bluuebunny/crossref_metadata_2025 huggingface dataset:
Increased serum angiotensin converting enzyme activity in type T insulin—dependent diabetes mellitus: its relation to metabolic control and diabetic complications
Authors: VAN DYK D. J. , ERMAN A. , ERMAN T. , CHEN‐GAL B. , SULKES J. , BONER G.
Published: November 2012

Abstract. Serum angiotensin‐converting enzyme (ACE) was measured in 150 insulin‐dependent diabetes mellitus (IDDM) patients and 72 healthy subjects by radioassay, using [3H]‐hippuryl‐glycyl‐glycine as a substrate. Mean (SD) serum ACE activity in diabetic patients was 120 ± 33 nmol ml−1 min−1 (range 46–215) and was significantly increased by 56% compared to control values (77 ± 23 nmol ml−1 min−1, range 46–125, P < 0·001). ACE activity > 125 nmol ml−1 min−1 was observed in 60 of 150 IDDM patients. 96 IDDM patients were normoalbuminuric (< 22 mg 24 h−1) and 49 patients were micro‐ or macroalbuminuric (range 22–6010 mg 24 h−1). Micro‐ and macroalbuminuric IDDM patients were found to have significantly greater ACE activity values than normoalbuminuric patients (128 ± 36 vs. 115 ± 30 nmol ml−1 min−1, P = 0·025). Metabolically well‐controlled IDDM patients (glycosylated haemoglobin ≤ 8%) had lower ACE activity values than the patients with glycosylated haemoglobin greater than 8% (109 ± 20 vs. 127 ± 32 nmol ml−1 min−1, P < 0·02). A significant correlation between degree of metabolic control and ACE activity was found (r = 0.435, P < 0·001) so that an increase in one glycosylated quartile unit is accompanied by an increase in ACE activity of 10·5 nmol ml−1 min−1. Thus ACE activity in the serum of IDDM patients was increased by 56% in 40% of the patients. It was increased in IDDM patients without complications and in patients with retinopathy or nephropathy. In diabetic patients with nephropathy, ACE activity was greater than in diabetic patients without nephropathy. ACE activity was positively correlated with metabolic control. The role of increased ACE activity in the development of diabetic nephropathy remains to be established.
Impact of two pulmonary enteral formulations on nutritional indices and outcomes
Authors: Cohen D. A. , Byham‐Gray L. , Denmark R. M.
Published: November 2012

Background

Enteral nutrition formulas enriched with eicosapentaenoic acid (EPA) and gamma‐linolenic acid (GLA) may modulate inflammatory processes and improve outcomes in mechanically‐ventilated patients with respiratory failure. The present study aimed to determine whether there were differences in nutritional indices (protein intake, energy intake, fat intake) and outcomes [days on mechanical ventilation, days in the intensive care unit (ICU)] between mechanically‐ventilated subjects who received a standard pulmonary enteral formula compared to those who received an EPA/GLA enriched pulmonary enteral formula.

Methods

Data on 50 adult subjects who were admitted to an ICU in a community hospital who required both mechanical ventilation and enteral nutrition support were collected (n = 19 in the standard enteral formula group; n = 31 in the EPA/GLA‐enriched enteral formula group). The present study involved both retrospective and prospective data.

Results

Subjects who were provided the EPA/GLA enriched enteral formula received significantly more enteral formula volume (P = 0.011), total fat (P < 0.0005) and total energy (P = 0.017) than subjects who were provided the standard enteral formula. When controlling for the effects of enteral formula volume, total fat intake and total energy intake as confounding variables, there were no significant differences between the enteral formula groups in ICU days (P = 0.440) or hours spent on mechanical ventilation (P = 0.410).

Conclusions

The use of a specialised pulmonary enteral formulation did not result in any statistically significant effects on ICU days and hours on mechanical ventilation. Subjects who were on the specialised formula did receive more enteral formula volume and more total energy intake, which may be clinically important. Further clinical studies are needed to address the impact that a specialised pulmonary enteral formula has on ICU stay and ventilator hours.
Parent and teacher perceptions of participation and outcomes in an intensive communication intervention for children with pragmatic language impairment
Authors: Baxendale Janet , Lockton Elaine , Adams Catherine , Gaile Jacqueline
Published: November 2012

Background

Treatment trials that enquire into parents’ and teachers’ views on speech–language interventions and outcomes for primary school‐age children are relatively rare. The current study sought perceptions of the process of intervention and value placed on outcomes resulting from a trial of intervention, the Social Communication Intervention Project (SCIP), for children with communication disorders characterized by persistent needs in pragmatics and social use of language.

Aims

Aims: To describe parent and teacher views around the process and experience of participating in SCIP intervention, including aspects of collaborative practice; and to gain understanding of parents’ and teachers’ perceptions of communication outcomes for children who had received intervention.

Methods & Procedures

Parents and teachers of eight children in the intervention arm of the SCIP study participated in semi‐structured interviews with a researcher within 2 months of completion of SCIP intervention. The framework method of analysis was used to explore predetermined themes based around a list of topics informed by previous thinking and experience of the research.

Outcomes & Results

Parents and teachers perceived liaison with the SCIP speech and language therapist as being an important element of the intervention. Indirect approaches to liaison with parents were perceived as effective in transferring information as were brief meetings with teachers. Teachers and parents were able to make explicit links between therapy actions and perceived changes in the child. Work on comprehension monitoring and emotional vocabulary was perceived to be particularly effective with respect to communication outcomes. Parents also reflected that they had adopted different strategies towards communication and behaviour in the home as a result of intervention. The limits of potential change in terms of child communication in areas such as non‐verbal communication and pragmatic skills were discussed by parents.

Conclusions & Implications

This analysis has contributed essential information to the evaluation of SCIP by describing the experience of the intervention as delivered, exploring processes of effective implementation and change in the school setting and by describing the value placed on different outcomes by parents and teachers. These findings can inform planning for collaborations between speech and language therapists and teachers and provide useful information about mechanisms of change in different components of the SCIP intervention which have not been individually evaluated before. Information on changes in children's communication skills which were perceived as meaningful to those living and working with the children daily is crucial to the acceptance and translation of the SCIP intervention into practice.
Fiskalpolitik und Finanzmärkte: Perspektiven für Forschung und Wirtschaftspolitik
Authors: Müller Gernot
Published: November 2012

The conduct of fiscal policy has been altered considerably in the context of the global financial crisis, that is, at times when financial markets conditions were extraordinary turbulent. Yet financial market conditions determine how fiscal impulses are transmitted through the economy and, eventually, the size of the fiscal multiplier. I develop a comprehensive perspective on how financial market conditions alter the effects of fiscal policy on economic activity within a New Keynesian framework. Drawing on historical as well as systematic considerations, I distinguish a scenario of 1) “normal times” characterized by smoothly operating financial markets, 2) financial markets characterized by tight credit conditions in the private sector and constraints on monetary policy and 3) financial markets, in addition, characterized by high sovereign risk. I argue that the size and even the sign of the multiplier may differ across these scenarios.
Universal Health Outcome Measures for Older Persons with Multiple Chronic Conditions
Authors:   Working Group on Health Outcomes for Older Persons with Multiple Chronic Conditions
Published: November 2012

Older adults with multiple chronic conditions (MCCs) require considerable health services and complex care. Because the persistence and progression of diseases and courses of treatments affect health status in multiple dimensions, well‐validated universal outcome measures across diseases are needed for research, clinical care, and administrative purposes. An expert panel meeting held by the National Institute on Aging in September 2011 recommends that older persons with MCCs complete a brief initial composite measure that includes general health; pain; fatigue; and physical health, mental health, and social role function, along with gait speed measurement. Suitable composite measures include the Medical Outcomes Study 8 (SF‐8) and 36 (SF‐36) ‐item Short‐Form Survey and the Patient Reported Outcomes Measurement Information System 29‐item Health Profile. Based on responses to items in the initial measure, short follow‐on measures should be selectively targeted to symptom burden, depression, anxiety, and daily activities. Persons unable to walk a short distance to assess gait speed should be assessed using a physical function scale. Remaining gaps to be considered for measure development include disease burden, cognitive function, and caregiver burden. Routine outcome assessment of individuals with MCCs could facilitate system‐based care improvement and clinical effectiveness research.
The Quantitative Importance of News Shocks in Estimated DSGE Models
Authors: KHAN HASHMAT , TSOUKALAS JOHN
Published: November 2012

We estimate a dynamic stochastic general equilibrium (DSGE) model with several frictions and both unanticipated and news shocks, using quarterly U.S. data from 1954 to 2004 and Bayesian methods. We find that unanticipated shocks dominate news shocks in accounting for the unconditional variance of output, consumption, and investment growth, interest rate, and the relative price of investment. The unanticipated shock to the marginal efficiency of investment is the dominant shock, accounting for over 45% of the variance in output growth. News shocks account for less than 15% of the variance in output growth. Within the set of news shocks, nontechnology sources of news dominate technology news, with wage markup news shocks accounting for about 60% of the variance share of both hours and inflation. We find that in the estimated DSGE model (i) the presence of endogenous countercyclical price and wage markups due to nominal frictions substantially diminishes the importance of news shocks relative to a model without these frictions, and (ii) while there is little change in the estimated contributions of technology news when we restrict wealth effects on labor supply, the contributions of nontechnology news shocks are relatively more sensitive.
Price Setting in the Euro Area: Some Stylized Facts from Individual Producer Price Data
Authors: VERMEULEN PHILIP , DIAS DANIEL A. , DOSSCHE MAARTEN , GAUTIER ERWAN , HERNANDO IGNACIO , SABBATINI ROBERTO , STAHL HARALD
Published: November 2012

This paper summarizes the microevidence on the setting of producer prices in the euro area. The main findings are: (i) 21% of producer prices are adjusted each month, (ii) producer prices are changed more frequently and by smaller amounts than consumer prices (even after controlling for product characteristics), (iii) price decreases are relatively frequent, (iv) inflation correlates positively with the difference between the frequency of price increases and decreases, and (v) there is substantial variation in price flexibility across sectors, which can be explained in part by differences in the cost structure, the degree of competition, and the level of sectoral inflation.
Investments in Scientific Research: Examining the Funding Threshold Effects on Scientific Collaboration and Variation by Academic Discipline
Authors: Clark Benjamin Y. , Llorens Jared J.
Published: November 2012

This paper seeks to examine how federal financial support of academic scientists shapes their collaborative behavior. More specifically, it investigates two questions: (i) are there threshold sizes of federal grants that have effects on collaboration? and (ii) do the threshold sizes differ by discipline? To test and model these questions, this paper uses data collected in a 2004–2005 survey by theResearchValuingMappingProject (a project based atGeorgiaTech and led byBarryBozeman) of 2,086 academically based research scientists and engineers. The analysis in this paper reaffirms the positive relationship between federal funding and collaboration seen in previous works, but the findings suggest that there is in fact a threshold effect—as the positive relationship has a diminishing influence. The findings of this paper are more limited with respect to how academic disciplines’ threshold levels differ. The results indicate a difference in the threshold levels between disciplines for three of the eight models.
Treatment errors resulting from use of lasers and IPL by medical laypersons: results of a nationwide survey
Authors: Hammes Stefan , Karsai Syrus , Metelmann Hans‐Robert , Pohl Laura , Kaiser Kathrine , Park Bo‐Hyun , Raulin Christian
Published: November 2012

Background: The demand for hair and tattoo removal with laser and IPL technology  (intense pulsed light technology) is continually increasing. Nowadays these treatments are often carried out by medical laypersons without medical supervision in franchise companies, wellness facilities, cosmetic institutes and hair or tattoo studios. This is the first survey is to document and discuss this issue and its effects on public health.

Patients and methods: Fifty patients affected by treatment errors caused by medical laypersons with laser and IPL applications were evaluated in this retrospective study. We used a standardized questionnaire with accompanying photographic documentation. Among the reports there were some missing or no longer traceable parameters, which is why 7 cases could not be evaluated.

Results: The following complications occurred, with possible multiple answers:  81.4% pigmentation changes, 25.6% scars, 14% textural changes and 4.6% incorrect information. The sources of error (multiple answers possible) were the following:  62.8% excessively high energy, 39.5% wrong device for the indication, 20.9% treatment of patients with darker skin or marked tanning, 7% no cooling, and 4.6% incorrect information.

Conclusions: The causes of malpractice suggest insufficient training, inadequate diagnostic abilities, and promising unrealistic results. Direct supervision by a medical specialist, comprehensive experience in laser therapy, and compliance with quality guidelines are prerequisites for safe laser and IPL treatments. Legal measures to make such changes mandatory are urgently needed.
Gonorrhea: Data on antibiotic resistance and accompanying infections at the University Hospital Dresden over a 10‐year time period
Authors: Abraham Susanne , Poehlmann Christoph , Spornraft‐Ragaller Petra
Published: November 2012

Background: Over the last years, growing resistance of gonorrhea to quinolones has emerged worldwide. Currently, cases with resistance to oral and parenteral third‐generation cephalosporins are increasingly reported. Because gonorrhea is not a notifiable infection in Germany, data on epidemiology and antimicrobial surveillance of gonorrhea are scarce. We present the results of N. gonorrhoea testing at the University Hospital Dresden over the course of ten years.

Patients and Methods: The results of cultural and nucleic acid amplification testing of gonorrhea and accompanying infections of 1,850 smears between 2001 and 2010 were analyzed retrospectively.

Results: Among 181 patients (mean age 30.4 years) 159 had positive PCR analyses for gonorrhea and 50 positive cultures of Neisseria gonorrhoea. The rate of ciprofloxacin resistance was high (in 46% of all isolates), primarily in men. Resistance to cefotaxime and ceftriaxone could not be detected so far. In 40% of the cases at least one accompanying urogenital infection occurred, predominantly with Chlamydia trachomatis.

Conclusions: Similar to other regions of Germany, a high percentage of resistance to quinolones was found in gonorrhea, but not to cephalosporins. Additionally, accompanying infections were frequent and warrant screening. In the light of recent cases of resistance to cephalosporins currently emerging in Europe, cultural diagnosis of gonorrhea should definitely be intensified by all means. The results should be integrated into a surveillance system.
Playful explicitness with grammar: a pedagogy for writing
Authors: Myhill Debra , Jones Susan , Watson Annabel , Lines Helen
Published: November 2012

The place of grammar within the teaching of writing has long been contested and successive research studies have indicated no correlation between grammar teaching and writing attainment. However, a recent study has shown a significant positive impact on writing outcomes when the grammar input is intrinsically linked to the demands of the writing being taught. The study adopted a mixed methods design with a large‐scale randomised controlled trial accompanied by a qualitative dataset, which provided contextual information about how the intervention was implemented. In this paper, we will outline the pedagogical principles that underpinned the intervention, and illustrate both the theoretical grounding and practical classroom examples that exemplify the approach. We will argue that any future policy or professional development that draws on this research must take account of these pedagogical principles, rather than focusing too superficially on either the grammar or the teaching materials which exemplify them.
An Overview of Regular Dialysis Treatment in Japan (As of 31 December 2010)
Authors: Nakai Shigeru , Iseki Kunitoshi , Itami Noritomo , Ogata Satoshi , Kazama Junichiro James , Kimata Naoki , Shigematsu Takashi , Shinoda Toshio , Shoji Tetsuo , Suzuki Kazuyuki , Taniguchi Masatomo , Tsuchida Kenji , Nakamoto Hidetomo , Nishi Hiroshi , Hashimoto Seiji , Hasegawa Takeshi , Hanafusa Norio , Hamano Takayuki , Fujii Naohiko , Masakane Ikuto , Marubayashi Seiji , Morita Osamu , Yamagata Kunihiro , Wakai Kenji , Wada Atsushi , Watanabe Yuzo , Tsubakihara Yoshiharu
Published: November 2012

A nationwide statistical survey of 4226 dialysis facilities was conducted at the end of 2010, and 4166 facilities (98.6%) responded. The number of new patients introduced into dialysis was 37 512 in 2010. This number has decreased for two consecutive years since it peaked in 2008. The number of patients who died in 2010 was 28 882, which has been increasing every year. The number of patients undergoing dialysis at the end of 2010 was 298 252, which is an increase of 7591 (2.6%) compared with that at the end of 2009. The number of dialysis patients per million at the end of 2010 was 2329.1. The crude death rate of dialysis patients in 2010 was 9.8%, and has been gradually increasing. The mean age of the new patients introduced into dialysis was 67.8 years and the mean age of the entire dialysis patient population was 66.2 years. Regarding the primary disease of the new patients introduced into dialysis, the percentage of patients with diabetic nephropathy was 43.6%, which is a slight decrease from that in the previous year (44.5%). Patients with diabetic nephropathy as the primary disease accounted for 35.9% of the entire dialysis patient population, which approaches the percentage of patients with chronic glomerulonephritis as the primary disease (36.2%). The percentage of patients who had undergone carpal tunnel release surgery (CTx) was 4.3%, which is a slight decrease from that at the end of 1999 (5.5%). The decrease in the percentage of patients who had undergone CTx was significant among the patients with dialysis durations of 20–24 years (1999, 48.0%; 2010, 23.2%). A total weekly Kt/V attributable to peritoneal dialysis and their residual functional kidney was 1.7 or higher for 59.4% of patients who underwent peritoneal dialysis.
Notes on husbandry, reproduction and development in the Pacific horned frog Ceratophrys stolzmanni (Anura: Ceratophryidae), with comments on its amplexus
Authors: Ortiz D. A. , Almeida‐Reinoso D. , Coloma L. A.
Published: November 2012

Aspects related to the natural history and behaviour of the Pacific horned frog Ceratophrys stolzmanni were investigated, mostly by observations under laboratory conditions. Ceratophrys stolzmanni is a poorly known species of horned frog (Ceratophryinae) that inhabits the xeric environments of Pacific coast in Ecuador and Peru. The species has been found only during the rainy season in western Ecuador. Herein, techniques for husbandry and reproduction, as well as reproductive and developmental features, are reported. Breeding was nocturnal and clutches, which were laid on the same night as courtship, contained a maximum of 2100 eggs. Development time (c. 27°C) from fertilization to hatching was 40 hours and metamorphosis was completed at 20–32 days. The amplectant position of C. stolzmanni differs from typical axillary amplexus of other anurans and may be the result of the unique morphology of Ceratophryinae. Data presented here are pivotal for captive‐management programmes related to conservation, education and hobbyist activities.

Se investigaron aspectos sobre historia natural y comportamiento del sapo bocón del Pacífico Ceratophrys stolzmanni, mayormente basados en observaciones bajo condiciones de laboratorio. Ceratophrys stolzmanni es una especie poco conocida de rana cornuda (Ceratophryinae) que habita los ambientes xéricos de la costa del Pacífico en Ecuador y Perú. La especie ha sido encontrada únicamente durante la estación lluviosa en Ecuador occidental. Aquí se reportan técnicas de mantenimiento y reproducción, así como características reproductivas y de desarrollo. La reproducción fue nocturna y las puestas de huevos, que fueron hechas la misma noche del cortejo, contuvieron un máximo de 2100 huevos. El tiempo de desarrollo (∼27°C) desde la fertilización hasta la eclosión fue 40 horas y la metamorfosis fue completada entre 20–32 días. La posición de amplexus de C. stolzmanni difiere del amplexus axilar típico de otros anuros, y puede ser el resultado de la morfología única de Ceratophryinae. Los datos presentados aquí son esenciales para programas de manejo en cautiverio relacionados a conservación, educación y actividades de afición.
Breeding programme priorities and management techniques for native and exotic freshwater fishes in Europe
Authors: Koldewey H. , Cliffe A. , Zimmerman B.
Published: November 2012

The main goal of aquariums today is to raise public awareness and positively change visitor behaviour towards the environment. In addition, aquariums are becoming increasingly engaged in fish conservation programmes within their range country or overseas. The World Association of Zoo and Aquariums has developed a global aquarium strategy for conservation and sustainability. Within Europe, conservation‐breeding programmes are managed by the European Association of Zoos and Aquaria, and the European Union of Aquarium Curators Fish and Aquatic Invertebrate Taxon Advisory Group. The large and growing number of species of freshwater fish under threat can make deciding which species are priorities for aquarium collections very difficult. The Regional Collection Plan is a mechanism that defines the role a species plays within a zoological collection, helping collection managers make decisions about which species of freshwater fish are prioritized for ex situ conservation management with an associated action plan used to ensure that conservation goals are realized. We present clear and demonstrable roles that public aquariums can play in the conservation of freshwater fishes and discuss the challenges for such conservation initiatives in European aquariums with the increasing trend for marine exhibits and marine‐focused aquariums.
Statistics: dealing with categorical data
Authors: Scott M. , Flaherty D. , Currall J.
Published: November 2012

This, the fifth of our series of articles on statistics in veterinary medicine, moves onto modelling categorical data, in particular assessing associations between variables. Some of the questions we shall consider are widely discussed in many clinical research publications, and we will use the ideas of hypothesis tests and confidence intervals to answer those questions.
Scientific considerations for complex drugs in light of established and emerging regulatory guidance
Authors: Holloway Chris , Mueller‐Berghaus Jan , Lima Beatriz Silva , Lee Sau (Larry) , Wyatt Janet S. , Nicholas J. Michael , Crommelin Daan J.A.
Published: November 2012

On March 9, 2012, the New York Academy of Sciences brought together experts representing a variety of perspectives—including academic, industrial, regulatory, as well as those from physicians and consumers—to discuss considerations for the non‐biological complex drug (NBCD) regulatory approval pathway, given the emerging regulatory guidelines for biosimilars (follow‐on biological complex drugs). Some of the organizers of the conference expressed their belief that NBCDs share a number of characteristic features with biologicals: the structure cannot be fully defined by the available (physicochemical) analytical tests, and quality assurance is based on in‐depth knowledge, consistency, and control of the production process. However, their view on NBCDs was not universally accepted among the experts who participated in the conference. Plenary sessions addressed the most recent regulatory developments, experimental design, interchangeability, and immunogenicity issues for follow‐on versions of complex drugs from the perspective of key audiences, including industry, regulatory agencies, physicians, and consumers. This report summarizes these various perspectives on NBCDs and the scientific and regulatory considerations associated with complex drug categories.
The psychology of tooth wear
Authors: Ahmed Khaled E
Published: November 2012

Aim

To review the main psychological and mental conditions that are manifested dentally in the form of tooth wear. These conditions include depression, eating disorders, and alcohol and drug use disorders. The paper will also review the comorbidity of these conditions and the relevance of other medical conditions and lifestyle factors, such as gastroesophageal reflux disorder, smoking and diet, in the expression of tooth wear.

Conclusion

A holistic, multidisciplinary, healthcare approach is required in management of tooth wear patients with underlying mental health disorders. Dentists and Dental Care Professionals can have an important role in identifying these mental disorders through the observed tooth wear. They can also play a key role in monitoring patients’ response and compliance to medical treatment through the monitoring of tooth wear progression and expression.
Downscaling of species distribution models:  a hierarchical approach
Authors: Keil Petr , Belmaker Jonathan , Wilson Adam M. , Unitt Philip , Jetz Walter
Published: November 2012

Reliable methods to downscale species distributions from coarse to fine grain (equivalent to resolution or support) hold great potential benefit for ecology and conservation. Existing methods have been based on partially unrealistic assumptions and yield mixed results.

Here, we introduce a novel and simple approach for downscaling species distribution models based on a hierarchicalBayesian modelling (HBM) framework. Our approach treats putative (unknown) fine‐grain presences/absences as latent variables, which are modelled as a function of observed fine‐grain environmental variables and constrained by observed coarse‐grain presences/absences using logistic regression. The aim is to produce downscaled fine‐grain probabilities of species occurrence that (1) closely resemble the probabilities produced by a logistic model parameterized with the observed fine‐grain data (the ‘reference model’) and (2) are improvements over conventional downscaling methods. We additionally test how fine‐grain occupancy based on power‐law scale‐area relationships modifies the downscaling results. We test our approach on 127 bird species from the San Diego breeding atlas data surveyed at 5 km grain.

TheHBMapproach provides unbiased fine‐grain probabilities of occurrence whilst the conventional methods (direct approach, point sampling) consistently over‐predict occurrence probabilities. Incorporation of the downscaled occupancy further improves reliability of the models, but only in cases when the fine‐grain occupancy is estimated accurately.

Summing predictions across grid cells and species,HBMs provide better estimates of fine‐grain species richness than conventional methods. They also provide better estimates of fine‐grain occupancy (prevalence).

The presentedHBM‐based downscaling approach offers improved predictions of fine‐grain presence and absence compared with existing methods. The combination of theBayesian approach with key macroecological relationships (specifically, the scale‐area relationship) offers a promising general basis for downscaling distributions that may be extended, for example, using generalized linear or additive models. These approaches enable integrative predictions of spatial biodiversity patterns at fine grains.
Reaction Pathway of Combustion Synthesis of Ti5Si3 in Cu–Ti–Si System
Authors: Wang Hui–Yuan , Lü Si–Jie , Xiao Wei , Liu Guo–Jun , Wang Jin–Guo , Jiang Qi–Chuan
Published: November 2012

The reaction pathway of combustion synthesis (CS) of Ti5Si3 in Cu–Ti–Si system was explored through a delicate microstructure and phase analysis on the resultant products during differential thermal analysis (DTA). The formation of Cu–Si eutectic liquids plays a key role in the reaction pathway, which provides easy route for reactant transfer and accelerates the occurrence of complete reaction. Cu initially reacted with Si to form Cu3Si by a solid‐state diffusion reaction, which further reacted with Cu to form Cu–Si liquids at the eutectic point of ~802°C; then Ti was dissolved into the surrounding Cu–Si liquids and led to the formation of Cu–Ti–Si ternary liquids; finally, Ti5Si3 was precipitated out of the saturated liquids by a solution–reaction–precipitation mechanism. The reaction pathway in CS of titanium silicide (Ti5Si3) could be described briefly as: Cu(s) + Ti(s) + Si(s)→Cu3Si(s) + Ti(s) + Si(s)→(Cu–Si)(l) + Ti(s)→(Cu–Ti–Si)(l)→Cu(l) + Ti5Si3(s).
Compressive Behavior of Ti3AlC2 and Ti3Al0.8Sn0.2C2MAX Phases at Room Temperature
Authors: Bei G‐P. , Laplanche G. , Gauthier‐Brunet V. , Bonneville J. , Dubois S.
Published: November 2012

In this study, we report on the compressive behavior of Ti3AlC2 and Ti3Al0.8Sn0.2C2 MAX phases at room temperature. We found that these two phases could be classified as Kinking Nonlinear Elastic (KNE) solids. The cyclic compressive stress–strain loops for Ti3AlC2 and Ti3Al0.8Sn0.2C2 are typical hysteretic and fully reversible. At failure, both compositions fracture in shear with maximum stresses of 545 MPa for Ti3AlC2 and 839 MPa for Ti3Al0.8Sn0.2C2. Consequently, the macroshear stresses for failure, τc, are 185 MPa and 242 MPa for Ti3AlC2 and Ti3Al0.8Sn0.2C2, respectively. In addition to the grain size effects, the presence of a ductile TixAly intermetallic distributed in the grain boundaries plays an important role in the enhancement of the ultimate compressive and macroshear stresses for Ti3Al0.8Sn0.2C2. SEM observations reveal that these two MAX phases exhibit crack deflections, intragranular fractures, kink band formation and delaminations, grain push‐in and pull‐out.
Benefits of fibre retention osseous resective surgery in the treatment of shallow infrabony defects. A double‐blind, randomized, clinical trial describing clinical, radiographic and patient‐reported outcomes
Authors: Cairo Francesco , Carnevale Gianfranco , Nieri Michele , Mervelt Jana , Cincinelli Sandro , Martinolli Chiara , Pini‐Prato Giovan Paolo , Tonetti Maurizio S.
Published: November 2012

Background

The aim of this randomized clinical trial was to evaluate the efficacy of Apically Positioned Flap with Fibre Retention Osseous Resective Surgery (FibReORS) or Osseous Resective Surgery (ORS) to treat periodontal pockets associated with infrabony defect ≤3 mm at posterior natural teeth.

Material and methods

Thirty patients with chronic periodontitis showing persistent periodontal pockets after cause‐related therapy were enrolled; 15 patients were randomly assigned to FibReORS (test group) and 15 to ORS (control group). Measurements were performed by a blind and calibrated examiner. Outcome measures included intra‐operative and post‐operative morbidity and root sensitivity, 1‐year probing depth (PD), gingival recession (Rec) and radiographic bone changes.

Results

No differences in clinical and bone defect parameters were observed at baseline. Marginal bone resection was reduced by 0.9–1.6 mm in the FibReORS group. ORS was associated with patient perception of greater surgical hardship (p = 0.0264), higher 1‐week pain experience (p = 0.0001) and greater dental hypersensitivity (p = 0.0002). After 1 year, shallow, maintainable PD with no difference between the two procedures (p = 0.3707) was obtained. FibReORS was associated with less final Rec (p < 0.0001) and less radiographic bone loss (p < 0.0001) than ORS. Dental hypersensitivity remained significantly higher in the ORS group (p = 0.0024).

Conclusion

FibReORS was similarly effective as ORS for PD reduction with less final Rec and patient morbidity.
Effect of ephedrine on intubating conditions created by propofol and rocuronium: a meta‐analysis
Authors: Sun Rao , Tian Jin Hui , Li Lun , Tian Hong Liang , Jia Wen Qin , Yang Ke Hu , Cao Nong
Published: November 2012

Objective To evaluate the effect of ephedrine on intubation conditions (ICs) one minute after anesthesia induction using propofol and rocuronium.

Methods: PubMed, EMbase, The Cochrane Library, ISI Web of Knowledge, Chinese Biomedical Literature Database, Google Scholar, and other databases were searched from inception to September 2012 to collect relevant randomized clinical trials (RCTs). We evaluated the risk of bias of the included studies by the Cochrane Collaboration's risk of bias tool and analyzed the data using RevMan 5.1. As the outcomes, excellent ICs, clinically acceptable ICs and side effects were evaluated with risk ratios (RRs).

Results: Five RCTs involving 396 patients were identified. The results of the meta‐analysis demonstrated that ephedrine increased the rate of excellent ICs (RR = 2.40, 95% CI 1.89 to 3.05), but had no effects on the rate of clinically acceptable ICs (RR = 1.15, 95% CI 0.93 to 1.42) and the incidence of side effects (RR = 2.00, 95% CI 0.19 to 21.36). Besides, the results of subgroup analysis showed that both low dose and high dose of ephedrine increased the rate of excellent ICs, but only low dose increased the rate of clinically acceptable ICs. The results of sensitive analysis showed that both favored ephedrine (excellent ICs: RR = 2.54, 95% CI 1.69 to 3.83; clinically acceptable ICs: RR = 1.21, 95% CI 1.07 to 1.38).

Conclusion: Ephedrine, without extra side effects, created superior ICs one minute after anesthesia induction using propofol and rocuronium, and low dose (i.e., 70–100 μg/kg) is recommended as the possible optimal dose.
Electrophysiological Properties of the Microstome and Macrostome Morph of the Polymorphic Ciliate Tetrahymena vorax
Authors: Grønlien Heidi K. , Bruskeland Guttorm E. , Jansen Anne K. , Sand Olav
Published: November 2012

Polymorphic ciliates, like Tetrahymena vorax, optimize food utilization by altering between different body shapes and behaviours. Microstome T. vorax feeds on bacteria, organic particles, and solutes, whereas the larger macrostome cells are predators consuming other ciliates. We have used current clamp and discontinuous single electrode voltage clamp to compare electrophysiological properties of these morphs. The resting membrane potential was approximately −30 mV in both morphs. The input resistance and capacitance of microstomes were approximately 350 MΩ and 105 pF, whereas the corresponding values for the macrostomes were 210 MΩ and 230 pF, reflecting the larger cell size. Depolarizing current injections elicited regenerative Ca2+ spikes with a maximum rate of rise of 7.5 Vs−1 in microstome and 4.7 Vs−1 in macrostome cells. Depolarizing voltage steps from a holding potential of −40 mV induced an inward Ca2+ ‐current (Ica) peaking at −10 mV, reaching approximately the same value in microstome (−1.4 nA) and macrostome cells (−1.2 nA). Because the number of ciliary rows is the same in microstome and macrostome cells, the similar size of ICa in these morphs supports the notion that the voltage‐gated Ca2+ channels in ciliates are located in the ciliary membrane. In both morphs, hyperpolarizing voltage steps revealed inward membrane rectification that persisted in Na+‐free solution and was only partially inhibited by extracellular Cs+. The inward rectification was completely blocked by replacing Ca2+ with Co2+ or Ba2+ in the recording solution, and is probably due to Ca2+ ‐activated inward K+ current secondary to Ca2+ influx through channels activated by hyperpolarization.
Phytophthora infestans Field Isolates from Gansu Province, China are Genetically Highly Diverse and Show a High Frequency of Self Fertility
Authors: Han Miao , Liu Gang , Li Ji‐Ping , Govers Francine , Zhu Xiao‐Qiong , Shen Chong‐Yao , Guo Li‐Yun
Published: November 2012

The genetic diversity of 85 isolates of Phytophthora infestans collected in 2007 from Gansu province in China was determined and compared with 21 isolates collected before 2004. Among them, 70 belonged to the A1 mating type and 15 were self‐fertile (SF). The mitochondrial DNA haplotypes revealed both Ia (25%) and IIa (75%) haplotypes. Metalaxyl resistance occurred with high frequency (54%) in Gansu. Simple sequence repeat (SSR) genotyping revealed 26 genotypes (13 from the Tianshui region) among the 85 isolates, and 18 genotypes among the 21 isolates collected before 2004, without overlap in genotypes detected in the two groups. Cluster analysis showed clear subdivisions within the different mating type isolates. Among Gansu's isolates, Nei's and Shannon's diversity indices were highest in isolates collected in Tianshui where both A1 and SF isolates were found. Analysis of molecular variance of isolates from Gansu indicated that 51% and 49% of the variance was explained by within‐area and among‐area variance, respectively. The results suggest that the occurrence of SF isolates increases the risk of sexual reproduction, the formation of oospore as initial inocula in the field, and affects the genotypic diversity in the population.
Hepatitis B virus exposure and vaccination in a cohort of people who inject drugs: What has been the impact of targeted free vaccination?
Authors: Winter Rebecca J , Dietze Paul M , Gouillou Maelenn , Hellard Margaret E , Robinson Priscilla , Aitken Campbell K
Published: November 2012

Background and Aim

Forty percent of new hepatitis B virus (HBV) infections in Australia occur in people who inject drugs (PWID); long‐term infection carries the risk of serious liver disease. HBV incidence among Australian PWID has not been measured since the advent of targeted (2001) and adolescent school‐based “catch‐up” (1998) vaccination programs. We measured HBV incidence and prevalence in a cohort of PWID in Melbourne, Australia and examined demographic and behavioral correlates of exposure and vaccination.

Methods

Community‐recruited PWID were surveyed about blood‐borne virus risk behaviors and their sera tested for HBV markers approximately three‐monthly over three years. Incidence was assessed using prospectively collected data. A cross‐sectional design was used to examine prevalence of HBV exposure and vaccination at baseline. Poisson regression was used to identify correlates of HBV exposure and vaccination.

Results

At baseline, 33.1% of participants (114/344) had been vaccinated against HBV, 40.4% (139/344) had been exposed (previously or currently infected), and 26.5% (91/344) were susceptible. HBV incidence was 15.7 per 100 person‐years. Independent associations with HBV exposure included female gender, South‐East Asian ethnicity, drug treatment in the past three months, injecting in prison, and prior exposure to hepatitis C virus. Independent associations with vaccination included being ≤ 25 years old, reporting HBV vaccination, and never having been to prison.

Conclusions

HBV infection continues at high incidence among Australian PWID despite the introduction of free vaccination programs. Innovative methods are needed to encourage PWID to complete HBV vaccination.
Geriatrics and the Triple Aim: Defining Preventable Hospitalizations in the Long‐Term Care Population
Authors: Ouslander Joseph G. , Maslow Katie
Published: November 2012

Reducing preventable hospitalizations is fundamental to the “triple aim” of improving care, improving health, and reducing costs. New federal government initiatives that create strong pressure to reduce such hospitalizations are being or will soon be implemented. These initiatives use quality measures to define which hospitalizations are preventable. Reducing hospitalizations could greatly benefit frail and chronically ill adults and older people who receive long‐term care (LTC) because they often experience negative effects of hospitalization, including hospital‐acquired conditions, morbidity, and loss of functional abilities. Conversely, reducing hospitalizations could mean that some people will not receive hospital care they need, especially if the selected measures do not adequately define hospitalizations that can be prevented without jeopardizing the person's health and safety. An extensive literature search identified 250 measures of preventable hospitalizations, but the measures have not been validated in the LTC population and generally do not account for comorbidity or the capacity of various LTC settings to provide the required care without hospitalization. Additional efforts are needed to develop measures that accurately differentiate preventable from necessary hospitalizations for the LTC population, are transparent and fair to providers, and minimize the potential for gaming and unintended consequences. As the new initiatives take effect, it is critical to monitor their effect and to develop and disseminate training and resources to support the many community‐ and institution‐based healthcare professionals and emergency department staff involved in decisions about hospitalization for this population.
Effects of an Advanced Practice Nurse In‐Home Health Consultation Program for Community‐Dwelling Persons Aged 80 and Older
Authors: Imhof Lorenz , Naef Rahel , Wallhagen Margaret I. , Schwarz Jürg , Mahrer‐Imhof Romy
Published: November 2012

Objectives

To evaluate the effects of an advanced practice nurse (APN) in‐home health consultation program (HCP) on quality of life, health indicators (falls, acute events), and healthcare utilization.

Design

Randomized clinical trial.

Setting

One urban area in the German‐speaking part of Switzerland.

Participants

Four hundred sixty‐one community‐dwelling individuals aged 80 and older (mean age 85, 72.7% female, all Caucasian) participated in the intervention (n = 231) and control (n = 230) groups.

Intervention

After a comprehensive geriatric assessment, participants were randomly assigned to the 9‐month HCP with four in‐home visits and three phone calls from APNs or to a control group with standard care with no intervention.

Measurements

The primary outcome was quality of life at 3, 6, and 9 months. Secondary outcomes were incidence of falls, acute events due to health problems, and healthcare utilization measured for 3‐month periods at 3, 6, and 9 months.

Results

The intervention and control groups did not differ significantly on any dimension of the World Health Organization Quality of Life questionnaire but differed significantly over 9 months in self‐reported acute events (116 vs 168, relative risk (RR) = 0.70, P = .001), falls (74 vs 101, RR = 0.71, P = .003), consequences of falls (63.1% vs 78.7%, chi‐square = 7.39, P = .007), and hospitalizations (47 vs 68, RR = .70, P = .03).

Conclusion

The in‐home HCP provided by APNs and guided by the principles of health promotion, empowerment, partnership, and family‐centeredness, can be effective in reducing adverse health outcomes such as falls, acute events, and hospitalizations.
Psychometric properties of the structured Satisfaction Questionnaire with Gastrostomy Feeding (SAGA‐8) for caregivers of children with gastrostomy tube nutritional support
Authors: Martínez‐Costa C. , Calderón C. , Pedrón‐Giner C. , Borraz S. , Gómez‐López L.
Published: November 2012

Background

To analyse the psychometric properties of the structured Satisfaction Questionnaire with Gastrostomy Feeding (SAGA‐8) in parents/caregivers of children with home enteral nutrition (HEN) by gastrostomy tube (GT).

Methods

Eighty‐six caregivers (mothers) of paediatric patients with HEN by GT were recruited. Patients suffered from neurological disease (61.6%) and other chronic diseases. The SAGA‐8 scale, a structured questionnaire to explore satisfaction with HEN by GT, and the Caregiver Burden Inventory (Zarit) were completed. The discriminating power of each of the SAGA‐8 items, internal consistency and external validity were evaluated. An exploratory factor analysis and Kaiser–Meyer–Olkin (KMO) was performed as well.

Results

Eighty‐four percent of the families expressed high satisfaction with GT feeding. All eight items of SAGA‐8 gave additional information. The exploratory factor analysis revealed that a significant part of the items’ variability could be explained by two independent factors: Factor 1 (direct benefit), which compiled the variables related to the perception of children's overall improvement by GT feeding; Factor 2 (indirect benefit), which grouped the variables related to a decrease in respiratory infections, feeding time and institutional support. Results from KMO (0.628) indicated the high adequacy of the items assessed in the factorial analysis. Moreover, the questionnaire presented high internal consistency (0.76), and the external validation analysis confirmed the correlation between SAGA‐8 and Zarit, thereby emphasising the approptiate use of the SAGA‐8 to detect carers’ satisfaction.

Conclusions

The SAGA‐8 questionnaire has a high discriminatory power to assess the degree of satisfaction experienced by parents/caregivers of children with HEN by GT and, subsequently, the patients’ wellbeing.