bluuebunny/crossref_metadata_2025 huggingface dataset:
Detection of improperly positioned feeding tubes
Authors: Metheny Norma A. , Aud Myra A. , Ignatavicius Donna D.
Published: September 2009

This article describes potentially disastrous outcomes associated with failure to determine when nasally inserted feeding tubes are improperly positioned. It also presents information that is important for risk managers to consider when developing protocols for testing placement of newly inserted feeding tubes.
Y2K, embedded chips, casualty hazards and due diligence in healthcare risk management
Authors: Childers J. Richard
Published: September 2009

Y2K raises challenges for healthcare risk managers that go beyond information technology issues. This article explains that (1) too little public attention is being paid to equipment which may well have Y2K faults and (2) few standards have been articulated for dealing with problems. Healthcare risk managers therefore must return to basic due diligence principles and develop their own standards and protocols. The article explains how to do due diligence and outlines suggested steps for dealing with the non‐information technology side of compliance due diligence.
Physicians' cognitive errors and their liability consequences
Authors: Bartlett Edward E.
Published: September 2009

Diagnostic errors account for one‐fifth of lawsuits against hospitals and physicians. Of greatest concern is the rising severity of lawsuits alleging diagnostic errors—over a 12‐year period the average indemnity for these claims has risen by 258%. The hospital departments most affected are the emergency room, obstetrics, radiology and pathology. This article probes the structure of diagnostic errors and makes recommendations how to reduce the frequency and severity of these claims.
High reliability perinatal units: An approach to the prevention of patient injury and medical malpractice claims
Authors: Knox G. Eric , Simpson Kathleen Rice , Garite Thomas J.
Published: September 2009

Perinatal units differ in their ability to prevent patient injury and medical malpractice litigation. Obstetrical units with favorable performance are distinguished by common organizational and clinical features. Organizationally, they resemble what behavioral scientists define as “high‐reliability organizations” (i.e., the ability to operate technologically complex systems essentially without error over long periods). Clinically, practices are based on nationally recognized guidelines and/or an operational philosophy of “safety first.” These organizational and clinical features are described so that physicians, nurses, and administrators might view their own clinical environments in the context of this perspective.
Sexual harassment: An ominous liability for healthcare professionals
Authors: West John C.
Published: September 2009

Sexual harassment can arise in virtually any employment setting. Healthcare facilities must be careful to avoid sexual harassment of their employees both fry other employees and by the myriad other persons who may come into contact with their employees in the workplace. Much of what makes sexual harassment an actionable offense are the perceptions of the victim. Employers should take a proactive approach to preventing, detecting and correcting instances of harassment.
Genetic testing: Do healthcare professionals have a duty to tell a patient's family members that they may be at risk?
Authors: Marta Mary R.
Published: September 2009

The author describes the healthcare professional's dilemma of keeping a patient's genetic information confidential. Provided are case law, commentary and policy developments addressing confidentiality of patient information as weighed against third parties' needs to know genetic information regarding their family members.
Risk management and pollution prevention: Thinking outside the box
Authors: Brannan Wayne L. , Carstarphen Kristin , Lightburn Jaconda , Black Aileen
Published: September 2009

The Medical University of South Carolina's risk management department received a 12‐month grant from South Carolina's General Assembly “Hazardous Waste Management Research Fund” for the purpose of identifying pollution prevention opportunities within South Carolina healthcare facilities. One hundred and one healthcare facilities were invited to participate in this study. Facilities ranged in size from zero‐licensed beds (clinics) to more than 300 beds. Seventy‐six South Carolina facilities (75%) participated in this project.
Uterine rupture during trial of labor: Risk management recommendations
Authors: Schnitker Korliss Ann
Published: September 2009

In the early 1990s, the cesarean section rate in the United States reached a plateau of approximately 24% of all births. Today, for a variety of reasons, significant efforts are under way to decrease this cesarean rate of almost one in four births. One area of focus is on efforts to decrease the number of “repeat” cesarean sections. Accordingly, the practice of vaginal birth after cesarean section (VBAC) has become commonplace in obstetrical units across the country. Experience now suggests that a history of cesarean delivery increases the risks for mother and child in future deliveries. One of these risks is uterine rupture. This article examines related trends, reviews guidelines promulgated by professional organizations and related literature, and offers risk management recommendations for mitigating the risks of VBAC.
Software facilitation of root cause analysis in healthcare organizations
Authors: Hirsch Kenneth A. , Wallace Dennis T.
Published: September 2009

Theoretical gains are possible through the use of software to facilitate root cause analysis in healthcare organizations. Critical features that should be possessed by root cause analysis software are identified, providing one means by which to evaluate such products.
Now that we own it, what do i do with it?: Identifying risk management issues in acquired physician practices. Part II
Authors: Mouse‐Young Donna
Published: September 2009

Healthcare risk managers are responsible for identifying and managing the unique exposures of the physicians office practice. This article addresses liability exposures that arise when dealing with medical records and documentation, medication management, and office systems for patient follow‐up.
Risk management issues in the reuse of single‐use medical devices
Authors: West John C.
Published: September 2009

The future of the practice of reusing single‐use medical devices is currently uncertain because the U.S. Food and Drug Administration is poised to promulgate regulations on the subject. This article deals with the risk issues associated with contracting with an external vendor to perform this function under current FDA regulations and provides guidance for minimizing these risks.
Compliance with EMTALA: A guide for hospitals
Authors: Kendus Michele
Published: September 2009

This article presents the mandates of the Emergency Medical Labor and Treatment Act promulgated through the Department of Health and Human Services, and through the courts' interpretations. In addition, the conflict between statutory mandates and managed care requirements, and the unsettled issue of whether the statute applies to inpatient circumstances, are presented.
Pediatric anesthesia: A large problem in small people
Authors: Huntington Elizabeth A.
Published: September 2009

About 70 percent of all pediatric care is delivered in non‐pediatric hospitals. A variety of factors have prompted community hospitals to initiate or expand existing pediatric surgical services. These include changes in medical economics and the evolving payer system, urban sprawl, patient access demands, and better community availability of pediatric sub‐specialists. Moreover, some community hospitals are providing complex pediatric surgery or are operating on young infants — services that were once exclusively the domain of the tertiary pediatric provider. These recent demographic changes have raised concerns regarding the quality and safety of anesthesia services at these institutions.

This article discusses the unique characteristics of the pediatric surgical patient and the clinical risks associated with pediatric anesthesia. The authors offer strategies and recommendations for ensuring patient safety and managing credentialing and privileging issues.
Binding of phosphorylated peptides and inhibition of their interaction with disease‐relevant human proteins by synthetic metal‐chelate receptors
Authors: Riechers Alexander , Grauer Andreas , Ritter Stefan , Sperl Bianca , Berg Thorsten , König Burkhard
Published: September 2009

The modulation of biological signal transduction pathways by masking phosphorylated amino acid residues represents a viable route toward pharmacologic protein regulation. Binding of phosphorylated amino acid residues has been achieved with synthetic metal‐chelate receptors. The affinity and selectivity of such receptors can be enhanced if combined with a second binding site. We demonstrate this principle with a series of synthetic ditopic metal‐chelate receptors, which were synthesized and investigated for their binding affinity to phosphorylated short peptides under conditions of physiological pH. The compounds showing highest affinity were subsequently used to inhibit the interaction of the human STAT1 protein to a peptide derived from the interferon‐γ receptor, and between the checkpoint kinase Chk2 and its preferred binding motif. Two of the investigated ditopic synthetic receptors show a significant increase in inhibition activity. The results show that regulation of protein function by binding to phosphorylated amino acids is possible. The introduction of additional binding sites into the synthetic receptors increases their affinity, but the flexibility of the structures investigated so far prohibited stringent amino acid sequence selectivity in peptide binding. Copyright © 2009 John Wiley & Sons, Ltd.
A social identity perspective on leadership and employee creativity
Authors: Hirst Giles , van Dick Rolf , van Knippenberg Daan
Published: September 2009

This research uses a social identity analysis to predict employee creativity. We hypothesized that team identification leads to greater employee creative performance, mediated by the individual's creative effort. We hypothesized that leader inspirational motivation as well as leader team prototypicality would moderate the relationship between identification and creative effort. Consistent with these predictions, data based on 115 matched pairs of employee‐leader ratings in a research and development context showed an indirect relationship between team identification and creative performance mediated by creative effort. The analyses also confirmed the expected moderated relationships. Leader inspirational motivation enhanced the positive association between identification and creative effort, especially when leader prototypicality was high. We discuss the value of social identity analyses of employee creativity and of the integration of social identity and transformational leadership analyses. Copyright © 2009 John Wiley & Sons, Ltd.
Teleworker knowledge sharing and the role of altered relational and technological interactions
Authors: Golden Timothy D. , Raghuram Sumita
Published: September 2009

Given the growing importance and complexities of telework and the challenges associated with knowledge sharing, in this study we investigate teleworkers and their propensity to share knowledge. We do so by investigating if the relational qualities of teleworkers in the form of trust, interpersonal bond, and commitment, act to impact teleworker knowledge sharing. We also investigate how telework's altered spatial and technical interactions shape knowledge sharing, by testing the contingent role of technology support, face‐to‐face interactions, and electronic tool use. Results using matched data from 226 teleworkers support the role of teleworker trust, interpersonal bond, and commitment in predicting knowledge sharing. Moreover, the impact of trust on knowledge sharing is found to be moderated by technology support, face‐to‐face interactions, and use of electronic tools, whereas the impact of commitment is contingent upon the use of electronic tools. Copyright © 2009 John Wiley & Sons, Ltd.
The role of affective experience in work motivation: Test of a conceptual model
Authors: Seo Myeong‐Gu , Bartunek Jean M. , Barrett Lisa Feldman
Published: September 2009

The purpose of this paper was to contribute to understanding of the crucial role of emotion in work motivation by testing a conceptual model developed by Seo, Barrett, and Bartunek (2004) that predicted the impacts of core affect on three behavioral outcomes of work motivation, generative‐defensive orientation, effort, and persistence. We tested the model using an Internet‐based investment simulation combined with an experience sampling procedure. Consistent with the predictions of the model, pleasantness was positively related to all three of the predicted indices. For the most part, these effects occurred indirectly via its relationships with expectancy, valence, and progress judgment components. Also as predicted by the model, activation was directly and positively related to effort. Copyright © 2009 John Wiley & Sons, Ltd.
Differentiation of eight tea (Camellia sinensis) cultivars in China by elemental fingerprint of their leaves
Authors: Chen Yingxu , Yu Mingge , Xu Jie , Chen Xincai , Shi Jiyan
Published: September 2009

BACKGROUND: Tea is an infusion made from dried leaves of tea (Camellia sinensis) and can be a good dietary source of essential trace metals for humans. Therefore, it is necessary to consider variations in element content of tea leaves among tea cultivars. Thus, elemental fingerprint techniques, based on elemental contents (Al, B, Ca, Cd, Co, Cr, Cu, Fe, K, Mg, Mn, Na, P, Pb, and Zn) determined by inductively coupled plasma atomic emission spectrometry (ICP‐AES) and multivariate statistical analysis, have been used to differentiate eight tea cultivars.

RESULTS: The ranges of element concentrations in leaves of the eight cultivars were in good agreement with those obtained in previous studies and the level of most elements in tea leaves was significantly different among cultivars. The classifications of eight tea cultivars were 100% accurate in total by principal component analysis (PCA), hierarchical cluster analysis (HCA), linear discriminant analysis (LDA), and back‐propagation neural network (BPNN) analysis.

CONCLUSION: Each cultivar presented a distinctive element fingerprint and the elements in tea leaves can be significant predictors in differentiating tea cultivars. Copyright © 2009 Society of Chemical Industry
Leading ethically at the intersection where worlds collide
Authors: Fluker Walter Earl
Published: September 2009

When leaders ask people to change, they must expect resistance at the intersection. Leaders must discern, deliberate and decide on the fitting response to challenges that arise at the intersection. To discern, deliberate and decide effectively, leaders must re‐examine their core values and assumptions about identity (character); clarify relationships with others in their environment (civility); and maintain strong ties with their primary network of discourse and practice (community).
Aberrant protein expression is associated with decreased developmental potential in porcine cumulus–oocyte complexes
Authors: Paczkowski Melissa , Krisher Rebecca
Published: September 2009

Oocyte developmental competence is progressively obtained during pubertal development in females. Poor developmental potential in oocytes derived from prepubertal females suggests that essential processes required for oocyte development have not been fulfilled. The objective of this experiment was to analyze the protein profiles of porcine cumulus–oocyte complexes (COC) derived from cyclic and prepubertal females to identify alterations in protein abundance that correlate with developmental potential. COC complexes, aspirated from prepubertal and cyclic ovaries, were pooled into three replicates of 400 COCs each per treatment in ∼100 µl SOF‐HEPES medium. Protein samples were extracted and analyzed by two‐dimensional differential in gel electrophoresis (2D‐DIGE). Over 1,600 proteins were resolved on each of the three replicate gels. Sixteen protein spots were identified by mass spectrometry, representing 14 unique, differentially expressed proteins (volume ratio greater than 1.3). Glutathione‐S‐transferase and pyruvate kinase 3 were more abundant in COCs derived from cyclic females, whereas soluble epoxide hydrolase and transferrin were more abundant in prepubertal derived COCs. Abundance of several glycolytic enzymes (enolase 1, pyruvate kinase 3, and phosphoglycerate kinase) was increased in COCs derived from cyclic females, suggesting glucose metabolism is decreased in prepubertal derived COCs. We conclude that the abundance of proteins involved in metabolism and oxidative stress regulation is significantly altered in prepubertal derived COCs and may play a role in the mechanisms resulting in developmental competence. Mol. Reprod. Dev. 77: 51–58, 2010. © 2009 Wiley‐Liss, Inc.
Sensory information, instruction in a coping strategy, and recovery from surgery
Authors: Johnson Jean E. , Rice Virginia H. , Fuller Sarah S. , Endress M. Patricia
Published: September 2009

A study of 81 cholecystectomy patients evaluated the relative contributions of instruction in a specific coping strategy and two types of informational interventions on subjective and objective indicators of recovery from surgery. The two experimental factors in the 2 × 3 × 2 factorial design were instruction in coping activities (present or absent) and information (description of typical sensations, description of typical events, or no information). The nonexperimental factor was preoperative fear (high or low). Self‐report of moods, severity of pain, and bother of ambulation were the subjective indicators. Analgesics received, amount of ambulation, length of postoperative hospitalization, and time after hospital discharge before patients ventured from their homes were the objective indicators. Instruction in coping activities, description of sensations, and description of events all were found to dampen negative moods postoperatively for patients relatively fearful before surgery. Description of typical sensations significantly reduced the length of postoperative hospitalization and time after hospital discharge before patients ventured from their homes. Another sutdy of 68 herniorrhaphy patients, using the same design, resulted in only minor effects for any of the three interventions. Explanations for the different results between studies are offered.
Patient encounters by primary care nurse students
Authors: Chen Shu‐Pi C. , Barkauskas Violet H. , Ohlson Virginia M. , Chen Edwin H.
Published: September 2009

Student‐patient encounter data were systematically documented. Health problems identified by primary care nurse students were classified and analyzed. Primary health care practicums in three areas of specialization were obstetric‐gynecologic, general adult, and pediatric services. A student‐patient encounter form was constructed to record encounter data. A total of 1,689 encounter forms were completed by 30 nurse students enrolled in primary health care practicums during the years 1972–75. The identified health problems were classified by the International Classification of Diseases Adapted for Use in the United States. The results indicated: (a) the focus of primary health care for obstetric‐gynecologic and pediatric patients was on health maintenance, whereas the focus for general adult patients was on illness care; (b) symptoms and ill‐defined health conditions were frequently encountered by the students, particularly with general adult patients; (c) a cluster of health problems was identified for each of the three areas of specialization. The findings seemed to justify the need to develop a health problem classification system for primary health care.
Sex differences in sick role behavior during hospitalization after open heart surgery
Authors: Brown Julia S. , Buchanan Debra , Hsu Lee‐Nah
Published: September 2009

The proposition examined here is that there are sex differences in the enactment of the sick role. Specifically, in comparing the recovery of 50 male and 50 female patients following open heart surgery, it was hypothesized that male patients would (a) be transferred from the cardiac recovery room earlier, (b) be discharged from the hospital earlier, (c) achieve independence in self‐care and in ambulation earlier, and (d) receive fewer pain medications and tranquilizers. Support was found only for the hypotheses of earlier hospital discharge and earlier self‐care. The patient's physical condition—indicated by type of surgery, time in operating room, time on bypass, and units of blood—was related to time in recovery room and length of postoperative hospitalization. Of the variables examined, age emerged as the most powerful predictor of medication dosage, with older patients receiving significantly fewer analgesics and tranquilizers. The following conclusions were reached: (a) the salience of sex role expectations for sick role behavior varies with the particular measure considered and (b) the overall significance of sex role expectations in determining sick role behavior was slight for this sample of seriously ill patients.
Marked improvement in glycaemic control in a type 2 diabetes patient following a liver transplant for cirrhotic steatohepatitis
Authors: Parker V , Smith M
Published: September 2009

We present the case of a 58‐year‐old woman with poorly controlled, insulin‐treated type 2 diabetes mellitus who underwent a liver transplant for cirrhosis due to non‐alcoholic fatty liver disease complicated by encephalopathy and portal hypertension. Within four months of surgery she exhibited marked improvement in insulin sensitivity, as evidenced by reduced exogenous insulin requirement, with cessation of insulin therapy at 11 months and a consequent dramatic improvement in glycaemic control, eventually achieving an optimal glycosylated haemoglobin concentration on no specific diabetes treatment aside from dietary advice. This was despite a standard regimen of immunosuppressive treatments including prednisolone, tacrolimus and sirolimus which all have the propensity to induce insulin resistance. This case provides an interesting insight into the cause and effect of insulin resistance in the setting of non‐alcoholic fatty liver disease. Copyright ©2009 John Wiley & Sons.
Acquired somatic mutations in the microsatellite DNA, in children with bronchial asthma
Authors: Thomou Christina , Paraskakis Emmanouil , Neofytou Eirini , Kalmanti Maria , Siafakas Nikolaos M. , Tzortzaki Eleni G.
Published: September 2009

Objectives

High incidence of genetic alterations at the microsatellite (MS) DNA level has been reported in asthmatic adults.

Working Hypothesis

The aim of this study was to investigate whether microsatellite instability (MSI) and loss of heterozygosity (LOH) were detectable phenomena in children with asthma.

Methodology

DNA was extracted from sputum and blood cells of 27 children (10.8 ± 2.5 years) with mild to moderate asthma, and from 8 healthy, never‐smoked young adults. Fourteen polymorphic MS markers, namely D5S207, D5S820, D5S637, D6S344, D6S2223, D6S263, SGC35231, D11S1253, D11S1337, D11S97, USAT24G1, D13S273, D14S258, and D14S292, located on chromosomes (chr) 5q, 6p, 11q, 13q, and 14q were used to assess MSI and LOH.

Results

None of the healthy subjects exhibited any genetic alteration. Five out of 27 children (18.5%) exhibited MSI or LOH in sputum cells versus blood samples from which 3 in the marker USAT24G1 (chr 13q14.1), 1 in the marker D14S258 (chr 14q23‐q24.3), and 1 in the marker D5S637 (chr 5q12‐q13). Compared to a previous study, with asthmatic adults, whereas MSI and/or LOH was exhibited in ∼60% of the cases, the current study reported <20% of genetic alterations, at the MS DNA, in asthmatic children.

Conclusions

Our results showed that genetic instability in the MS DNA, is present in asthmatic children, but to less extent than in adult asthmatics from previous studies. These findings may support the hypothesis that somatic mutations may be early acquired in the natural course of asthma and could represent another contributor to the molecular pathogenesis of the disease. However, further studies are needed to clarify this hypothesis. Pediatr Pulmonol. ©2009 Wiley‐Liss, Inc.
Quantum bit‐error rate in plug‐and‐play quantum key distribution systems caused by axial magnetic fields
Authors: Mecozzi A. , Antonelli C. , Brodsky M.
Published: September 2009

We provide a formalism for the polarization evolution in plug and play quantum key distribution systems, and adapt this formalism for the aggregate Faraday effect in fibers arising from an axial magnetic field. We show the implication of such field on detector readings, and offer a formal expression for quantum bit‐error rate (QBER) for these systems. Assuming a Maxwellian statistics for the Faraday angle, as predicted by recent analytical and numerical studies, we finally calculate the average QBER.
Innovation search of new ventures in a technology cluster: the role of ties with service intermediaries
Authors: Zhang Yan , Li Haiyang
Published: September 2009

In this study, we examine the relationships between new ventures' ties with service intermediaries (i.e., technology service firms, accounting and financial service firms, law firms, and talent search firms) and their product innovation in the context of a technology cluster. Because service intermediaries sit at the intersection of many firms, organizations and industries, they maintain extensive networks in a cluster. We propose that new ventures' ties with service intermediaries enable the ventures to plug into these networks and contribute to the ventures' product innovation by broadening the scope of their external innovation search and reducing their search cost. Moreover, we argue that the positive relationships between new ventures' ties with service intermediaries and their product innovation will become stronger when search in the networks in the cluster is more important to the ventures' product innovation. Based upon a sample of new ventures in a technology cluster in China, our results support these arguments. Copyright © 2009 John Wiley & Sons, Ltd.
The sliding isolation pendulum – an improved recentring bridge bearing
Authors: Braun Christian
Published: September 2009

Sliding isolation pendulum bearings, known as seismic isolators, with adaptations for the service condition, represent improved recentring bridge bearings. They are an attractive alternative to elastomeric bearings for the support of structures on recentring bearings, which lead to a better distribution of horizontal loads as well as to a reduction in constraints. In combination with a special sliding material and characterized by long life and high loadbearing capacity, sliding isolation pendulum bearings have small dimensions as well as the capability a exact presetting and for horizontal stiffness that is independent of load capacity, change of material characteristics due to temperature, ageing and manufacture. Further, the requirements in terms of serviceability of a bridge bearing are upheld.
A micromechanical model for martensitic phase‐transformations in shape‐memory alloys based on energy‐relaxation
Authors: Bartel T. , Hackl K.
Published: September 2009

We develop a micromechanical model for single‐crystalline materials undergoing diffusionless solid‐to‐solid phase transitions. It is based on the specification of laminated microstructures on the materials' microscale and hence is designed to approximate the rank‐1‐convex hull of the underlying energy‐density for the phase‐mixture. In order to capture the hysteretic behavior of such materials like shape‐memory‐alloys we also account for dissipation by means of evolution equations for the inelastic internal variables. In this context, we derive different evolution‐laws from inelastic potentials via least‐action principles. Several material‐point computations emphasize the characteristics of the presented model.
Numerical study of the effect of Navier slip on the driven cavity flow
Authors: He Q. , Wang X.‐P.
Published: September 2009

We study the driven cavity flow using the Navier slip boundary condition. Our results have shown that the Navier slip boundary condition removes the corner singularity induced by the no‐slip boundary condition. In the low Reynolds number case, the behavior of the tangential stress is examined and the results are compared with the analytic results obtained in [14]. For the high Reynolds number, we study the effect of the slip on the critical Reynolds number for Hopf bifurcation. Our results show that the first Hopf bifurcation critical Reynolds number is increasing with slip length.
Rotation of a slender particle in a shear flow: influence of the rotary inertia and stability analysis
Authors: Altenbach H. , Brigadnov I. , Naumenko K.
Published: September 2009

The rotation of an inertialess ellipsoidal particle in a shear flow of a Newtonian fluid has been firstly analyzed by Jeffery [17]. He found that the particle rotates such that the end of its axis of symmetry describes a closed periodic orbit. In the special case of a slender particle the Jeffery solution predicts the particle alignment parallel to the streamlines. In a recent publication [3] it was shown that the orbits are no longer observable if the rotary inertia is taken into account. Furthermore, in the case of a slender particle the inertia may cause the jump over the equilibrium alignment. In this paper we address a detailed analysis of the slender particle behavior in the shear flow. We recall the constitutive equation for the hydrodynamic moment and formulate equations of rotary motion. For a special initial condition we reduce the problem to a single second‐order ordinary differential equation with respect to the angle of rotation about a fixed axis. The phase portrait of this equation illustrates different cases of the particle behavior depending on the initial conditions and the “inertia” parameter. They include the particle alignment to a semi‐stable equilibrium position, the non‐uniform rotation about a fixed axis as well as the quantization effect (the particle locates in the neighborhood of the first equilibrium point over a relatively long time and then rotates towards the next equilibrium point).
On the constraint problems of sleigh
Authors: Xu S.‐S. , Li S.‐M. , Berakdar J.
Published: September 2009

To assess the traditional solutions of the constraint problems of sleigh, we introduce a resistent torque acting on the knife blade. The derived solutions conform with experience whereas the traditional counter‐intuitive results follow from our findings as special cases when the resistent torque is very small or/and the length of the knife blade vanishes.
Ischemia of the lateral femoral cutaneous nerve during periacetabular osteotomy using Smith-Petersen approach
Authors: Kiyama Takahiko , Naito Masatoshi , Shiramizu Kei , Shinoda Tuyoshi , Maeyama Akira
Published: September 2009

Background

Lateral femoral cutaneous nerve (LFCN) injury is a common complication in the Smith-Petersen approach to the hip. This complication may be induced by neural ischemia or direct trauma during the procedure. The purpose of this study was to investigate the relationship between the neural ischemia of LFCN and postoperative sensory disturbance.

Materials and methods

Nineteen patients who underwent periacetabular osteotomy through the Smith-Petersen approach were investigated. To evaluate neural ischemia, we measured the blood flow of LFCN using a laser Doppler flowmetry. The measurements were performed before and after osteotomy at the point 1 cm distal from the lower border of the inguinal ligament. LFCN was retracted to the medial side during the procedure. There was no direct trauma to LFCN in all cases. Postoperative sensory disturbance was evaluated at 2 weeks, 3 months, and 1 year follow-up after surgery.

Results

After osteotomy, the blood flow of LFCN was decreased to 2.4 from 3.3 ml min−1 100 g−1 when compared with that before osteotomy (P < 0.01). Postoperatively, 14 of 19 patients had sensory disturbance at 2 weeks, 8 of 19 patients at 3 months, and 2 of 19 patients at 1 year follow-up. The blood flows of both patients who had persistent symptoms over 1 year after surgery had been decreased by more than 50% during operation.

Conclusions

Decrease of blood flow of LFCN by more than 50% seems to cause persistent symptoms after surgery through the Smith-Petersen approach even if direct trauma to the nerve is avoided. Excessive traction by retractors is thought to be the main cause of blood flow reduction.
Inborn errors of metabolism and motor disturbances in children
Authors: García‐Cazorla A. , Wolf N. I. , Serrano M. , Pérez‐Dueñas B. , Pineda M. , Campistol J. , Fernández‐Alvarez E. , Colomer J. , DiMauro S. , Hoffmann G. F.
Published: September 2009

Motor disturbances are very common in paediatric neurology. Often families can be reassured that these are just variants of normal development. However, abnormal movements can also be the hallmark of severe brain dysfunction of different and complex origins. This review concentrates on motor disturbances as frequent and important symptoms of inborn errors of metabolism. A structured diagnostic approach is developed taking into account age‐dependent physiological developments and pathophysiological responses of gross and fine motor functions. A series of investigations are presented with the primary aim of early diagnosis of treatable conditions. The correct recognition and differentiation of movement disorders (ataxia, rigid akinetic syndrome (‘parkinsonism’), dystonia, athetosis, tremor, and others), spasticity, and neuromuscular disorders, requires profound neurological expertise. A high level of suspicion and close interaction between paediatric neurologists and specialists in inborn errors of metabolism are indispensable to effectively and timely identify patients in whom motor disturbances are the presenting and/or main symptom of an inborn error.
Role of the Disease in the Psychological Impact of Pre‐Symptomatic Testing for SCA2 and FAP ATTRV30M: Experience with the Disease, Kinship and Gender of the Transmitting Parent
Authors: Paneque Milena , Lemos Carolina , Sousa Alda , Velázquez Luis , Fleming Manuela , Sequeiros Jorge
Published: September 2009

To identify possible factors affecting the psychological impact of pre‐symptomatic testing for spinocerebellar ataxia type 2 (SCA2) and familial amyloid polyneuropathy (FAP ATTRV30M), we studied (1) the effect of previous experience with the disease in the family, (2) kinship with the closest affected relative and (3) gender of affected parent, when adapting to test results; as well as (4) differences in the course of psychological wellbeing in 63 subjects (28 at‐risk for FAP ATTRV30M, and 35 at risk for SCA2), who pursued predictive testing for these diseases, in Cuba and in Portugal. Our research shows that individuals with little or no experience with the disease in their family exhibited more anxiety; at‐risk subjects for SCA2 or FAP ATTRV30M who had a first degree relative with the disease showed lower levels of anxiety and depression during pre‐symptomatic testing. Also those with an affected mother had lower levels of depression, either immediately, or one year after receipt of test results. Adaptation to pre‐symptomatic testing results differed for subjects at‐risk for the two different conditions. Unlike the FAP ATTRV30M families, carriers for SCA2 reported pathological levels of depression immediately after‐testing (3 weeks), although those levels had returned to normal levels at 6 months. Subjects at‐risk for FAP ATTRV30M tended to have less anxiety than those tested for SCA2, at the one‐year follow‐up. Overall, depression levels improved over time, while anxiety remained more constant. A longer awareness of the disease in the family, closer kinship, and a transmitting mother all lessened the impact of pre‐symptomatic testing, as expressed by the post‐test levels of anxiety and depression.
A Quick and Parallel Analytical Method Based on Quantum Dots Labeling for ToRCH-Related Antibodies
Authors: Yang Hao , Guo Qing , He Rong , Li Ding , Zhang Xueqing , Bao Chenchen , Hu Hengyao , Cui Daxiang
Published: September 2009

Quantum dot is a special kind of nanomaterial composed of periodic groups of II–VI, III–V or IV–VI materials. Their high quantum yield, broad absorption with narrow photoluminescence spectra and high resistance to photobleaching, make them become a promising labeling substance in biological analysis. Here, we report a quick and parallel analytical method based on quantum dots for ToRCH-related antibodies including Toxoplasma gondii, Rubella virus, Cytomegalovirus and Herpes simplex virus type 1 (HSV1) and 2 (HSV2). Firstly, we fabricated the microarrays with the five kinds of ToRCH-related antigens and used CdTe quantum dots to label secondary antibody and then analyzed 100 specimens of randomly selected clinical sera from obstetric outpatients. The currently prevalent enzyme-linked immunosorbent assay (ELISA) kits were considered as “golden standard” for comparison. The results show that the quantum dots labeling-based ToRCH microarrays have comparable sensitivity and specificity with ELISA. Besides, the microarrays hold distinct advantages over ELISA test format in detection time, cost, operation and signal stability. Validated by the clinical assay, our quantum dots-based ToRCH microarrays have great potential in the detection of ToRCH-related pathogens.
Ultrafast Dynamics of Localized and Delocalized Polaron Transitions in P3HT/PCBM Blend Materials: The Effects of PCBM Concentration
Authors: Lioudakis Emmanouil , Alexandrou Ioannis , Othonos Andreas
Published: September 2009

Nowadays, organic solar cells have the interest of engineers for manufacturing flexible and low cost devices. The considerable progress of this nanotechnology area presents the possibility of investigating new effects from a fundamental science point of view. In this letter we highlight the influence of the concentration of fullerene molecules on the ultrafast transport properties of charged electrons and polarons in P3HT/PCBM blended materials which are crucial for the development of organic solar cells. Especially, we report on the femtosecond dynamics of localized (P2at 1.45 eV) and delocalized (DP2at 1.76 eV) polaron states of P3HT matrix with the addition of fullerene molecules as well as the free-electron relaxation dynamics of PCBM-related states. Our study shows that as PCBM concentration increases, the amplified exciton dissociation at bulk heterojunctions leads to increased polaron lifetimes. However, the increase in PCBM concentration can be directly related to the localization of polarons, creating thus two competing trends within the material. Our methodology shows that the effect of changes in structure and/or composition can be monitored at the fundamental level toward optimization of device efficiency.
Synthesis, Antimicrobial Activity and Micellization of Gemini Anionic Surfactants in a Pure State as Well as Mixed With a Conventional Nonionic Surfactant
Authors: Abd El‐Salam Fatma H.
Published: September 2009

New gemini anionic surfactants were prepared from sodium salts of monoalkyl sulfosuccinate esters of ethylene glycol having variably long tails (C12, C16, C18) and dichloroethane. The chemical structures of the prepared surfactants were confirmed using different spectroscopic techniques. The surfaces tension values of the synthesized surfactants were measured at 25 °C individually or mixing at different molar fractions with ethoxylated alkylphenol. In all cases, mixed micellar aggregates were formed and critical micellar concentrations of binary mixtures containing different mole fractions of the surfactants were measured. The micellization processes of the individual and mixed surfactants were investigated. The effect of different alkyl chains of gemini anionic surfactants on properties of binary systems and molar ratio in the mixed aggregates were deduced. The critical micelle concentration of mixed surfactants shifted to lower values compared to those of the single surfactants. Effectiveness values increased with decreases in the mole fraction of gemini anionic surfactants. The negative values of interaction parameter (β) increased with increases in the chain length of anionic surfactants. The activity coefficient (f1, f2) and total minimum surface area of mixed solution were calculated. Also, the gemini anionic surfactants prepared have moderate antimicrobial activity towards bacteria and not active towards fungi.
Generation and characterization of functional cardiomyocytes using induced pluripotent stem cells derived from human fibroblasts
Authors: Gai Hui , Leung Elaine Lai‐Han , Costantino Peter D. , Aguila Jerell R. , Nguyen David M. , Fink Louis M. , Ward David C. , Ma Yupo
Published: September 2009

We have successfully developed both spontaneous and inductive cardiomyocyte differentiation of iPS cells reprogrammed from human foreskin fibroblasts. The reprogrammed iPS cells morphologically resemble human cardiomyocytes which can beat. RT‐PCR and immunostaining show that cardiac markers are expressed that are comparable to the differentiation pattern of authentic human embryonic stem cells, indicating the existence of both immature and mature differentiated cardiomyocytes. 5‐Azacytidine greatly enhanced the efficiency of cardiomyocyte differentiation, whereas dimethylsulfoxide had no effect. Low serum and bone morphogenetic protein‐2 marginally improved differentiation efficiency. iPS cell‐derived cardiomyocytes changed their beat frequency in response to cardiac drugs, which included ion channel blockers and α/β adrenergic stimulators. Derived cardiomyocytes look promising as an in vitro system for potential drug screen and/or toxicity, making this system closer to practical use in the near future.
Evidence for the use of a numerical rating scale to assess the intensity of pediatric pain
Authors: Miró Jordi , Castarlenas Elena , Huguet Anna
Published: September 2009

The aim of this work was to evaluate the psychometric properties of the Numerical Rating Scale‐11 (NRS‐11) when used to assess pediatric pain intensity. We performed two studies: 175 schoolchildren, aged 8–12, participated in Study 1 and 63 children undergoing surgery and aged 6–16, participated in Study 2. The NRS‐11 showed (a) adequate convergent construct validity when correlated with the Faces Pain Scale – Revised (FPS‐R; r1 = 0.78, r2 = 0.93); (b) adequate discriminant validity in relation to measures of pain‐related affect (z1 = 3.55, z2 = 7.62) and disability (z1 = 7.62, z2 = 6.83); and (c) adequate criterion‐related validity using measures of pain‐related affect (r1 = .58, r2 = .66), disability (r1 = 0.22, r2 = .39), and quality of life (r2 = −.46). Schoolchildren were asked whether they preferred using the NRS‐11 or the FPS‐R when reporting the intensity of their pain. While both sexes and both the younger and older age groups preferred the FPS‐R, this preference was more marked among girls and younger children.

The NRS‐11 has shown an acceptable level of validity for assessing pain intensity in both samples, however, additional research is needed in order to fully clarify the lower age limit in which the NRS‐11 can be used.
Do community mental health teams caring for severely mentally ill patients adjust treatments and services based on patients’ antisocial or criminal behaviours?
Authors: Hodgins S. , Cree A. , Khalid F. , Patel K. , Sainz-Fuentes R. , Shortt M. , Mak T. , Riaz M.
Published: September 2009

Background

Antisocial behaviour is common among patients with severe mental illness (SMI) requiring hospitalisation.

Aim

To determine whether differential treatments and services are provided to patients with SMI who engage in antisocial behaviour.

Method

A random sample of 161 inpatients with SMI were recruited from general adult wards and assessed at baseline and two years later. Information on symptoms, aggressive behaviour, substance misuse, and service use was obtained from patients and clinical files.

Results

Past antisocial behaviours were not associated with type or intensity of treatments and services. Severity of positive symptoms, aggressive behaviour, and illicit drug use were positively associated with the frequency of CMHT contact, but not with the type of CMHT, type of medication, or other treatments and benefits.

Conclusions

While the frequency of meetings with CMHTs increased with the severity of antisocial behaviours, no specific treatments were provided to patients with SMI engaging in antisocial behaviours.
Anomalous electrophoretic migration of newly synthesized ribosomal RNAs and their precursors from cells with DKC1 mutations
Authors: Gu Bai-Wei , Zhao Chunjun , Fan Jian-Meng , Dai Qing , Bessler Monica , Mason Philip J.
Published: September 2009

Mutations in the X‐linked gene, DKC1, encoding dyskerin, cause dyskeratosis congenita by leading to decreased telomerase activity and causing short telomeres. Dyskerin is also a pseudouridine synthase that modifies nascent ribosomal and other RNAs and it is not known if this function is affected by the mutations. Here we show that newly synthesized ribosomal RNA, extracted from human and mouse cells with pathogenic mutations, shows anomalous mobility in agarose gels under certain denaturation conditions. The anomalously migrating RNA is turned over rapidly. Analysis of ribosomal RNA in these cells suggests the altered mobility is due to inefficient pseudouridylation.
The β1 subunit of Na+/K+‐ATPase interacts with BKCa channels and affects their steady‐state expression on the cell surface
Authors: Jha Smita , Dryer Stuart E.
Published: September 2009

MINT‐7260414: Slo1 (uniprotkb:Q08460) physically interacts (MI:0915) with NKbeta1 (uniprotkb:P08251) by two hybrid (MI:0018)
A role for the MAPK/ERK pathway in oligodendroglial differentiation in vitro: stage specific effects on cell branching
Authors: Younes‐Rapozo V. , Felgueiras L.O.R. , Viana N.L. , Fierro I.M. , Barja‐Fidalgo C. , Manhães A.C. , Barradas P.C.
Published: September 2009

The mitogen‐activated protein kinase/extracellular signal‐regulated kinase (MAPK/ERK) pathway is important for both long‐term survival and timing of the progression of oligodendrocyte differentiation. Oligodendroglial cells treated with MEK inhibitor were distinguished by using stage specific markers: NG2 proteoglycan, A2B5, 2′3′nucleotide‐cyclic 3′phosphodiesterase (CNPase) and myelin basic protein (MBP), and classified according to their morphology into different developmental stages. Treatment significantly increased the number of cells with more immature morphologies and decreased the number of mature cells. Furthermore, it increased the number of rounded cells that could not be classified into any of the oligodendroglial developmental stages. The strongest effects were usually observed shortly after treatment. Rounded cells were CNPase/MBP positive and they were not stained by anti‐NG2 or A2B5, indicating that they were mature cells unable either to extend and/or to maintain their processes. These data showed an effect of the MAPK/ERK pathway on oligodendroglial branching, with possible consequences for the formation of the myelin sheath.
Conflicts of Interest in the Stock Recommendations of Investment Banks and Their Determinants
Authors: Shen Chung-Hua , Chih Hsiang-Lin
Published: September 2009

This study explores the phenomena associated with conflicts of interest, particularly as they pertain to the brokerage and proprietary trading divisions of investment banks. This distinguishes it from past studies, which have researched conflicts of interest between underwriting and brokerage divisions. We examine whether or not an investment bank issues buy recommendations to the market and buys (sells) the same recommended stocks through its proprietary trading division before (after) recommendations, and if so, to what extent this goes on. We find that these conflicts of interest do exist and that these investment banks can profit from their recommendations in the short run.