Home About us Contact
|
Home About us Contact | ||
|
|
||
During
Terms modified by During Selected AbstractsWATER ABSORPTION, LEACHING and COLOR CHANGES DURING the SOAKING FOR PRODUCTION of SOY-BULGURJOURNAL OF FOOD PROCESS ENGINEERING, Issue 2 2004MUSTAFA BAYRAM ABSTRACT In this study, the soaking process, which is the first step of soy-bulgur production to develop a new type food product, was investigated. the soaking operation was conducted at 30, 50 and 70C for 120 min and samples were taken from the soybean and soaking water at 10 min intervals. Moisture content and color (L, a, b and YI values) of soybean were measured, as well as soluble solids content and color (L, a, b and YI values) of soaking water during the soaking process. the results were analyzed by using ANOVA and Duncan test. Soaking time and temperature were significantly effective (P < 0.05) on all variables, except the time effect on the YI-value. During the soaking, moisture content, lightness (L) and yellowness (b) increased and, redness (a) and yellowness index (YI) of soybean decreased. Soluble solids content, yellowness and yellowness index increased in contrast to a decrease in the lightness and greenness of the soaking water. As a result, soluble solids content in the soaking water increased, which illustrated the leaching of soluble solids from soybean to water. Color of soybean turned to lights, in contrast to darkening and opaqueness of water during soaking. Results showed that the moisture content, soluble solid content, L, a, b and YI values can be successfully modeled using polynomial equations, which can be used to estimate their changes during the soaking operation. [source] Pediatric Interventional Cardiology in the United States is Dependent on the Off-label Use of Medical DevicesCONGENITAL HEART DISEASE, Issue 1 2010Jamie S. Sutherell MD ABSTRACT Objective., A substantial unmet medical device need exists in pediatric care. As a result, the off-label use of approved devices is routine in pediatric interventional cardiology, but the extent and nature of this practice has not been previously described. The purpose of this study, therefore, is to evaluate the prevalence and nature of off-label cardiac device use in an active pediatric interventional program in the United States. Study Design., This study is a retrospective review of all interventional cardiac procedures performed at our institution from July 1, 2005 to June 30, 2008. Diagnostic (noninterventional) catheterizations, myocardial biopsies, invasive electrophysiology studies, and studies involving investigational devices were excluded. Interventions performed were compared with the manufacturer's labeled indications for each device. Results., During this 3-year period, 473 patients (median age 4.1 years) underwent 595 transcatheter interventions. An approved device was utilized for an off-label application in 63% of patients, and in 50% of all interventions performed. The most frequent off-label procedures were stent implantations (99% off-label), balloon dilations (78% off-label), and coil embolizations (29% off-label). In contrast, the off-label use of septal and ductal occluders was relatively uncommon. Conclusions., In our routine (noninvestigational) practice of pediatric interventional cardiology, 63% of patients underwent procedures utilizing medical devices for off-label indications. These data underscore the need to enhance cardiac device review and approval processes in the United States to include pediatric applications. [source] Early identification of non-remission in first-episode psychosis in a two-year outcome studyACTA PSYCHIATRICA SCANDINAVICA, Issue 5 2010E. Simonsen Simonsen E, Friis S, Opjordsmoen S, Mortensen EL, Haahr U, Melle I, Joa I, Johannessen JO, Larsen TK, Røssberg JI, Rund BR, Vaglum P, McGlashan TH. Early identification of non-remission in first-episode psychosis in a two-year outcome study. Objective:, To identify predictors of non-remission in first-episode, non-affective psychosis. Method:, During 4 years, we recruited 301 patients consecutively. Information about first remission at 3 months was available for 299 and at 2 years for 293 cases. Symptomatic and social outcomes were assessed at 3 months, 1 and 2 years. Results:, One hundred and twenty-nine patients (43%) remained psychotic at 3 months and 48 patients (16.4%) remained psychotic over 2 years. When we compared premorbid and baseline data for the three groups, the non-remitted (n = 48), remitted for <6 months (n = 38) and for more than 6 months (n = 207), duration of untreated psychosis (DUP) was the only variable that significantly differentiated the groups (median DUP: 25.5, 14.4 and 6.0 weeks, respectively). Three months univariate predictors of non-remission were being single, longer DUP, core schizophrenia, and less excitative and more negative symptoms at baseline. Two-year predictors were younger age, being single and male, deteriorating premorbid social functioning, longer DUP and core schizophrenia. In multivariate analyses DUP, negative and excitative symptoms predicted non-remission at 3 months, but only DUP predicted at 2 years. Conclusion:, Long DUP predicted both 3 month and 2-year non-remission rates in first-episode psychosis. [source] Assessment of Incidence, Cause, and Consequences of Pressure Ulcers to Evaluate Quality of Provided CareDERMATOLOGIC SURGERY, Issue 11 2009JAN WILLEM H. P. LARDENOYE MD BACKGROUND Pressure ulcers are one of the most frequently registered complications in general surgery. OBJECTIVE To obtain insight into the incidence, cause, and consequences of pressure ulcers and to evaluate the value of pressure ulcer registration to assess quality of care. RESULTS During the 9-year study period, 275 pressure ulcers were registered (5.8% of total registered complications). Age and female sex were independent risk factors for pressure ulcer development. Pressure ulcer classification was as follows: mild (53.3%), moderate (35.6%), severe (9.5%), and irreversible damage (1.5%). Patients undergoing hip surgery and major limb amputation were at risk for pressure ulcer development (10.4% and 8.8%, respectively). In most patients (89.5%), pressure ulcers had no consequences other than local wound therapy; in 12 patients (4.4%), pressure ulceration led to alteration in medication; in 15 patients (5.5%), length of hospital stay was prolonged; and four patients (0.4%) suffered from irreversible damage. CONCLUSION The incidence of pressure ulcers is strongly correlated to sex, age, and indication of admittance. Most ulcers were classified as mild and had no consequences. The insight obtained into incidence, cause, and consequences of pressure ulcers can be used as an indicator of quality of provided care if adjusted for case mix and indication of operation. [source] Trends in Pediatric Melanoma Mortality in the United States, 1968 through 2004DERMATOLOGIC SURGERY, Issue 2 2008KEVAN G. LEWIS MD BACKGROUND AND OBJECTIVE Mortality from melanoma in children is a poorly understood and controversial problem in dermatology. There is paucity of research into this important public health dilemma. The purpose of this study was to characterize pediatric melanoma mortality in the United States and to evaluate trends over time. METHODS AND MATERIALS Deaths were derived from a database of more than 75 million records of the U.S. Center for National Health Statistics based on routine death certification. Information on age, race, gender, and geographic location was available for years 1968 through 2004. RESULTS During the 37-year period, there were 643 deaths attributed to melanoma in children under 20 years of age in the United States, an average of 18 per year. The overall age-adjusted mortality rate for melanoma in children was 2.25 deaths per year (per 10 million at-risk individuals). Mortality rates were strongly associated with age. In the oldest age group (age 15,19 years) the mortality rate was approximately an order of magnitude 8,18 times higher compared to younger age groups. Mortality among males was 25% higher than females. Mortality rates for white children were more than twice as high as black children. Overall mortality from melanoma in children declined steadily from 1968 to 2004. The highest mortality rates were observed in Idaho, Nevada, Arizona, and New Mexico. CONCLUSIONS Although mortality from melanoma among children in the United State is low, the magnitude of the public health burden from this preventable cause of death is substantial. In contrast to results of studies suggesting that the incidence of melanoma may be rising in children and adolescents, the data suggest that mortality in these groups may be falling. Additional study is warranted to further characterize and ultimately reduce mortality from childhood melanoma. [source] Immediate Pathologic Effects on the Vein Wall of Foam SclerotherapyDERMATOLOGIC SURGERY, Issue 10 2007CAMILLO ORSINI MD BACKGROUND During the past 10 years, sclerotherapy has radically changed, the foam sclerotherapy method being better than that of liquid sclerotherapy. OBJECTIVES We have analyzed the immediate pathologic effects on the saphenous vein wall in vivo after sclerotherapy with sodium tetradecyl sulfate (STD) foam. METHODS A group of six patients affected by chronic venous insufficiency, operated on by stripping of the saphenous vein, underwent an intraoperative procedure of sclerotherapy to an isolated but not yet removed tract of saphenous vein with 3% STD foam. RESULTS The pathologic damage of the foam was extremely rapid with complete damage of the endothelium within the first 2 minutes. In the successive 15 and 30 minutes there was edema of the intimal with its progressive separation from the tunica media and the initial formation and adhesion of the thrombus to the tunica media. CONCLUSIONS In this in vivo report we analyze the capacity of 3% STD foam sclerotherapy to damage the saphenous vein wall. The damage is extremely fast and shows the detachment of the intimal and the development of the microthrombus. [source] Rosiglitazone combined with insulin preserves islet , cell function in adult-onset latent autoimmune diabetes (LADA)DIABETES/METABOLISM: RESEARCH AND REVIEWS, Issue 2 2005Zhiguang Zhou Abstract Background LADA is thought to result from the chronic autoimmune destruction of the insulin-producing pancreatic , cells. In addition to antidiabetic effects, the newly developed insulin sensitizer-thiazolidinediones have the potential to increase the insulin content of islet cells by downregulating local inflammation and autoimmune response. Therefore, we hypothesized that LADA patients might benefit from thiazolidinediones treatment. Methods LADA patients, with a fasting C-peptide (FCP) of 0.3 nmol/L or more, were enrolled and randomly assigned to receive subcutaneous insulin alone (insulin group, n = 12) or rosiglitazone plus insulin (insulin + RSG group, n = 11) to compare the impacts on islet , cell function. Plasma glucose, HbA 1c, fasting C-peptide (FCP) and C-peptide after 2 h 75-g glucose load (PCP) were determined every 6 months. GAD-Ab and C-peptide were measured with radioimmune assays. Islet , cell function was evaluated by PCP and ,CP(,CP = PCP-FCP). Results All of the 23 patients have been followed up for 6 months, 17 cases for 12 months and 14 for 18 months. (1) During 6 months' follow-up, there were no significant changes for ,CP and PCP levels in both groups. (2) PCP and ,CP levels in insulin + RSG group patients stayed steady during the 12 months' observation (P = 0.161 for both PCP and ,CP), while in the insulin alone group, both FCP (P = 0.021) and PCP (P = 0.028) levels decreased significantly. Furthermore, PCP (P = 0.004) and ,CP(P = 0.015) differences between 12th month and baseline were higher in insulin + RSG group than those in the insulin group. (3) When observed up to 18 months, PCP and ,CP levels in insulin + RSG group patients still stayed steady, while PCP and ,CP levels decreased more in the insulin alone group. Conclusions This pilot study suggests that rosiglitazone combined with insulin may preserve islet , cell function in LADA patients. Copyright © 2004 John Wiley & Sons, Ltd. [source] Juvenile Hormone Binding Protein Titers During Adult Metamorphosis in Manduca sextaENTOMOLOGICAL RESEARCH, Issue 4 2003Young Jin KANG ABSTRACT ABSTRACT During the pupal and adult stages, the JHBP levels displayed a sex-related difference, with females showing higher levels than males. A sharp increase in JHBP levels was observed at day 2 of the pupal stage. After day 2 the JHBP titer declined precipitously, and then remained unchanged until day 12 in males. JHBP titers in females decreased slightly after day 2 and then remained relatively constant until day 12. In both sexes, the JHBP levels showed a steep increase and peaked around day 15. During the previtellogenic period, the JHBP titers declined dramatically until adult ecdysis. During early adult stage, JHBP titiers in the female remained constant at preecdysis level. This information could broaden our understanding of pest physiology during adult metamorphosis, and could have extensive implications for developing insect growth regulators to control agricultural pests. [source] Of coiled oysters and big brains: how to rescue the terminology of heterochrony, now gone astrayEVOLUTION AND DEVELOPMENT, Issue 5 2000Stephen Jay Gould SUMMARY During the past decade, the terminology of heterochrony, heretofore consistent and workable, has become internally illogical and incoherent as the unfortunate result of an extension of terms, properly devised to describe shifts in developmental timing of shapes and features, to the rates and timings that cause these shifts. All the resulting, and extensive, confusion in the literature arises as a pure consequence of this error in logic and nomenclature, and not at all from disagreement about the important empirical questions described by this central concept and phenomenon in the integration of evolution and development. In particular, the claim that the same feature in human evolution (the paedomorphic shape of the human cranium) expresses either neoteny or the apparently opposite phenomenon of hypermorphosis only records the terminological error, and not any factual disagreement,for this neotenic feature has probably arisen by a prolongation of juvenile growth patterns inappropriately designated as "hypermorphosis of rate." I show that a prominent and unchallenged case of neoteny in fossil oysters arises by exactly the same evolutionary mode. When we restore the terminology of heterochrony by the "paedomorphic" intellectual event of dropping these inadaptive terminal accretions (the illogical extension of shape categories to describe rates), then the concept of heterochrony will again make proper distinctions by designating a clearly meaningful category of evolutionary changes originating by shifts in timing for features already present in ancestors. "It's not all heterochrony",and this particular statement of "less is more" represents heterochrony's strength as an interesting subset with definite meaning, rather than an illogical hodge-podge apparently applicable to all phenomena, and therefore explaining nothing. [source] Trace Element Determination by ICP-AES and ICP-MS: Developments and Applications Reported During 2004 and 2005GEOSTANDARDS & GEOANALYTICAL RESEARCH, Issue 3 2006Kathryn L. Linge This review describes significant developments in trace element determination using inductively coupled plasma-atomic emission spectrometry (ICP-AES) and inductively coupled plasma-mass spectrometry (ICP-MS) that were reported in 2004 and 2005. It focuses on the application of ICP techniques to geological and environmental samples; fundamental studies in ICP-MS and ICP-AES instrumentation are not included. The literature reviewed indicated that the majority of new publications concerned advances in ICP-MS analysis rather than ICP-AES. However, ICP-AES developments are still being published, particularly in the areas of sample preconcentration and sample introduction. The trend in increasing publication of developments in hyphenated speciation techniques looks set to persist as knowledge of elemental speciation becomes critical for many environmental studies. Collision or reactions cells were the most reported technique for spectral interference removal in ICP-MS, probably reflecting the growing adoption of cell instruments in laboratories during the last few years. [source] Prophylactic therapy for haemophilia: early experienceHAEMOPHILIA, Issue 2003E. Berntorp Summary., During the 1960s, it was reported from Sweden that haemophiliacs with factor levels above 1% rarely develop arthropathy. This observation suggested that severe haemophilia could be converted to a milder form by regular infusions with factor concentrate. After several earlier publications, a report was published in 1992 that detailed 25 years' experience with prophylaxis in 60 patients from the Malmö centre. The results showed that starting prophylaxis early in life with a dose regimen that would prevent factor VIII or IX plasma levels from falling below 1% could prevent the development of haemophilic arthropathy. Also, older age groups who had received less intensive treatment, and who started prophylaxis later in life, were still in a much better condition than historic controls. In the 1970s several small but well-controlled studies from the USA, Germany and Italy clearly showed the benefit of prophylaxis in reducing bleeding frequency. Early experience from the Netherlands was published in 1971. Since these early studies, the results have been corroborated from many countries and in a large multinational study. Although the benefits of prophylaxis seem unquestionable, several research questions remain to be better elucidated, such as when to start and when to stop, dosing and dose interval, and how to assess the long-term treatment effects. These issues are of great economic importance, and the need for health economical studies is obvious. [source] Plasma 5-Hydroxytryptamine (5-HT) in Migraine During an Attack-Free PeriodHEADACHE, Issue 4 2006Eiichiro Nagata MD Objective.,We measured the plasma 5-HT, 5-hydroxytryptophan (5-HTP), and tryptophan levels in controls, migraine patients with aura (MWA), and migraine patients without aura (MWoA) during an attack-free period. Background.,Serotonin (5-hydroxytryptamine, 5-HT) has been implicated in the pathophysiology of migraine. The precise relationship between 5-HT and migraine, however, remains unclear. Methods.,Blood samples in controls, MWA, and MWoA patients during an attack-free period were collected from brachial arteries and analyzed using HPLC. Results.,The plasma tryptophan and 5-HTP levels were not significantly different between the controls and migraine patients (either MWA or MWoA). However, the plasma 5-HT level in the MWA patients was significantly lower than that in the controls and MWoA patients. Conclusions.,The present data suggest that reduced levels of 5-HT in MWA may result from either a dysfunction in the enzymes involved in serotonin biosynthesis or a dysfunction in 5-HT release or uptake from platelets and lymphocytes. These findings indicate the existence of a serotonin metabolism dysfunction in MWA patients that may differ from the state of serotonin metabolism in MWoA patients. [source] Use of the Migraine Disability Assessment Questionnaire in Children and Adolescents With Headache: An Italian Pilot StudyHEADACHE, Issue 7 2003D. D'Amico MD Objectives.,To determine the suitability of the Migraine Disability Assessment (MIDAS) Questionnaire for assessing disability in children and adolescents with headache and to obtain preliminary information about disability in different primary headaches. Background.,During the last decade, researchers have begun to employ standardized methodologies to investigate the global impact of primary headaches. Disease-specific instruments have been developed to measure headache-related disability. The MIDAS Questionnaire, which is the most extensively studied of these instruments, was designed to assess the overall impact of headaches over the 3 months before compilation. The MIDAS Questionnaire is an optimal tool to assess headache-related disability in adults. Methods.,Ninety-five patients aged 7 to 17 years with tension-type headache, migraine, or both completed the validated Italian form of the MIDAS questionnaire on 2 occasions. Test-retest reliability was assessed by the Spearman rank correlation test. The Cronbach , assessed internal consistency. The patients answered questions about the adequacy of the questionnaire. Results.,The Cronbach , was .8. Correlation coefficients were generally high for the overall MIDAS score and for the items investigating disability in school and in family/leisure activities; they were lower for the items about housework. Most patients thought that the MIDAS Questionnaire was useful (98.9%) and that it captured the impact of their headaches (58.9%); 41% thought that questions about disability in housework were useless, 44.2% suggested adding questions regarding inability to do homework. All primary headaches had a considerable impact on daily activities, but patients with migraine tended to have lower headache frequencies and lower total disability time; those with tension-type headache suffered more days in which activities, although performed, were substantially impaired. Conclusions.,The MIDAS Questionnaire is useful for assessing disability in children and adolescents with different primary headaches. Minimal changes in the phrasing and content of the items would be sufficient to render the MIDAS specific for the younger population with headache. [source] Safety of efalizumab in adults with chronic moderate to severe plaque psoriasis: A phase IIIb, randomized, controlled trialINTERNATIONAL JOURNAL OF DERMATOLOGY, Issue 5 2006Kim A. Papp MD Background, To provide safety data for efalizumab, a recombinant humanized monoclonal IgG1 antibody, in adults with chronic plaque psoriasis. Methods, A 12-week, Phase IIIb, randomized, double-blind, parallel-group, placebo-controlled trial. At 58 study sites in the USA and Canada, 686 patients with moderate to severe chronic plaque psoriasis received an initial conditioning dose of efalizumab 0.7 mg/kg subcutaneously (SC) followed by either 11 weekly doses of efalizumab 1 mg/kg SC or matching placebo. Main outcome measures were safety and tolerability outcomes (primary) and efficacy outcomes (secondary). Results, During 12 weeks of therapy with efalizumab or placebo, the incidence of clinical adverse events was 82.2% and 72.9%, respectively; the incidence of serious adverse events was 1.8% and 3.4%, respectively; and the incidence of nonserious adverse events leading to withdrawal was 1.8% and 1.7%, respectively. In the efalizumab group, there were no clinically significant changes in vital signs or laboratory parameters and no evidence of end-organ toxicities. A significantly higher proportion of patients receiving efalizumab than those receiving placebo achieved , 75% improvement in the Psoriasis Area and Severity Index (PASI) (P < 0.001), , 50% improvement in PASI (P < 0.001), and a static Physician's Global Assessment rating of Minimal or Clear (P < 0.001). The mean improvement in the Psoriasis Symptom Assessment was significantly greater in the efalizumab group (P < 0.001). Conclusions, Efalizumab treatment SC for 12 weeks was safe, well tolerated, and effective in patients with moderate to severe chronic plaque psoriasis. [source] Polymyositis and dermatomyositis associated with malignancy: a 30-year retrospective studyINTERNATIONAL JOURNAL OF DERMATOLOGY, Issue 11 2002Nobuo Wakata MD Background Polymyositis and dermatomyositis in association with malignancy are paraneoplastic syndromes, but the incidence, treatment and factors that predict associated cancer and its prognosis all remain unclear. Patients and Method During the 30-year period 1969,99, we treated 64 patients who had polymyositis (including two with cancer) and 28 patients who had dermatomyositis (including 10 with cancer). We compared the clinical findings of the patients who had cancer with the findings of those who did not have cancer. Results The risk of cancer is significantly higher in dermatomyositis and somewhat higher in polymyositis. An increased cancer risk was found in male patients with dermatomyositis who were older than 50 years. Cancer was diagnosed within 4 years before or after the diagnosis of polymyositis or dermatomyositis, and usually within 1 year. An operation was not possible in many of the patients with cancer because of the advanced stage of the disease. Conclusion Our findings suggest that early discovery of malignancy is critical in cases of polymyositis and dermatomyositis. [source] Linking Purpose and Tactics: America and the Reconsideration of the Laws of War During the 1990sINTERNATIONAL STUDIES PERSPECTIVES, Issue 2 2008Stephanie Carvin The critique of the laws of war (and international law in general) coming out of America as the war on terror began seemed to have emerged as a response to the horror of 9/11 and the belief that the United States was now engaged in a "new paradigm" of warfare. However, the Bush administration's argument needs to be situated in a wider historical context. The source of the arguments against applying the Geneva Conventions to the prisoners caught in Afghanistan emerged well before 9/11 and can be traced to the end of the Cold War. These doctrines emerged out of the work of the "new sovereigntists" and out of the frustrations guided by coalition warfare. This paper seeks to trace the origin of these arguments which challenge the traditional division between jus ad bellum (the law governing the resort to force) and jus in bello (the law governing tactics in warfare). [source] Spirituality and job satisfaction among female Jewish Israeli hospital nursesJOURNAL OF ADVANCED NURSING, Issue 2 2010Aryeh Lazar lazar a. (2010) Spirituality and job satisfaction among female Jewish Israeli hospital nurses. Journal of Advanced Nursing 66(2), 334,344. Abstract Title.,Spirituality and job satisfaction among female Jewish Israeli hospital nurses. Aim., This paper is a report of a study conducted to examine the relationship between spirituality and hospital nurses' work satisfaction and to determine the unique contributions of various specific aspects of spirituality to their work satisfaction. Background., Spirituality has been indicated as a possible contributor to nurses' job satisfaction. However, few researchers have examined the relationship between spirituality and nurses' job satisfaction. Method., During 2007, 120 female Jewish Israeli hospital nurses responded to a questionnaire including a multidimensional measure of spirituality and a measure of overall job satisfaction. Results., Correlation analysis indicated a positive relationship between life coherency aspects of spirituality and spiritual values with job satisfaction. Hierarchical regression analysis indicated the particular importance of an idealistic spiritual orientation (positive contribution) and a transcendent spiritual orientation (negative contribution) to the prediction of nurses' job satisfaction. Conclusion., The relationship between spirituality and nurses' job satisfaction is complex. Hospital managers may be able to enhance job satisfaction by providing opportunities for nurses to satisfy their spiritual needs (in particular, altruistic and ideological orientations) on the job. In addition, nurses with a strong transcendent orientation may be identified and given special attention to increase the likelihood of job satisfaction. [source] Korean mothers' psychosocial adjustment to their children's cancerJOURNAL OF ADVANCED NURSING, Issue 5 2003Hae-Ra Han PhD RN Background., During the course of adjustment to their child's illness and medical treatment, parents of children with cancer may experience numerous challenges and difficulties. Although parental adjustment has been a research topic for many years, little research has been conducted among families in different cultures and countries. Aim., To identify factors that influence maternal psychosocial adjustment to childhood cancer using a new cultural group: Korean. Methods., A sample of 200 Korean mothers of children with cancer was included in the study. Guided by the double ABCX model of family adjustment and adaptation, a series of variables (i.e. maternal stress, coping, social support and selected illness-related and demographic questions) were examined for their relationships with maternal psychosocial adjustment to childhood cancer. Results., Using a hierarchical multiple regression, we found perceived level of stress, coping, social support, and time since diagnosis to be significant correlates of maternal psychosocial adjustment. Stress accounted for most (50%) of the total variance explained (56%) in maternal adjustment. Conclusion., The results suggest that the stress-coping framework may be appropriate in explaining maternal responses to childhood cancer across cultures. [source] Plasma Carboxymethyl-Lysine, an Advanced Glycation End Product, and All-Cause and Cardiovascular Disease Mortality in Older Community-Dwelling AdultsJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 10 2009Richard D. Semba MD OBJECTIVES: To determine whether older adults with high plasma carboxymethyl-lysine (CML), an advanced glycation end product, are at higher risk of all-cause and cardiovascular disease (CVD) mortality. DESIGN: Prospective cohort study. SETTING: Population-based sample of adults aged 65 and older residing in Tuscany, Italy. PARTICIPANTS: One thousand thirteen adults participating in the Invecchiare in Chianti study. MEASUREMENTS: Anthropometric measures, plasma CML, fasting plasma total, high-density and low-density lipoprotein cholesterol, triglycerides, glucose, creatinine. Clinical measures: medical assessment, diabetes mellitus, hypertension, coronary heart disease, heart failure, stroke, cancer. Vital status measures: death certificates and causes of death according to the International Classification of Diseases. Survival methods were used to examine the relationship between plasma CML and all-cause and CVD mortality, adjusting for potential confounders. RESULTS: During 6 years of follow-up, 227 (22.4%) adults died, of whom 105 died with CVD. Adults with plasma CML in the highest tertile had greater all-cause (hazard ratio (HR)=1.84, 95% confidence interval) CI)=1.30,2.60, P<.001) and CVD (HR=2.11, 95% CI=1.27,3.49, P=.003) mortality than those in the lower two tertiles after adjusting for potential confounders. In adults without diabetes mellitus, those with plasma CML in the highest tertile had greater all-cause (HR=1.68, 95% CI=1.15,2.44, P=.006) and CVD (HR=1.74, 95% CI=1.00,3.01, P=.05) mortality than those in the lower two tertiles after adjusting for potential confounders. CONCLUSION: Older adults with high plasma CML are at higher risk of all-cause and CVD mortality. [source] Stopping to Rest During a 400-Meter Walk and Incident Mobility Disability in Older Persons with Functional LimitationsJOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 2 2009Sonja Vestergaard PhD OBJECTIVES: To examine the association between stopping to rest during a 400-m usual-pace walk test (400-MWT) and incident mobility disability in older persons with functional limitations. DESIGN: Prospective cohort study. SETTING: Community based. PARTICIPANTS: Four hundred twenty-four participants in the Lifestyle Intervention and Independence for Elders Pilot (LIFE-P) Study aged 70 to 89 with functional limitations (summary score ,9 on the Short Physical Performance Battery (SPPB)) but able to complete the 400-MWT within 15 minutes. MEASUREMENTS: Rest stops during the 400-MWT were recorded. The onset of mobility disability, defined as being unable to complete the 400-MWT or taking more than 15 minutes to do so, was recorded at Months 6 and 12. RESULTS: Fifty-four (12.7%) participants rested during the 400-MWT at baseline, of whom 37.7% experienced mobility disability during follow-up, versus 8.6% of those not stopping to rest. Performing any rest stop was strongly associated with incident mobility disability at follow-up (odds ratio (OR)=5.4, 95% confidence interval (CI)=2.7,10.9) after adjustment for age, sex, and clinic site. This association was weaker, but remained statistically significant, after further adjusting for SPPB and time to complete the 400-MWT simultaneously (OR=2.6, 95% CI=1.2,5.9). CONCLUSION: Stopping to rest during the 400-MWT is strongly associated with incident mobility disability in nondisabled older persons with functional limitations. Given the prognostic value, rest stops should be recorded as part of the standard assessment protocol for the 400-MWT. [source] Coinfection with Campylobacter species: an epidemiological problem?JOURNAL OF APPLIED MICROBIOLOGY, Issue 2 2001J.F. Richardson Aims: To determine the frequency of coinfection with multiple strains in sporadic cases of human Campylobacter infection. Method and Results: During 1999 10 single colonies of Campylobacter were cultured from each of 53 positive faecal samples. Five isolates were taken from nonselective agar after passive filtration of faecal suspensions and five isolates were taken from selective agar plates. All isolates were sero- and phage typed and their antibiotic resistance determined. Pulsed-field gel electrophoresis and flagellin gene typing were performed on selected isolates. One patient was infected with Camp. coli, the remainder with strains of Camp. jejuni. The majority of patients was infected with a single strain of Campylobacter, but from each of four samples, 7·5%, two strains of Camp. jejuni, confirmed by molecular typing, were identified. Conclusions: Coinfection occurs in sporadic cases of campylobacteriosis. Significance and Impact of the Study: This study has implications in outbreak investigation when distinct strains have been isolated from epidemiologically related patients and/or the suspected source or vehicle. [source] Evaluation of a Prediction Model for Long-Term Fracture Risk,JOURNAL OF BONE AND MINERAL RESEARCH, Issue 4 2005L Joseph Melton III MD Abstract The NOF cost-effectiveness model, based on clinical risk factors and femoral neck aBMD, predicted overall fracture risk in a cohort of postmenopausal women followed for up to 22 years. Introduction: To assess the ability of a statistical model to predict long-term fracture risk for a population of postmenopausal women, we compared observed fractures to those predicted by the National Osteoporosis Foundation's (NOF) cost-effectiveness model. Materials and Methods: In this population-based study, 393 postmenopausal Rochester, MN, women had baseline measurements of femoral neck areal BMD (aBMD) and assessment of the clinical risk factors (personal fracture history, family history of osteoporotic fracture, low body weight, and smoking status) that were included in the NOF model. They were then followed prospectively for up to 22 years. Fractures were ascertained by periodic interview and review of community medical records. Standardized incidence ratios (SIRs) compared observed fractures to predicted numbers. Results: During 4782 person-years of follow-up, 212 women experienced 503 fractures, two-thirds of which were caused by moderate trauma. When undiagnosed (incidentally noted) vertebral and rib fractures were excluded, there was general concordance between observed and predicted fractures of the hip (SIR, 0.78; 95% CI, 0.56-1.01), distal forearm (SIR, 1.22; 95% CI, 0.86-1.68), spine (SIR, 0.76; 95% CI, 0.50-1.11), and all other sites combined (SIR, 1.18; 95% CI, 0.97-1.42). Fracture prediction by the NOF model was about as good after 10 years as it was earlier during follow-up. Conclusions: This study validates the ability of a statistical model based on femoral neck aBMD and common clinical risk factors to predict the actual occurrence of fractures in a cohort of postmenopausal white women. [source] Effects of acupressure on menstrual distress in adolescent girls: a comparison between Hegu,Sanyinjiao Matched Points and Hegu, Zusanli single pointJOURNAL OF CLINICAL NURSING, Issue 7-8 2010Huei-Mein Chen Aim and objectives., To examine a comparison between Hegu and Sanyinjiao matched points and Hegu, Zusanli single point on adolescent girls' menstrual distress, pain and anxiety perception. Background., Primary dysmenorrhoea is a major cause of temporary disability, with a prevalence ranging from 60,93%, depending upon the population and study. No one has yet compared the effects of single point and multiple point acupressures. Design., A single blind randomised experimental study was used. Methods., Adolescents (n = 134) randomly assigned to experimental groups Zusanli (n = 30), Hegu (n = 33) and Hegu,Sanyinjiao Matched Points (n = 36) received acupressure intervention protocol for 20 minutes, while the control group (n = 35) did not receive any acupressure intervention. Four instruments were used to collect data: (1) the Visual Analog Scale for Pain; (2) the Menstrual Distress Questionnaire Short Form; (3) the Short-Form McGill Pain Questionnaire and (4) the Visual Analog Scale for Anxiety. Results., During the six-month follow-up, acupressure at matched points Hegu and Sanyinjiao reduced the pain, distress and anxiety typical of dysmenorrhoea. Acupressure at single point Hegu was found, effectively, to reduce menstrual pain during the follow-up period, but no significant difference for reducing menstrual distress and anxiety perception was found. Zusanli acupressure had no significant effects of reducing menstrual pain, distress and anxiety perception. Conclusion., This controlled trial provides preliminary evidence that six-month acupressure therapy provides female adolescents with dysmenorrhoea benefits. Relevance to clinical practice., Acupressure is an effective and safe non-pharmacologic strategy for the treatment of primary dysmenorrhoea. We recommend the use of acupressure for self-care of primary dysmenorrhoea at Hegu and Sanyinjiao matched points and single point Hegu, as pressure placement at these points is easy for adolescent girls to learn and practice. [source] Decision-making during hospitalization: parents' and children's involvementJOURNAL OF CLINICAL NURSING, Issue 3 2004Inger Hallström RN Background., Ethical duties of health professionals include the obligation to enhance their patients' competence and ability to participate. Aims and objectives., To explore what kind of decisions and how these decisions were made during a child's hospitalization. Design., During a 9-week period 24 children and their parents were followed during the course of events at the hospital. In total 135 hours of observations were made and analysed in two steps. Results., In most of the situations one or both parents were present with the child. Most decisions were of a medical nature, and commonly decisions were made in consultation with those affected by the decision. Although one or more persons protested in 83 of the 218 described situations, decisions were seldom reconsidered. Conclusions., The children and their parents were usually involved in the decision-making process. Children and parents made few decisions themselves and even if they disagreed with the decision made, few decisions were reconsidered. Relevance to clinical practice., Having a voice in decision-making helps the child to develop a sense of himself as a person and gives the parents a feeling that they are part of a team giving their child optimal care during hospitalization. Promoting children's rights is one of the most important roles for the children's nurse. [source] Effect of an amine-fluoride-triclosan mouthrinse on plaque regrowth and biofilm vitalityJOURNAL OF CLINICAL PERIODONTOLOGY, Issue 4 2002Nicole B. Arweiler Abstract Background: The purpose of this double-blind, prospective, latin-square crossover randomised study was to examine the efficacy of a mouthrinse solution containing a combination of triclosan, amine fluoride and sodium fluoride on supragingival plaque regrowth compared to a placebo and a chlorhexidine solution. Methods: 12 volunteers refrained after professional oral prophylaxis from all mechanical hygiene measures for the following 96 h and rinsed instead cross-over in a randomised order with either chlorhexidine dicluconate (0.2%, positive control), a verum solution (0.5% amine fluoride, 0.028% sodium fluoride, 0.03% triclosan) or a placebo solution. The plaque index was assessed after 24 and 96 h (PI 1, PI 2) and the plaque area (PA) photographed and calculated after 96 h of undisturbed plaque regrowth. Moreover plaque samples were taken after 24 and 96 h and examined with the vital fluorescence technique to assess the vitality of the biofilm microbiota (VF 1, VF 2). Results: The amine-fluoride-triclosan solution reduced the clinical parameters (PI and PA) as well as the vitality of the plaque flora (VF) significantly when compared to the placebo solution. The verum reached a 36.5% (p<0.05) and a 39.8% reduction (p<0.0001) in PI 1 and PI 2, respectively, concomittant with a reduction of 23.8% and 32.2% (p<0.001) in VF 1 and VF 2 and of 46.9% (p<0.0001) in PA at day 4. This was less than the reductions found with the positive control, i.e., the 0.2% chlorhexidine solution (54.2% and 71.1% reduction in PI 1 and PI 2, 40.0% and 53.4% in VF 1 and VF 2 and 71.5% in PA). However, significant differences between both active solutions were only established for PI 2 and PA. Conclusion: During 4-day plaque regrowth the amine-fluoride-triclosan product displayed a significant antibacterial and plaque-reducing action in comparison to the control. Zusammenfassung Hintergrund: Der Zweck dieser prospektiven, gekreuzten, randomisierten Doppeltblindstudie war die Überprüfung der Effektivität einer Mundspüllösung, die eine Kombination von Triclosan, Aminfluorid und Natriumfluorid enthielt, auf die Neuetablierung der supragingivalen Plaque im Vergleich zu einem Placebo und einer Chlorhexidinlösung. Methoden: 12 Probanden wurde nach einer professionellen Prophylaxe jegliche mechanische Hygiene für die folgenden 96 Stunden untersagt. Sie spülten dafür überkreuzt in einer zufälligen Reihenfolge entweder mit Chlorhexidindiglukonat (0.2%, positive Kontrolle), einer Versuchslösung (0.5% Aminfluorid, 0.028% Natriumfluorid, 0.03% Triclosan) oder einer Placebolösung. Der Plaque-index wurde nach 24 Stunden und 96 Stunden erhoben (PI 1, PI 2). Die Plaquefläche (PA) wurde fotografiert und berechnet nach 96 Stunden des ungestörten Plaquewachstums. Zusätzlich wurden Plaqueproben nach 24 und 96 Stunden entnommen und mit der Vitalfluoreszenztechnik die Vitalität der Mikroflora des Biofilms bestimmt (VF 1, VF 2). Ergebnisse: Die Aminfluorid-Triclosan-Lösung reduzierte die klinischen Parameter (PI und PA) sowie die Vitalität der Plaqueflora (VF) signifikant, im Vergleich mit der Placebolösung. Die Versuchslösung erreichte eine 36.5%ige (p<0.05) und eine 39.8%ige Reduktion (p<0.001) bei PI 1 und PI 2, verbunden mit einer Reduktion von 23.8% und 32.2% (p<0.01) bei VF 1 und VF 2 und 46.9% (p<0.0001) bei PA am Tag 4. Dies war geringer als die Reduktionen, die mit der positiven Kontrolle gefunden wurden, d.h. mit der 0.2%igen Chlorhexidin-Lösung (54.2% und 71.1% Reduktion bei PI 1 und PI 2, 40.0% und 53.4% bei VF 1 und VF 2 sowie 71.5% bei PA). Jedoch wurden signifikante Differenzen zwischen beiden aktiven Lösungen nur bei PI 2 und PA gefunden. Zusammenfassung: Während eines 4tägigen Plaquewachstums zeigte das Aminfluorid-Triclosan-Produkt eine signifikante antibakterielle und plaquereduzierende Wirkung im Vergleich zu der Kontrolle. Résumé Origine: Le but de cette étude randomisée, croisée, prospective en double aveugle a été d'examiner l'efficacité d'une solution contenant une association de fluorure d'amine, de fluorure de sodium et de triclosan sur l'accumulation de la plaque dentaire sus-gingivale comparée à un placebo et à une solution de chlorhexidine (CHX). Méthodes: Après un nettoyage professionnel, 12 volontaires ont arrêté toutes mesures d'hygiène buccale pendant 96 h. Ils se sont rinçés de manière randomisée et croisée avec du digluconate de CHX 0.2%, une solution verum (fluorure d'amine 0.5%, fluorure de sodium 0.028% et triclosan 0.03%) ou une solution placebo. L'indice de plaque a été mesurée après 24 h (Pli 1) et 96 h (Pli 2) et la zone de plaque (PA) photographiée et calculée après 96 h. Des échantillons de plaque dentaire ont été prélevés après 24 h (VF 1) et 96 h (VF 2) et examinés par la technique de vitalité de fluorescence, pour mesurer la vitalité de la flore du biofilm. Résultats: La solution flurorure d'amine/triclosan réduisait significativement les paramètres cliniques (Pli et PA) ainsi que la vitalité de la flore (VF) comparée à la solution placebo. Le vérum atteignait des réductions respectives de 37% (p<0.05) et 40% (p<0.0001) des Pli 1 et Pli 2 concomitantes avec une réduction de 24 et 32% (p<0.001) de VF 1 et VF 2 et de 47% (p<0.0001) de PA au jour 4. Ceci était inférieur aux réductions trouvées dans le contrôle positif, c.-à-d. la CHX 0.2% (54 et 71% de réduction de Pli 1 et Pli 2, 40 et 53% de VF 1 et VF 2, et 72% de PA). Cependant, les différences significatives entre les deux solutions actives ont été mises en évidence uniquement pour Pli2 et PA. Conclusion: Durant cette courte croissance de la plaque dentaire, le produit fluorure d'amine/triclosan montrait une action antibactérienne et anti-plaque supérieure à celle du contrôle. [source] Shortening of Median Door-to-Balloon Time in Primary Percutaneous Coronary Intervention in Singapore by Simple and Inexpensive Operational Measures: Clinical Practice Improvement ProgramJOURNAL OF INTERVENTIONAL CARDIOLOGY, Issue 5 2008CHI-HANG LEE M.B.B.S., F.A.C.C. Background: Primary percutaneous coronary intervention is the standard reperfusion strategy for ST-segment elevation myocardial infarction in our center. We aimed to shorten the median door-to-balloon time from over 100 minutes to 90 minutes or less. Methods: We have been using three strategies since March 2007 to shorten the door-to-balloon time: (1) the intervention team is now activated by emergency department physicians (where previously it had been activated by coronary care unit); (2) all members of the intervention team have converted from using pagers to using cell phones; and (3) as soon as the intervention team is activated, patients are transferred immediately to the cardiac catheterization laboratory (where previously they had waited in the emergency department for the intervention team to arrive). An in-house physician and a nurse would stay with the patients before arrival of the intervention team. Results: During 12 months, 285 nontransfer patients (analyzed, n = 270) underwent primary PCI. The shortest monthly median door-to-balloon time was 59 minutes; the longest monthly median door-to-balloon time was 111 minutes. The overall median door-to-balloon time for the entire 12 months was 72 minutes. On a per-month basis, the median door-to-balloon time was 90 minutes or less in 10 of 12 months. On a per-patient basis, the median door-to-balloon time was 90 minutes or less in 182 patients (67.4%). There was 1 case (0.4%) of inappropriate activation by the emergency department. While waiting for the intervention team to convene, 1 patient (0.4%) deteriorated and had to be resuscitated in the cardiac catheterization laboratory. Conclusions: Improved health care delivery can be achieved by changing simple and inexpensive operational processes. [source] The Failure of the Sport7 TV-channel: Controversies in a Business Network*JOURNAL OF MANAGEMENT STUDIES, Issue 7 2003Harry Sminia ABSTRACT During 1996, TV viewers in the Netherlands witnessed the rise and fall of Sport7: a dedicated sports TV channel. Apparently, Sport7 did not succeed to become part of the business network of television and sports. This paper describes and explains why the venture failed. It builds on earlier insights from research on the outcomes of joint ventures and the business networks perspective. These insights are combined and utilized within the framework of the theory of social becoming (Sztompka, 1991). As such, for a new venture like Sport7, the outcome depends on the settlement of a number of controversies that arise with the establishment of a new actor in an existing business network. In the case of Sport7, the settlement of these controversies appeared to go against this new venture, ultimately leading to the demise of this new TV channel. [source] Activity of Hypothalamic Dopaminergic Neurones During the Day of Oestrus: Involvement in Prolactin SecretionJOURNAL OF NEUROENDOCRINOLOGY, Issue 10 2010C. M. Leite A secretory surge of prolactin occurs on the afternoon of oestrus in cycling rats. Pituitary prolactin is inhibited by dopamine. We evaluated the activity of the neuroendocrine dopaminergic neurones during oestrus and dioestrus, as determined by dopaminergic activity in the median eminence and neurointermediate lobe of the pituitary, as well as Fos-related antigen expression in tyrosine hydroxylase (TH)-immunoreactive (ir) neurones of the arcuate nucleus (ARC) and periventricular nucleus (Pe). During oestrus, the 4-dihydroxyphenylacetic acid/dopamine ratio in the median eminence decreased at 16.00 h, coinciding with the increase in plasma prolactin levels. Similarly, the expression of Fos-related antigen in TH-ir neurones of Pe and rostral-, dorsomedial- and caudal-ARC also decreased at 16.00 h. On dioestrus, 4-dihydroxyphenylacetic acid/dopamine ratio in the median eminence and Fos-related antigen expression in TH-ir neurones of Pe and rostral-ARC decreased at 18.00 h, whereas prolactin levels were unaltered. No variation in dopaminergic activity was found in the neurointermediate lobe of the pituitary on either oestrus or dioestrus. The number of TH-ir neurones in the ARC and parameters of dopaminergic activity were found to be generally lower on oestrus compared to dioestrus. The transitory decrease in the activity of neuroendocrine dopaminergic neurones temporally associated with the prolactin surge on the afternoon of oestrus suggests a role for dopamine in the generation of the oestrous prolactin surge. [source] Increased Activation of the ACC During a Spatial Working Memory Task in Alcohol-Dependence Versus Heavy Social DrinkingALCOHOLISM, Issue 5 2010Sabine Vollstädt-Klein Background:, Activation of the anterior cingulate cortex (ACC) in a spatial working memory task has been associated with risk factors for alcohol use disorders such as low alcohol effects and positive alcohol expectations in adolescents. To transfer these results into adults, we used the same task in adults. Methods:, During functional magnetic resonance imaging, 12 light social, 7 heavy social, and 11 non-abstinent-dependent alcohol drinkers performed a spatial working memory task and completed measures of automatic alcohol-related thoughts and behavior (Obsessive,Compulsive Drinking Scale,OCDS), alcohol use of the last 90 days, and general intelligence. Results:, Behavioral performance in the spatial working memory task was not significantly different in all 3 groups. Controlling for differences in general intelligence alcohol-dependent participants showed a higher task-related activation of the dorsal ACC (dACC) in comparison with light and heavy social drinkers. Measures of the OCDS were positively correlated with the activation in the left hippocampus and right thalamus in all participants. Conclusions:, Our results support the findings of increased dACC activation during a spatial working memory task as a risk factor for alcohol dependence. Increased task-related activation in the dACC was only observed in alcohol-dependent participants and not in heavy social drinkers with comparable alcohol consumption. Furthermore, the absence of behavioral performance differences between groups as well as an association between dACC activation and working memory performance indicates subtle working memory deficits. Low capacity of working memory has been linked to more automatic and less self-regulated behavior in studies on natural reward processing. Therefore, additional neural activation during performance of the non-alcohol-related working memory task in participants with higher OCDS values in the left hippocampus and the right thalamus may be a consequence of decreased neural capacity because of distracting alcohol-related thoughts. [source] Effects of Land-Use and Land-Cover Change on Evapotranspiration and Water Yield in China During 1900-2000,JOURNAL OF THE AMERICAN WATER RESOURCES ASSOCIATION, Issue 5 2008Mingliang Liu Abstract:, China has experienced a rapid land-use/cover change (LUCC) during the 20th Century, and this process is expected to continue in the future. How LUCC has affected water resources across China, however, remains uncertain due to the complexity of LUCC-water interactions. In this study, we used an integrated Dynamic Land Ecosystem Model (DLEM) in conjunction with spatial data of LUCC to estimate the LUCC effects on the magnitude, spatial and temporal variations of evapotranspiration (ET), runoff, and water yield across China. Through comparisons of DLEM results with other model simulations, field observations, and river discharge data, we found that DLEM model can adequately catch the spatial and seasonal patterns of hydrological processes. Our simulation results demonstrate that LUCC led to substantial changes in ET, runoff, and water yield in most of the China's river basins during the 20th Century. The temporal and spatial patterns varied significantly across China. The largest change occurred during the second half century when almost all of the river basins had a decreasing trend in ET and an increasing trend in water yield and runoff, in contrast to the inclinations of ET and declinations of water yield in major river basins, such as Pearl river basin, Yangtze river basin, and Yellow river basin during the first half century. The increased water yield and runoff indicated alleviated water deficiency in China in the late 20th Century, but the increased peak flow might make the runoff difficult to be held by reservoirs. The continuously increasing ET and decreasing water yield in Continental river basin, Southwest river basin, and Songhua and Liaohe river basin implied regional water deficiency. Our study in China indicates that deforestation averagely increased ET by 138 mm/year but decreased water yield by the same amount and that reforestation averagely decreased ET by 422 mm/year since most of deforested land was converted to paddy land or irrigated cropland. In China, cropland-related land transformation is the dominant anthropogenic force affecting water resources during the 20th Century. On national average, cropland expansion was estimated to increase ET by 182 mm/year while cropland abandonment decreased ET by 379 mm/year. Our simulation results indicate that urban sprawl generally decreased ET and increased water yield. Cropland managements (fertilization and irrigation) significantly increased ET by 98 mm/year. To better understand LUCC effects on China's water resources, it is needed to take into account the interactions of LUCC with other environmental changes such as climate and atmospheric composition. [source] | |||||||||||||||||||||||||||||||||||||||||||||||||