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Aims and objectives The aim of this study was to evaluate the impact of supportive interventions perceived by both the ICU patients′ relatives and the healthcare providers, such as deferred intake interviews for providing information and discussing the emotional impacts, encouragement to keep a diary, and the introduction of weekly psychosocial rounds, on the perceptions of relatives of patients in the intensive care unit. Background Patient- and family-centered care is gaining interest, with a shift from provider-centric norms to care arranged around patients′ and relatives individual beliefs and needs. This is expected to have a positive influence on the quality of care. Communication is one of the most important factors impacting the perceived quality of care in the intensive care unit from the perspective of patients′ relatives. New interventions have been introduced to help the patients′ relatives to meet their communication needs. Design A time-trend quantitative design. Methods Two convenience samples of relatives were included (in 2012 and 2013) in four different intensive care units from a large university medical centre in the Netherlands. Results Survey data from 211 relatives (75% net response rate in 2012) and 123 relatives (66% net response rate in 2013) were used for the analysis. The second measurement showed significant improvements regarding informational aspects of care, clarification of roles in participatory caretaking, and shared-decision making. Conclusion The results suggest that the additional support offered to patients′ relatives increased perceived quality of care, particularly with respect to informational needs. However, patient- and family-centred care still requires a change in the mind-set of healthcare professionals. This new point of view should overcome perceived barriers and foster a culture of partnership with patients′ relatives in the ICU. Relevance to clinical practice Training in providing psychosocial support for the needs of relatives leads to a stronger perception of patient-centredness. This article is protected by copyright. All rights reserved.

Ferric ethylene diamine-N,N'-bis(hydroxy phenyl acetic acid) (FeEDDHA)-based iron (Fe) fertilizers are commonly applied to plants grown on calcareous soils and comprise a mixture of FeEDDHA components. Upon application to the soil, the pore water concentrations of the active ingredients racemic and meso o,o-FeEDDHA show a gradual decline unrelated to plant uptake or biodegradation. In the present study, the potential of soil copper (Cu) to reduce the effectiveness of FeEDDHA-based fertilizers in calcareous soils by displacing Fe from o,o-FeEDDHA has been evaluated through modelling and experiments. Predictions with mechanistic multi-surface models show that there is a thermodynamic basis for assuming that under equilibrium conditions a certain fraction of o,o-EDDHA ligands in soil solution can be chelated to Cu, in particular for meso o,o-EDDHA. The large affinity of o,o-CuEDDHA for binding to the soil solid phase, demonstrated in a batch interaction experiment, greatly increases the potential impact of Cu competition on the o,o-FeEDDHA solution concentration; for a given quantity of o,o-CuEDDHA in soil solution, a much larger quantity of o,o-CuEDDHA is adsorbed to the solid phase. Finally, evidence for the actual displacement of Fe from o,o-FeEDDHA by Cu was found in a soil incubation study. With these results, the boundary conditions are met for explaining the observed gradual decline in o,o-FeEDDHA concentration with Cu competition.

Hippocampal atrophy is associated with memory impairment and dementia and serves as a key biomarker in the preclinical stages of Alzheimer's disease. Physical activity, one of the most promising behavioral interventions to prevent or delay cognitive decline, has been shown to be associated with hippocampal volume; specifically increased aerobic activity and fitness may have a positive effect on the size of the hippocampus. The majority of older adults, however, are sedentary and have difficulty initiating and maintaining exercise programs. A modestly more active lifestyle may nonetheless be beneficial. This study explored whether greater objectively measured daily walking activity was associated with larger hippocampal volume. We additionally explored whether greater low-intensity walking activity, which may be related to leisure-time physical, functional, and social activities, was associated with larger hippocampal volume independent of exercise and higher-intensity walking activity. Segmentation of hippocampal volumes was performed using Functional Magnetic Resonance Imaging of the Brain's Software Library (FSL), and daily walking activity was assessed using a step activity monitor on 92, nondemented, older adult participants. After controlling for age, education, body mass index, cardiovascular disease risk factors, and the Mini Mental State Exam, we found that a greater amount, duration, and frequency of total daily walking activity were each associated with larger hippocampal volume among older women, but not among men. These relationships were specific to hippocampal volume, compared with the thalamus, used as a control brain region, and remained significant for low-intensity walking activity, independent of moderate- to vigorous-intensity activity and self-reported exercise. This is the first study, to our knowledge, to explore the relationship between objectively measured daily walking activity and hippocampal volume in an older adult population. Findings suggest the importance of examining whether increasing nonexercise, lifestyle physical activities may produce measurable cognitive benefits and affect hippocampal volume through molecular pathways unique to those related to moderate-intensity exercise.

Summary Purpose: A disturbed balance between excitatory and inhibitory neurotransmission underlies epileptic activity, although reports concerning neurotransmitter systems involved remain controversial. Methods: We quantified densities of 15 receptors in neocortical biopsies from patients with pharmacoresistant focal temporal lobe epilepsy and autopsy controls, and searched for correlations between density alterations and clinical factors or the occurrence of spontaneous synaptic potentials in vitro. Key Findings: α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid (AMPA), kainate, N-methyl-d-aspartate (NMDA), peripheral benzodiazepine, muscarinic (M)1, M2, nicotinic, α1, α2h, serotonin (5-HT)1A, and adenosine (A)1 receptor densities were significantly altered in biopsies. The epileptic cohort was subdivided based on clinical (febrile seizures, hippocampal sclerosis, neocortical pathologies, surgery outcome) or electrophysiologic (spontaneous field potentials) criteria, resulting in different patterns of significantly altered receptor types when comparing a given epileptic group with controls. Only AMPA, kainate, M2, and 5-HT1A receptors were always significantly altered. γ-Aminobutyric acid (GABA)A, GABAB, and 5-HT2 receptor alterations were never significant. Correlation patterns between receptor alterations and illness duration or seizure frequency varied depending on whether the epileptic cohort was considered as a whole or subdivided. Significance: Neocortical temporal lobe epilepsy is associated with a generalized receptor imbalance resulting in a net potentiation of excitatory neurotransmission. Peripheral benzodiazepine receptor alterations highlight that astrocytes are also impaired by seizure activity.

Low socioeconomic status (SES) is associated with increased risk for adverse health outcomes; those with low SES are thought to experience greater environmental disadvantage and exposure to chronic stress over the life course. The effects of chronic stress on health have been measured by cortisol levels and variations in their diurnal pattern. However, the patterns of association between SES and cortisol have been equivocal in older adults. This paper examined in 98 older adults participating in the Brain Health Substudy of the Baltimore Experience Corps Trial baseline patterns of diurnal variation in salivary cortisol associated with lower versus higher SES using total income and perceived SES relative to others. For each measure, participants stratified into lower versus higher SES showed a more blunted rate of decline in diurnal salivary cortisol over the day in adjusted models (P values ≤ 0.05). There were no SES-related differences in awakening cortisol, cortisol-awakening response, or area under the curve. These findings confirm prior evidence of a biologic pathway through which socioeconomic disadvantage is linked to biologic vulnerability, and through which the impact of volunteer service in Experience Corps may be measured.

OBJECTIVES: To evaluate how accounting for driving status altered the relationship between volunteering and mortality in U.S. retirees. DESIGN: Observational prospective cohort. SETTING: Nationally representative sample from the Health and Retirement Study in 2000 and 2002 followed to 2006. PARTICIPANTS: Retirees aged 65 and older (N=6,408). MEASUREMENTS: Participants self‐reported their volunteering, driving status, age, sex, race or ethnicity, presence of chronic conditions, geriatric syndromes, socioeconomic factors, functional limitations, and psychosocial factors. Death by December 31, 2006, was the outcome. RESULTS: For drivers, mortality in volunteers (9%) and nonvolunteers (12%) was similar; for limited or non‐drivers, mortality for volunteers (15%) was markedly lower than for nonvolunteers (32%). Adjusted results showed that, for drivers, the volunteering‐mortality odds ratio (OR) was 0.90 (95% confidence interval (CI)=0.66–1.22), whereas for limited or nondrivers, the OR was 0.62 (95% CI=0.49–0.78) (interaction P=.05). The effect of driving status was greater for rural participants, with greater differences between rural drivers and rural limited or nondrivers (interaction P=.02) and between urban drivers and urban limited or nondrivers (interaction P=.81). CONCLUSION: The influence of volunteering in decreasing mortality seems to be stronger in rural retirees who are limited or nondrivers. This may be because rural or nondriving retirees are more likely to be socially isolated and thus receive more benefit from the greater social integration from volunteering.

In this research, we examined whether fixed pattern noise or more specifically Photo Response Non-Uniformity (PRNU) can be used to identify the source camera of heavily JPEG compressed digital photographs of resolution 640 x 480 pixels. We extracted PRNU patterns from both reference and questioned images using a two-dimensional Gaussian filter and compared these patterns by calculating the correlation coefficient between them. Both the closed and open-set problems were addressed, leading the problems in the closed set to high accuracies for 83% for single images and 100% for around 20 simultaneously identified questioned images. The correct source camera was chosen from a set of 38 cameras of four different types. For the open-set problem, decision levels were obtained for several numbers of simultaneously identified questioned images. The corresponding false rejection rates were unsatisfactory for single images but improved for simultaneous identification of multiple images.

We describe a novel signaling mechanism mediated by the G-protein-coupled receptor (GPCR) angiotensin II (Ang II) type 2 receptor (AT(2)). Yeast two-hybrid studies and affinity column binding assay show that the isolated AT(2) C-terminus binds to the transcription factor promyelocytic zinc finger protein (PLZF). Cellular studies employing confocal microscopy show that Ang II stimulation induces cytosolic PLZF to co-localize with AT(2) at the plasma membrane, then drives AT(2) and PLZF to internalize. PLZF slowly emerges in the nucleus whereas AT(2) accumulates in the perinuclear region. Nuclear PLZF binds to a consensus sequence of the phosphatidylinositol-3 kinase p85 alpha subunit (p85 alpha PI3K) gene. AT(2) enhances expression of p85 alpha PI3K followed by enhanced p70(S6) kinase, essential to protein synthesis. An inactive mutant of PLZF abolishes this effect. PLZF is expressed robustly in the heart in contrast to many other tissues. This cardiac selective pathway involving AT(2), PLZF and p85 alpha PI3K may explain the absence of a cardiac hypertrophic response in AT(2) gene-deleted mice.

The coagulation of humic substances and its role in controlling the solubility of organic matter in soils are not well understood. We therefore studied the physico-chemical behaviour of purified humic acid from forest soil coagulated with Na, Ca, Cu, Al at pH 4 and 6, and then modelled the behaviour with the Non-Ideal Consistent Competitive Adsorption Dorman (NICA-Donnan) model. We found that the coagulation of humic acid occurs when the Dorman potential is less negative than -0.08 V. Based on this result, an empirical relation between the Dorman potential of humic acid and its concentration in solution was derived. In addition, the Dorman potential of the dissolved organic matter in the soil solution of six soil profiles from forests was calculated using the NICA-Dorman model under the assumption that all the dissolved organic matter behaves as humic acid. The measured concentration of dissolved organic matter also decreases in a soil profile, as the calculated potential becomes less negative. The results are in many cases in semi-quantitative agreement with the predicted concentration based on the humic acid coagulation experiment. Acid soils contain more dissolved organic matter, which may result from the presence of a fairly large fraction of more soluble organic molecules, such as fulvic acid.

Accurate measurement of the free metal ion is difficult, especially for trace metals present in very small concentrations (less than micromolar) in natural systems. The recently developed Donnan membrane technique can measure the concentrations in solution in the presence of inorganic and organic complexing agents. We have developed this method further to make it applicable for analysing soil samples. The major development is the linkage of a soil column with the Donnan cell. The operational aspects of the method, including equilibrium time, buffering capacity and correction for differences in ionic strength, were investigated and optimized. The method was applied to determine concentrations of free Cu2 , Cd2 , Pb2 and Zn2 in the soil solution of 15 soil samples (pH 2.97.1, organic C < 2.9137.4 g kg1, clay 0.251.6Ž Compared with other speciation methods, the Donnan membrane technique has the advantage of allowing the measurement of several elements simultaneously and it minimizes the disturbance of substrate. The detection limit of the technique is about 109 m. This method can be applied to study the biogeochemical behaviour of metals in soils, sediments and other solid materials.

Residual acrylamide can cause severe suppression of signal intensity during matrix-assisted laser desorption/ionization (MALDI) peptide mass mapping experiments. This suppression phenomenon can compromise the ability to detect low picomole and subpicomolar amounts of peptides extracted from two-dimensional gels. A rapid and simple method that exploits the use of pipette tips incorporating C18 packing materials for the enhancement of MALDI signal intensity is presented. The utility of the method is demonstrated with peptide solutions incorporating residual acrylamide and/or gel monomer components. Copyright © 2000 John Wiley & Sons, Ltd.

Summary. We studied a large Swiss family with dominantly inherited hereditary spherocytosis and band 3 (anion exchanger 1, AE1) deficiency. Band 3 cDNA was analysed by single-strand conformation polymorphism analysis and nucleotide sequencing. A new point mutation was found: G771D (GGC→GAC). This change was present in all eight investigated patients but absent in four healthy members of the family. It is located at a highly conserved position in the middle of transmembrane segment 11, introducing a negative charge in a stretch of 16 apolar or neutral residues. None of the six amino-acid substitutions already known in this region as being associated with band 3 deficiency were recorded. To rule out any major transcriptional or post-transcriptional defect, we evaluated the amount of band 3 mRNA by RNase mapping using a band 3-protein 4.1 chimaeric probe. Similar mRNA amounts were present in patients and controls. Our results strengthen the view that some amino-acids, that are well conserved throughout the AE family, may be crucial for the insertion and/or the stabilization of band 3 within the lipid bilayer. At the present time, most of the mutations altering such residues are located in the C-terminal region of band 3.

The analysis of a targeted group of nucleoside antibiotics has been accomplished through the use of selective ion-molecule reactions and collision-activated dissociation (CAD) techniques in a quadrupole ion trap. A series of homologous ether reagent ions generated from dimethyl ether, di-n-butyl ether and 2-methoxyethanol were used as chemical ionization reagents. Because chemical ionization with dimethyl ether and di-n-butyl ether reagent ions did not provide selectivity and signal enhancement for the analysis of these biopharmaceuticals, a chemical ionization reagent with special hydrogen-bonding capabilities was used. The reagent ion that showed the greatest promise is a product of 2-methoxyethanol, CH3OCH2CH2OCH2+. This highly reactive species, which reacts selectively with nitrogen-containing compounds, can undergo both nucleophilic attack and anchoring via hydrogen bond formation between the methoxy oxygen and an acidic hydrogen of the nucleoside substrate. The reaction of the CH3OCH2CH2OCH2+ ion with each of the nucleoside antibiotics resulted in formation of [M + 13]+ and [M + 89]+ products. The CAD spectra indicated that the adducts are covalently bound species and that the nucleotide moiety dominates both the reactive and dissociative behavior of the nucleoside antibiotics.