tailbud stage. In the present study, first, we have shown that Hr‐Pitx is also expressed in the papilla‐forming region at the neurula to tailbud stages, and then we addressed transcription regulatory mechanisms for the expression of Hr‐Pitx in the papilla‐forming region. We have identified the genomic region ranging from 850 to 1211 bp upstream from the translation start site of the Hr‐Pitx gene as an enhancer region that drives the transcription of Hr‐Pitx in the papilla‐forming region. Within the enhancer region, putative transcriptional factor binding sites for Otx as well as Fox were shown to be required for its activity. Finally, we carried out knocking down experiments of Hr‐Otx function using an antisense morpholino oligonucleotide, in which the knocking down of Hr‐Otx function resulted in reduction of the enhancer activity and loss of the expression of Hr‐Pitx in the papilla‐forming region. In Xenopus laevis, it has been reported that Pitx genes are expressed downstream of Otx function during development of the cement gland, an adhesive organ of its larva. Taken together, it is suggested that the expression regulatory mechanism of Pitx, involving Otx as the upstream gene, in the developing adhesive organ is conserved between ascidians and vertebrates.
Nursings’ need for the idea of spirituality
Authors: Pesut Barbara
Published: August 2012

PESUT B. Nursing Inquiry 2013; 20: 5–10  Nursings’ need for the idea of spirituality

Spirituality is an idea that has sustained significant interest in nursing over the past quarter century. Extensive conceptual work has generated robust critique around clarity and professional jurisdictional claims. However, less attention has been paid to the challenges nursing has faced that have contributed to the spirituality quest. Reflecting on my own experiences as a scholar writing in this literature over the past decade, I suggest three challenges that spirituality has attempted to redress: to relate across difference in a globalized world, to be good in a world of uncertain morality and to find meaning in a disenchanted world. The idea of spirituality could be viewed as resistance against othering, against law based ethics, and against politics and power. But the impact of the idea of spirituality has yet to be determined and caution is in order. As important as this resistance is, nursing must refrain from creating a new world of insiders and outsiders and from minimizing the role of religious ethics in a globalized world. Spirituality, like its predecessor religion, will likely continue to play an enduring role in providing fundamental meaning for nursing work.
Regional pulmonary response to a methacholine challenge using hyperpolarized 3He magnetic resonance imaging
Authors: COSTELLA STEPHEN , KIRBY MIRANDA , MAKSYM GEOFFREY N. , MCCORMACK DAVID G. , PATERSON NIGEL A. M. , PARRAGA GRACE
Published: August 2012

Background and objective:  Spirometry is insensitive to small airway abnormalities in asthma. Our objective was to evaluate regional lung structure and function using hyperpolarized 3He magnetic resonance imaging (MRI) before, during and after a methacholine challenge (MCh).

Methods:  Twenty‐five asthmatics (mean age = 34 ± 11 years) and eight healthy volunteers (HV) (mean age = 33 ± 11 years) underwent spirometry, plethysmography and hyperpolarized 3He MRI prior to a MCh. MRI was repeated following the MCh and again 25 min after salbutamol administration. 3He MRI gas distribution was quantified using semiautomated segmentation of the ventilation defect percent (VDP). Tissue microstructure was measured using the 3He apparent diffusion coefficient (ADC). Analysis of variance with repeated measures was used to evaluate changes at each time point as well as to determine interactions between regions of interest (ROI) and subject group. Pearson's correlations were performed to evaluate associations between 3He MRI measurements and established clinical measures.

Results:  In asthmatics, but not HV, whole‐lung ADC was increased post‐MCh (P < 0.01). In asthmatics only, ADC was increased post‐MCh in posterior ROI (P < 0.01) and all ROI in the superior‐inferior direction (P < 0.01). VDP was increased in posterior and inferior ROI (P < 0.001). There was a correlation between VDP and specific airway resistance (r = 0.74, P < 0.0001), dyspnoea score (r = 0.66, P < 0.01) and fractional exhaled nitric oxide (r = 0.45, P < 0.05).

Conclusions:  We evaluated the regional pulmonary response to methacholine and salbutamol using 3He MRI and showed heterogeneous VDP and ADC consistent with bronchoconstriction and gas trapping, respectively, post‐MCh. These regional alterations resolved post‐salbutamol.
Antenatal 3‐D sonographic features of uterine synechia
Authors: Sato Miki , Kanenishi Kenji , Ito Megumi , Tanaka Hirokazu , Takemoto Mikihiko , Hata Toshiyuki
Published: August 2012

We present a case of uterine synechia diagnosed by conventional 2‐D color Doppler, 3‐D sonography, and magnetic resonance imaging at 26 weeks' gestation. 3‐D sonography clearly revealed umbilical cord prolapse through an oblique transverse uterine synechia. Loops of the umbilical cord were below and the fetus was superior to the uterine synechia. The edge of the umbilical cord loops was attached to the amniotic membrane, and a small echo‐free space was noted beneath the attachment. 2‐D color Doppler showed arterial blood flow consistent with the maternal heart rate. Magnetic resonance imaging confirmed the oblique horizontal membrane dividing the uterus with umbilical cord prolapse, its attachment to the amniotic membrane, and a small echo‐free space in the low, liquor‐filled amniotic cavity. We demonstrate how 3‐D sonography provided a novel visual depiction of uterine synechia, which greatly helped in prenatal diagnosis and counseling.
Two cases of paraovarian tumor of borderline malignancy
Authors: Suzuki Satoshi , Furukawa Shigenori , Kyozuka Hyo , Watanabe Takafumi , Takahashi Hidenori , Fujimori Keiya
Published: August 2012

Paraovarian tumor of borderline malignancy is rare. Only 13 cases in Japan, including the present cases, and 40 cases overseas have been reported. We report two cases of paraovarian tumor of borderline malignancy. Case 1: A 38‐year‐old woman was found to have a right ovarian cyst. Transvaginal ultrasonography showed a unilocular cystic tumor and a solid part of 8 mm in diameter within the tumor. Malignancy could not be ruled out, therefore the laparotomy was performed. The tumor was paraovarian tumor. Intraoperative rapid histological diagnosis was made and the patient was diagnosed with a serous borderline tumor. There has been no recurrence 1 year after surgery. Case 2: A 30‐year‐old woman was found to have a right hydrosalpinx, or an ovarian cyst, with a solid part inside. Transvaginal ultrasonography showed the solid part within the tumor was 14 × 9 mm. Laparoscopic surgery was performed and we diagnosed the tumor as paraovarian cyst. Histological diagnosis was mucinous borderline tumor. There has been no recurrence 11 months after surgery.
Management of patient with arrhythmogenic right ventricular cardiomyopathy during pregnancy
Authors: Iriyama Takayuki , Kamei Yoshimasa , Kozuma Shiro , Taketani Yuji
Published: August 2012

Arrhythmogenic right ventricular cardiomyopathy (ARVC) is a cardiac disease that affects the right side of the heart and causes ventricular arrhythmias. It is considered as the most common cause of sudden cardiac death in young adults. However, risk and optimal management of ARVC during pregnancy and delivery remain unclear due to the small number of reported cases. Here we report a case of successful management of pregnancy and delivery in a patient with ARVC, who had a history of sustained ventricular tachycardia from her previous pregnancy.
Novel mutation of the sex‐determining region on the Y chromosome in a 46,XY female patient with monolateral dysgerminoma: A case report
Authors: Battaglia Francesco , Plotti Francesco , Angelucci Michela , Aloisi Alessia , Angioli Roberto
Published: August 2012

Patients with 46,XY complete gonadal dysgenesis (Swyer syndrome) are characterized by the presence of female internal genital tract and bilateral streak gonads in a phenotypic female. These women have a high risk of developing rare type II malignant germ cell tumors. We report a rare case of a 33‐year‐old 46,XY female patient, who presented with an adnexal mass suspected for dysgerminoma, with a novel mutation of the sex‐determining region on the Y chromosome consisting in the variant c.301C> G (p.L101V). Considering that effective screening is not available and the high risk of developing malignant neoplasm, prophylactic gonadectomy is mandatory.
Increased incidence of brain metastases in BRCA1‐related ovarian cancers
Authors: Sekine Masayuki , Yoshihara Kosuke , Komata Dai , Haino Kazufumi , Nishino Koji , Tanaka Kenichi
Published: August 2012

Aim:  Brain metastasis from ovarian cancer is a very rare phenomenon. BRCA1‐related ovarian cancers show specific pathobiological profiles, advanced stage, and sensitivity to chemotherapeutic agents. However, no clear relationship to any known metastatic behavior has yet been found, so we examined the BRCA1 mutation and expression profiles in ovarian cancer cases with brain metastases.

Material and Methods:  We examined our clinical records of 340 ovarian cancer cases from 1983 to 2007 to ascertain cases with brain metastases. In the molecular genetic analyses, we performed loss of heterozygosity (LOH), direct sequence and immunohistochemical staining analysis of BRCA1.

Results:  We ascertained seven cases with brain metastases in 340 ovarian cancer cases (7/340 = 2.1%). Among the seven cases, three cases had ovarian and/or breast cancer patients in third‐degree relatives. We detected four LOH‐positive cases and a germline mutation of BRCA1 in two of the four cases. Furthermore, the remaining two cases showed absent staining of the BRCA1 protein. Therefore, four of seven cases with brain metastases were considered BRCA1‐related ovarian cancers (4/7 = 57.1%). All four of the cases were serous adenocarcinoma.

Conclusion:  Our results suggest that the loss of BRCA1 function may be involved in the phenomenon of brain metastasis from ovarian cancer. Further molecular biologic analyses will be required for a better understanding of this rare phenomenon.
Proteomic identification of PKM2 and HSPA5 as potential biomarkers for predicting high‐risk endometrial carcinoma
Authors: Teng Yincheng , Ai Zhihong , Wang Yudong , Wang Juan , Luo Laimin
Published: August 2012

Aim:  Endometrial carcinoma (EC) is a common gynecologic malignancy. EC has a favorable prognosis because it is usually diagnosed at an early stage. However, the recurrence rate is high and the prognosis is poor for high‐risk EC. Identification of new biomarkers for the prediction of high‐risk features will help to guide the treatment and improve the prognosis of patients with EC.

Material and Methods:  Differentially expressed proteins among high‐risk EC, low‐risk EC, and normal endometrial tissues were determined by two‐dimensional gel electrophoresis (2‐DE) and a liquid chromatography electrospray ionization tandem mass spectrometry (LC–ESI–MS/MS) proteomics approach. Then, the candidate proteins were examined by immunohistochemical analysis.

Results:  Thirteen protein spots were differentially expressed between the high‐ and low‐risk groups, and 25 protein spots were differentially expressed between the high‐risk and normal endometrium groups. Twenty‐two proteins were identified by MS analysis. PKM2 and HSPA5 were elevated in the high‐risk EC tissues compared with both the low‐risk EC and normal endometrial tissues. The elevated expression of PKM2 and HSPA5 in high‐risk EC tissue was confirmed by immunohistochemical analysis.

Discussion:  PKM2 and HSPA5 may play an important role in the progression of EC. These two proteins are potential biomarkers to better predict high‐risk EC and thereby guide clinical therapy.
Anatomo‐functional organization of the ventral primary motor and premotor cortex in the macaque monkey
Authors: Maranesi Monica , Rodà Francesca , Bonini Luca , Rozzi Stefano , Ferrari Pier Francesco , Fogassi Leonardo , Coudé Gino
Published: August 2012

The ventral agranular frontal cortex of the macaque monkey is formed by a mosaic of anatomically distinct areas. Although each area has been explored by several neurophysiological studies, most of them focused on small sectors of single areas, thus leaving to be clarified which is the general anatomo‐functional organization of this wide region. To fill this gap, we studied the ventral convexity of the frontal cortex in two macaque monkeys (Macaca nemestrina) using intracortical microstimulation and extracellular recording. Functional data were then matched with the cytoarchitectonic parcellation of the recorded region. The results demonstrated the existence of a dorso‐ventral functional border, encompassing the anatomical boundary between areas F4 and F1, and a rostro‐caudal anatomo‐functional border between areas F5 and F4. The ventral subdivision of areas F4 and F1 was highly electrically excitable, represented simple mouth movements and lacked visual properties; in contrast, their dorsal counterpart showed a higher stimulation threshold, represented forelimb and mouth motor acts and hosted different types of visual properties. The data also showed that area F5 was scarcely excitable, and displayed various motor specificity (e.g. for the type of grip) and complex visual (i.e. mirror responses) properties. Overall, the posterior areas F4 and F1 appear to be involved in organizing and controlling goal‐directed mouth motor acts and simple movements within different parts of the external (dorsal sector) and internal (ventral sector) space, whereas area F5 code motor acts at a more abstract level, thus enabling the emergence of higher order socio‐cognitive functions.
Comparative effectiveness of water infusion vs air insufflation in colonoscopy: a meta‐analysis
Authors: Jun W. U. , Bing H. U.
Published: August 2012

Aim  Colonoscopy with air insufflation is known to result in abdominal pain and discomfort. We aimed to determine the effectiveness of water infusion during colonoscopy through a meta‐analysis.

Method  Original papers and abstracts published up to October 2011 were searched in MEDLINE, EMBASE, Cochrane Library Database and important meeting abstracts. Clinical appraisal and data extraction were conducted by two reviewers independently. Statistical analysis was performed by meta‐analysis using a fixed effects model or a random effects model.

Results  Seven studies involving 872 patients were included. Meta‐analysis showed that the water infusion group had fewer patients requiring abdominal compression or position change [risk ratio (RR) 0.73, 95% CI 0.59, 0.91], a lower mean pain score (RR −1.10, 95% CI −1.26, −0.95), lower maximum pain score (RR −2.34, 95% CI −2.92, −1.76) and fewer patients requiring on‐demand sedation (RR 0.45, 95% CI 0.31, 0.66) than the air insufflation group during colonoscopy. There were no significant differences in caecal intubation rate, caecal intubation time, total procedure time and adenoma detection rate.

Conclusion  Water infusion significantly decreases patient discomfort and abdominal pain during colonoscopy without affecting operation time and intubation success rate.
Early and late symptomatic anastomotic leakage following low anterior resection of the rectum for cancer: are they different entities?
Authors: Floodeen H. , Hallböök O. , Rutegård J. , Sjödahl R. , Matthiessen P.
Published: August 2012

Aim  The aim of the study was to compare patients with symptomatic anastomotic leakage following low anterior resection of the rectum (LAR) for cancer diagnosed during the initial hospital stay with those in whom leakage was diagnosed after hospital discharge.

Method  Forty‐five patients undergoing LAR (n = 234) entered into a randomized multicentre trial (NCT 00636948), who developed symptomatic anastomotic leakage, were identified. A comparison was made between patients diagnosed during the initial hospital stay on median postoperative day 8 (early leakage, EL; n = 27) and patients diagnosed after hospital discharge at median postoperative day 22 (late leakage, LL; n = 18). Patient characteristics, operative details, postoperative course and anatomical localization of the leakage were analysed.

Results  Leakage from the circular stapler line of an end‐to‐end anastomosis was more common in EL, while leakage from the stapler line of the efferent limb of the J‐pouch or side‐to‐end anastomosis tended to be more frequent in LL (P = 0.057). Intra‐operative blood loss (P = 0.006) and operation time (P = 0.071) were increased in EL compared with LL. On postoperative day 5, EL performed worse than LL with regard to temperature (P = 0.021), oral intake (P = 0.006) and recovery of bowel activity (P = 0.054). Anastomotic leakage was diagnosed most often by a rectal contrast study in EL and by CT scan in LL. The median initial hospital stay was 28 days for EL and 10 days for LL (P < 0.001).

Conclusion  The present study has demonstrated that symptomatic anastomotic leakage can present before and after hospital discharge and raises the question of whether early and late leakage after LAR may be different entities.
Cutting Edge Thinking
Authors: WRIGHT CHRIS
Published: August 2012

The Credit Crunch ushered in an era of austerity with massive cuts and job losses. It highlighted the gulf between the world of real people and the abstraction of high finance. Put simply, to prevent the melt‐down of the global economy, the needs, hopes and ambitions of millions are being sacrificed. Who controls and issues money is key. To be viable any system must be big enough for people to have faith it won't fail, and it has to be administered soundly. Local government is accountable to its electorate and, as such, should put their welfare first. It is essentially an administrative machine and certainly isn't going to go away. A truly local economy could emerge with authorities initially paying part of their staff's wages in local currency and accepting it in payment of rates. At a stroke, job cuts could be reversed and people's skills and experience valued again.