bluuebunny/crossref_metadata_2025 huggingface dataset:
Uterine compression sutures for postpartum hemorrhage: an overview
Authors: Matsubara Shigeki , Yano Hitoshi , Ohkuchi Akihide , Kuwata Tomoyuki , Usui Rie , Suzuki Mitsuaki
Published: January 2013

In 1997, B‐Lynch pioneered the use of uterine compression sutures for postpartum hemorrhage. Since then, some researchers, including ourselves, have devised various uterine compression sutures. High‐level evidence has not been demonstrated as to whether compression sutures achieve better and safer hemostasis for postpartum hemorrhage than other methods, and, if they do, whether one suture is more efficient and safer than another. However, generally speaking, uterine compression sutures have achieved hemostasis while preserving fertility in many women and thus their efficacy and safety have been time‐tested. Each suture has both merits and drawbacks: obstetricians must be aware of the fundamental characteristics of various sutures. In this review, we summarize the technical procedures, efficacy, safety and complications of various uterine compression sutures. We add our own experiences and opinions where necessary.
Through the looking glass: primary epithelioid angiosarcoma in the left atrium, a unique site for a rare malignancy
Authors: Hynes Sean O. , Attah Chike B. , Ingoldsby Helen , Kolcow Walenty , MacNeill Briain , Veerasingam Dave , Orosz Zsolt
Published: January 2013

Malignant cardiac tumours occurring on the left side are vanishingly rare entities. We describe a case of a 73‐year‐old male who underwent surgery for a left‐sided cardiac tumour following initial presentation with transient ischaemic attacks. In addition to the unusual presentation and subsequent metastatic pattern to the femur, the tumour's pathological diagnosis was that of an epithelioid variant of an angiosarcoma which has not been previously described in this anatomical location.
Semiquantitative multi‐analysis of plasma obtained from Romney lambs (Ovis aries) by inductively coupled plasma mass spectrometry, and the classification according to feed type
Authors: Takahashi Fumihito , Mochizuki Mariko , Sato Touko , Katayama Kinya , Kenyon Paul R. , Morris Stephen T. , Kemp Peter D. , Ozawa Takeyuki , Ueda Fukiko , Tazaki Hiroyuki
Published: January 2013

The establishment of a classification system for domestic animals on consumed feed stuff is thought to be important from both a hygiene and market point of view. We collected plasma samples of Romney lambs (Ovis aries) which were fed one of the following: a herb‐clover mix (n = 10) which included chicory, red clover, white clover and plantain; a plant‐grass mix (n = 10) which included plantain, ryegrass and white clover; or a grass mix (n = 10) which included ryegrass and white clover. A total of 20 elements in plasma samples obtained from the lambs were analyzed using inductively coupled plasma mass spectrometry. The data were then analyzed by principal component analysis. The lambs were divided into three groups on a score plot depending on the different feed conditions. Furthermore, discriminant analyses of the elements were examined, using linear discriminant analysis with forward stepwise regression. This discriminant function correctly classified the samples from each group. The accuracy of classification of each group, as shown by 10‐fold cross‐validation, proved the effectiveness of the established discriminant function. It is concluded that using linear discriminant analysis might be a useful tool for the validation of elements from plasma in lambs grown in different conditions.
Pharmacokinetic and pharmacodynamic evaluation of linagliptin in African American patients with type 2 diabetes mellitus
Authors: Friedrich Christian , Glund Stephan , Lionetti Dominick , Kissling C. James , Righetti Julian , Patel Sanjay , Graefe‐Mody Ulrike , Retlich Silke , Woerle Hans‐Juergen
Published: January 2013

Aim

This was an open label, multicentre phase I trial to study the pharmacokinetics and pharmacodynamics of the dipeptidyl peptidase‐4 (DPP‐4) inhibitor linagliptin in African American patients with type 2 diabetes mellitus (T2DM).

Methods

Forty‐one African American patients with T2DM were included in this study. Patients were admitted to a study clinic and administered 5 mg linagliptin once daily for 7 days, followed by 7 days of outpatient evaluation.

Results

Primary endpoints were area under the plasma concentration–time curve (AUC), maximum plasma concentration (Cmax) and plasma DPP‐4 trough inhibition at steady‐state. Linagliptin geometric mean AUC was 194 nmol l−1 h (geometric coefficient of variation, 26%), with a Cmax of 16.4 nmol l−1 (41%). Urinary excretion was low (0.5% and 4.4% of the dose excreted over 24 h, days 1 and 7). The geometric mean DPP‐4 inhibition at steady‐state was 84.2% at trough and 91.9% at maximum. The exposure range and overall pharmacokinetic/pharmacodynamic profile of linagliptin in this study of African Americans with T2DM was comparable with that in other populations. Laboratory data, vital signs and physical examinations did not show any relevant findings. No safety concerns were identified.

Conclusions

The results of this study in African American patients with T2DM support the use of the standard 5 mg dose recommended in all populations.
Incidence and natural history of pure red cell aplasia in major ABO‐mismatched haematopoietic cell transplantation
Authors: Aung Fleur M. , Lichtiger Benjamin , Bassett Roland , Liu Ping , Alousi Amin , Bashier Qaiser , Ciurea Stefan O. , de Lima Marcos J. , Hosing Chitra , Kebriaei Partow , Nieto Yago , Oran Betul , Parmar Simrit , Qazilbash Muzaffar , Shah Nina , Khouri Issa , Champlin Richard E. , Popat Uday
Published: January 2013

Major ABO mismatching is not considered a contraindication to allogeneic haematopoietic stem cell transplantation (HSCT). Modern reduced‐intensity conditioning and reduced‐toxicity regimens cause much less myeloablation than conventional myeloablative regimens, such as cyclophosphamide with busulfan or total body irradiation, which may affect the incidence of pure red cell aplasia (PRCA). We estimated the incidence and described the natural history of PRCA in patients with major ABO‐mismatched donor stem cells. Between 2007 and 2008, 161 (27% of all patients undergoing HSCT) underwent allogeneic HSCT with major ABO‐mismatched stem cells and 12 (7·5%) of these patients developed PRCA. Thirty and ninety day T‐cell and myeloid cell chimerism and neutrophil and platelet engraftment did not differ between patients who developed PRCA and those who did not. The only risk factor associated with PRCA was the use of a fludarabine/busulfan conditioning regimen. All patients with PRCA needed red cell transfusion for several months after HSCT resulting in significant iron overload. Pure red cell aplasia resolved spontaneously in the majority (seven patients) but only resolved after stopping tacrolimus in three patients. Hence, after major ABO‐mismatched HSCT, the incidence of PRCA was 7·5% and it resolved spontaneously or after withdrawal of immunosuppression in the majority of patients.
Exploring avidity: understanding the potential gains in functional affinity and target residence time of bivalent and heterobivalent ligands
Authors: Vauquelin Georges , Charlton Steven J
Published: January 2013

Bivalent ligands are increasingly important therapeutic agents. Although the naturally occurring antibodies are predominant, it is becoming more common to combine different antibody fragments or even low molecular weight compounds to generate heterobivalent ligands. Such ligands exhibit markedly increased affinity (i.e. avidity) and target residence time when both pharmacophores can bind simultaneously to their target sites. This is because binding of one pharmacophore forces the second tethered one to stay close to its corresponding site. This ‘forced proximity’ favours its binding and rebinding (once dissociated) to that site. However, rebinding will also take place when the diffusion of freshly dissociated ligands is merely slowed down. The present differential equation‐based simulations explore the way both situations affect ligand binding. Both delay the attainment of binding equilibrium (resulting in steep saturation curves) and also increase the target residence time. Competitive ligands are able to interfere in a concentration‐dependent manner, although much higher concentrations are required in the ‘forced proximity’ situation. Also, it is only in that situation that the ligand shows increased affinity. These simulations shed light on two practical consequences. Depending on the pharmacokinetic half‐life of the bivalent ligand in the body, it may not have sufficient time to achieve equilibrium with the target. This will result in lower potency than expected, although it would have significant advantages in terms of residence time. In in vitro experiments, the manifestation of steep saturation curves and of accelerated dissociation in the presence of competitive ligands could mistakenly be interpreted as evidence for non‐competitive, allosteric interactions.
Spatio‐temporal Analysis of the Effects of Hurricane Ivan on Two Contrasting Epiphytic Orchid Species in Guanahacabibes, Cuba
Authors: Wiegand Thorsten , Raventós José , Mújica Ernesto , González Elaine , Bonet Andreu
Published: January 2013

Hurricanes represent the dominant type of disturbance in many tropical coastal forests. Here, we focus on mortality of epiphytic orchids caused by hurricane Ivan in the Guanahacabibes National Park (Cuba) and subsequent population recovery. We analyzed different aspects of hurricane damage on two contrasting epiphytic orchids, Broughtonia cubensis and Dendrophylax lindenii, as observed in three plots of coastal vegetation and in three plots of semi‐deciduous forest, respectively. First, we quantified the damage to host trees and orchids and explored if hurricane damage depended on height, size, or identity of the host tree. Second, we used mark connection and mark correlation functions to conduct a detailed analysis of small‐scale spatial patterns in hurricane damage for host trees and orchids. Finally, we analyzed the degree of recovery after Ivan during the 6 yr following the storm. Damage of B. cubensis host trees was independent of height and size, but Ivan severely affected larger and higher host trees of D. lindenii. Spatial analysis revealed non‐random structure in damage that differed between species. Broughtonia cubensis exhibited small‐scale spatial correlation in the proportion of damaged orchids, whereas D. lindenii did not. Dendrophylax lindenii showed ‘patchy’ damage patterns, correlated with height, but B. cubensis did not. The relative growth rate of B. cubensis for the 5–17 mo following Ivan was only moderately reduced and fully recovered in subsequent years, whereas that of D. lindenii was severely reduced the first year and did not fully recover thereafter. We hypothesize that differences in the host, vegetation type, and the traits of the two orchids contribute to the different responses to the hurricane.
Long‐term Changes in Bird Communities after Wildfires in the Central Brazilian Amazon
Authors: Mestre Luiz A. M. , Cochrane Mark A. , Barlow Jos
Published: January 2013

We examined long‐term responses of an Amazonian bird assemblage to wildfire disturbance, investigating how understory birds reacted to forest regeneration 1, 3, and 10 years after a widespread fire event. The bird community was sampled along the Arapiuns and Maró river catchments in central Brazilian Amazonia. Sampling took place in 1998, 2000, and 2008 using mist‐nets in eight plots (four burned, four unburned sites). Species richness did not change significantly in unburned sites. In burned sites, however, we found significantly lower richness in 1998, higher richness in 2000, and similar richness in 2008. Multi‐dimensional scaling ordination showed consistent differences in bird communities both within burned sites sampled in different sampling years, and between burned and unburned sites in all years. Of the 30 most abundant species, 12 had not recovered 10 years after the fires, including habitat specialists such as mixed flocks specialists and ant‐followers. Fire‐disturbance favored three species (two hummingbirds and a manakin) in the short term only. All other species were either favored throughout the study (seven species of omnivores and small insectivores) or did not show a clear response (eight species). In burned sites, we also found significantly lower abundance of species sensitive to disturbances and habitat specialists over the entire study period. Although the bird community seems to be recovering in terms of richness, the overall community composition and abundance of some species in post‐burned and unburned sites remain very different, and have not recovered after 10 years of forest regeneration.
Links Between the Intuitive Sense of Number and Formal Mathematics Ability
Authors: Feigenson Lisa , Libertus Melissa E. , Halberda Justin
Published: January 2013

Humans share with other animals a system for thinking about numbers in an imprecise and intuitive way. The approximate number system (ANS) that underlies this thinking is present throughout the lifespan, is entirely nonverbal, and supports basic numerical computations like comparing, adding, and subtracting quantities. Humans, unlike other animals, also have a system for representing exact numbers. This linguistically mediated system is slowly mastered over the course of many years and provides the basis for most of our formal mathematical thought. A growing body of evidence suggests that the nonverbal ANS and the culturally invented system of exact numbers are fundamentally linked. In this article, we review evidence for this relation, describing how group and individual differences in the ANS correlate with and even predict formal math ability. In this way, we illustrate how a system of ancient core knowledge may serve as a foundation for more complex mathematical thought.
Serum metabolomics reveals pathways and biomarkers associated with asthma pathogenesis
Authors: Jung J. , Kim S.‐H. , Lee H.‐S. , Choi G. S. , Jung Y.‐S. , Ryu D. H. , Park H.‐S. , Hwang G.‐S.
Published: January 2013

Background

Asthma is a chronic inflammatory disease caused by complex interactions of genetic, epigenetic, and environmental factors. For this reason, new approaches are required to clarify the pathogenesis of asthma by systemic review.

Objective

We applied a 1H‐NMR metabolomics approach to investigate the altered metabolic pattern in sera from patients with asthma and sought to identify the mechanism underlying asthma and potential biomarkers.

Method

A global profile of sera from patients with asthma (n = 39) and controls (n = 26) was generated using 1H‐NMR spectroscopy coupled with multivariate statistical analysis. Endogenous metabolites in serum were rapidly measured using the target‐profiling procedure.

Results

Multivariate statistical analysis showed a clear distinction between patients with asthma and healthy subjects. Sera of asthma patients were characterized by increased levels of methionine, glutamine, and histidine and by decreased levels of formate, methanol, acetate, choline, O‐phosphocholine, arginine, and glucose. The metabolites detected in the sera of patients with asthma are involved in hypermethylation, response to hypoxia, and immune reaction. Furthermore, the levels of serum metabolites from patients with asthma correlated with asthma severity; in particular, lipid metabolism was altered in patients with lower forced expiratory volume in 1 s percentage (FEV1%) predicted values. In addition, potential biomarkers showed strong predictive power in ROC analysis, and the presence of asthma in external validation models was predicted with high accuracy (90.9% for asthma and 100% for control subjects).

Conclusion & Clinical Relevance

These data showed that 1H‐NMR‐based metabolite profiling of serum may be useful for the effective diagnosis of asthma and a further understanding of its pathogenesis.
Mutations in CIB2 calcium and integrin‐binding protein disrupt auditory hair cell calcium homeostasis in Usher syndrome type 1J and non‐syndromic deafness DFNB48
Authors: Jan A
Published: January 2013

Alterations of the CIB2 calcium‐ and integrin‐binding protein cause Usher syndrome type 1J and non‐syndromic deafness DFNB48

Riazuddin et al. (2012)

Nature Genetics 44(11):1265–1271
The Effects of a New WTO Agreement on Canada's Chicken Market: A Differentiated Products Modeling Approach
Authors: Rafajlovic Juanita , Cardwell Ryan
Published: January 2013

Current World Trade Organization (WTO) negotiations include proposals that would affect the trade barriers protecting Canada's chicken producers from foreign competition. This research analyzes the effects of the most recent proposals to emerge from WTO negotiations on Canada's chicken industry. We develop a partial‐equilibrium model that generates welfare effects for the Canadian chicken industry supply chain. The baseline model is adapted to represent chicken as two distinct products: white meat and dark meat. Simulation results suggest that the welfare effects of current WTO proposals would be small, providing that chicken receives the sensitive products designation. Liberalization leads to higher total welfare in the chicken industry, which is accounted for by consumer welfare that increases by a larger amount than producer welfare decreases. The results are very sensitive to the disaggregation of chicken as two products; a finding that should inform future research.
On the longevity of Hymenoscyphus pseudoalbidus in petioles of Fraxinus excelsior
Authors: Gross A. , Holdenrieder O.
Published: January 2013

Air‐dried pseudosclerotia produced by the ash dieback pathogen Hymenoscyphus pseudoalbidus (anamorph: Chalara fraxinea) can survive up to 3 months. Under field conditions, they are capable of postponing fructification for 1 year. The implications of this observation for epidemiology and control of ash dieback are discussed.
Native generalist herbivores promote invasion of a chemically defended seaweed via refuge‐mediated apparent competition
Authors: Enge Swantje , Nylund Göran Mikael , Pavia Henrik
Published: January 2013

Refuge‐mediated apparent competition was recently suggested as a mechanism that enables plant invasions. The refuge characteristics of introduced plants are predicted to enhance impacts of generalist herbivores on native competitors and thereby result in an increased abundance of the invader. However, this prediction has so far not been experimentally verified. This study tested if the invasion of a chemically defended seaweed is promoted by native generalist herbivores via refuge‐mediated apparent competition. The invader was shown to offer herbivores a significantly better refuge against fish predation compared with native seaweeds. Furthermore, in an experimental community, the presence of herbivores decreased the performance of neighbouring native seaweeds, but increased growth and relative abundance of the invader. These results provides the first experimental evidence that native generalist herbivores can shift a community towards a dominance of a well‐defended invader, inferior to native species in direct competitive interactions, by means of refuge‐mediated apparent competition.
Nymphal biology of Ephoron virgo (Olivier, 1791) (Ephemeroptera, Polymitarcyidae) in an Apenninic river (NW Italy)
Authors: Bo Tiziano , Cammarata Massimo , López‐Rodríguez Manuel Jesús , Tierno De Figueroa José Manuel , Fenoglio Stefano
Published: January 2013

Life cycle, feeding habits and nymphal density of a population of Ephoron virgo from the Bormida river (Northwestern Italy) were studied. Nymphs were present in the river from the beginning of May until August, with the highest density of nymphs recorded at the end of May–beginning of June. The life cycle was univoltine and the nymphal growth was fast. During the life cycle, an obligatory egg diapause occurs and individuals remain in this stage for up to nine months. Nymphs fed mainly on detritus, although mineral matter constituted a considerable percentage of the gut contents, predominantly in smaller nymphs.
Domestication‐related variation in social preferences in chickens is affected by genotype on a growth QTL
Authors: Wirén A. , Wright D. , Jensen P.
Published: January 2013

A growth‐related QTL on chicken chromosome 1 has previously been shown to influence domestication behaviour in chickens. In this study, we used Red Junglefowl (RJF) and White Leghorn (WL) as well as the intercross between them to investigate whether stress affects the way birds allocate their time between familiar and unfamiliar conspecifics in a social preference test (‘social support seeking’), and how this is related to genotype at specific loci within the growth QTL. Red Junglefowl males spent more time with unfamiliar chickens before the stressful event compared to the other birds, whereas all birds except WL males tended to spend less time with unfamiliar ones after stress. A significant QTL locus was found to influence both social preference under undisturbed circumstances and social support seeking. The WL allele at this QTL was associated not only with a preference for unfamiliar individuals but also with a shift towards familiar ones in response to stress (social support seeking). A second, suggestive QTL also affected social support seeking, but in the opposite direction; the WL allele was associated with increased time spent with unfamiliar individuals. The region contains several possible candidate genes, and gene expression analysis of a number of them showed differential expression between RJF and WL of AVPR2 (receptor for vasotocin), and possibly AVPR1a (another vasotocin receptor) and NRCAM (involved in neural development) in the lower frontal lobes of the brains of RJF and WL animals. These three genes continue to be interesting candidates for the observed behavioural effects.
Women Constructing Masculinity in Voluntary Firefighting
Authors: Ainsworth Susan , Batty Alex , Burchielli Rosaria
Published: January 2013

Within gender studies, research and theorizing have used archetypal ‘masculine’ occupations to explore how masculinity is accomplished and practised in social interaction. In contrast, little work has explored how masculinity is constructed in the voluntary sector. In this paper, we address this gap by exploring how masculinity is constructed and experienced by women volunteers who are active firefighters in rural and regional Victoria. Firefighting is widely recognized as a non‐traditional occupation for women and they are underrepresented as volunteers as well as paid employees. We explore masculinity from the perspective of women volunteers because this can enhance our understanding of masculinity as a relational achievement as well as help to identify practices that they experience as problematic. Our research shows how voluntary work can afford a distinct range of resources for the ‘doing’ of gender and how this reflects the specific organizational and geographical contexts in which such volunteering occurs.
Giving Up: How Gendered Organizational Cultures Push Mothers Out
Authors: Cahusac Emma , Kanji Shireen
Published: January 2013

Explanations for professional and managerial mothers' departure from paid work concentrate on childcare and women's preferences or choices. In contrast, our study, based on in‐depth interviews with professional and managerial mothers in London, shows that women's experiences within hegemonic masculine cultures play a key role. For example, working time norms require these mothers to work exceptionally long hours, to have permeable time boundaries even if they have negotiated reduced working hours and to ‘socialize’ in the evenings. Mothers are limited in their ability to protest or implement creative working time solutions because they feel they must hide their motherhood, which in itself creates tension. Mothers who are seemingly supported to work fewer hours are sidelined to lower‐status roles for which they are underpaid and undervalued in relation to their experience and previous seniority. Unless mothers mimic successful men, they do not look the part for success in organizations.
Tolvaptan, an orally active non‐peptide arginine vasopressin V2 receptor antagonist, reduces ascites in rats with chronic liver injury
Authors: Miyazaki Toshiki , Fujiki Hiroyuki , Yamamura Yoshitaka
Published: January 2013

Aim

This is a non‐clinical, proof of concept study, showing that tolvaptan has efficacy in reducing ascites in chronic liver injury, using a rat model induced by repeated dimethylnitrosamine (DMNA) injection.

Methods

A rat model of chronic liver injury was induced by 10 mg/kg of repeated i.p. injection with DMNA for 6–9 weeks. Tolvaptan was administrated to rats that showed obvious and stable ascites, and abdominal circumference was evaluated as a surrogate marker of ascites volume. Rats were placed in metabolic cages with free access to food and water to collect urine over a 24‐h period.

Results

Oral tolvaptan (1 and 3 mg/kg) promoted a remarkable diuretic effect, decreasing bodyweight and abdominal circumference in a dose‐dependent manner. Plasma sodium concentration was increased by tolvaptan due to the large amount of free‐water excretion following tolvaptan administration.

Conclusion

Tolvaptan had therapeutic efficacy in the reduction of ascites in rats with chronic liver injury. These results are consistent with the clinical data showing tolvaptan has therapeutic implications in the reduction of ascites in patients with decompensated cirrhosis.
Localization of A11‐reactive oligomeric species in prion diseases
Authors: Aidt Frederik H , Hasholt Lis F , Christiansen Michael , Laursen Henning
Published: January 2013

Aims

To investigate in prion diseases the in‐situ localization of prion protein oligomers sharing a common epitope with amyloid oligomers involved in a range of neurodegenerative diseases.

Methods and results

We performed immunohistochemistry on sporadic Creutzfeldt–Jakob disease (sCJD) (n = 9) and hereditary Gerstmann–Sträussler–Scheinker disease (GSS) (n = 1) specimens with the anti‐oligomer antibody A11 to determine the localization of reactive species. We found that A11 reactivity in the sCJD specimens was localized to the cerebral and cerebellar cortices both in spongiform and adjacent, non‐spongiform areas, reminiscent of multicentric or diffuse plaques. In the GSS specimens, we found that staining was closely associated with kuru‐like plaques, and that A11‐reactive species colocalized with protease‐resistant prion protein (PrpSc). We also observed sporadic neuronal cytosolic staining in both types of specimen.

Conclusions

We confirm that intracellular and extracellular A11‐reactive species are present in situ in sCJD cases and GSS, and that immunoreactivity for A11 and PrpSc overlaps. We argue that the A11‐reactive species are indeed composed of oligomeric PrpSc, and suggest that the toxic effects of PrpSc oligomers could be related to the generic oligomeric conformation recognized by A11.
Neuropilin‐1 and neuropilin‐2 expression in the adenoma–carcinoma sequence of colorectal cancer
Authors: Staton Carolyn A , Koay Ivan , Wu Jessie M , Hoh Leslie , Reed Malcolm W R , Brown Nicola J
Published: January 2013

Aims

Neuropilin‐1 (NRP1) and neuropilin‐2 (NRP2) are transmembrane glycoproteins which interact with vascular endothelial growth factor (VEGF) to prevent tumour cell apoptosis and regulate angiogenesis. However, the precise role of NRP1 and NRP2 in the adenoma–carcinoma sequence (ACS) of colorectal cancer remains unclear, and we aimed to determine this in surgical specimens comprising the ACS.

Methods and results

Histological analysis demonstrated that epithelial NRP1 expression increased significantly across the ACS (P = 0.0007), and correlated with microvessel density (MVD; r = 0.505, P = 0.0003) and weakly with VEGF (r = 0.251, P = 0.001). In contrast, although NRP2 epithelial expression was increased significantly in all carcinomas (P < 0.002), there was no correlation with MVD, VEGF or NRP1. Furthermore, patients showing coexpression of NRP1 and NRP2 had a potentially worse prognosis than those expressing a single neuropilin or neither one. Although vascular expression of NRP1 increased significantly across the ACS (P = 0.0004) and correlated with MVD (r = 0.361, P = 0.0006), NRP2 vascular expression decreased significantly (P = 0.0001) and showed an inverse correlation with MVD (r=−0.506, P = 0.0001), suggesting differential roles for neuropilins in the angiogenic process during colorectal cancer development.

Conclusions

These data suggest that an increase in NRP1 and NRP2 epithelial/tumour expression, as well as in NRP1 vascular expression, may be associated with disease progression in colorectal cancer.
Expression of olfactomedin 4 and claudin‐18 in serrated neoplasia of the colorectum: a characteristic pattern is associated with sessile serrated lesion
Authors: Sentani Kazuhiro , Sakamoto Naoya , Shimamoto Fumio , Anami Katsuhiro , Oue Naohide , Yasui Wataru
Published: January 2013

Aims

Olfactomedin 4 is a useful marker for stem cells in the intestine and is an independent prognostic molecule for survival in patients with colorectal cancer (CRC). Claudin‐18, a component of tight junctions, correlates with poor survival in patients with CRC and is associated with the gastric phenotype. We investigated the possible usefulness of these molecules in serrated neoplasia of the colorectum.

Methods and results

We performed immunohistochemical analysis of colorectal polyps, including hyperplastic polyps (HP), sessile serrated lesions (SSL), traditional serrated adenomas (TSA) and conventional adenomas (CA). We also investigated the association between expression of these molecules and clinicopathological parameters in serrated adenocarcinoma (SAC) and non‐SAC of the colorectum. Olfactomedin 4 expression was not detected or was decreased in SSL compared with the other polyp types. Claudin‐18 expression was higher in SSL than in the other types. Similarly, positivity for olfactomedin 4 in SAC was significantly lower than that in non‐SAC, and positivity for claudin‐18 in SAC was significantly higher than that in non‐SAC. Furthermore, claudin‐18‐positive SAC showed more advanced N grade and stage than claudin‐18‐negative SAC.

Conclusions

Reduced expression of olfactomedin 4 and ectopic expression of claudin‐18 might be useful markers in the differential diagnosis of serrated polyps.
Safety of midazolam for sedation of HIV‐positive patients undergoing colonoscopy
Authors: Backman ES , Triant VA , Ehrenfeld JM , Lu Z , Arpino P , Losina E , Gandhi RT
Published: January 2013

Objectives

Because of concerns regarding interactions between midazolam and antiretroviral therapy (ART), alternative sedatives are sometimes used during procedural sedation. Our objective was to compare outcomes in patients on ART who received intravenous (iv) midazolam vs. iv diazepam, a second‐line agent, during colonoscopy.

Methods

We conducted a retrospective analysis of adult HIV‐positive patients who underwent colonoscopy over a 3.5‐year period. Primary outcomes were sedation duration, nadir systolic blood pressure (SBP), nadir oxygen saturation, abnormal cardiac rhythm, and change in level of consciousness using a standardized scale. We calculated rates of adverse events according to benzodiazepine use and identified risk factors for complications using univariate and multivariate analyses.

Results

We identified 136 patients for this analysis: 70 received midazolam‐based sedation and 66 received a diazepam‐based regimen. There were no significant differences between the two groups with respect to sedation duration (mean 48.0 vs. 45.7 minutes for the midazolam and diazepam groups, respectively; P = 0.68), nadir SBP (mean 97.0 vs. 101.6 mmHg; P = 0.06), nadir oxygen saturation (mean 94.6 vs. 94.8%; P = 0.72) or rate of abnormal cardiac rhythm (11.4 vs. 19.7%; P = 0.18). More patients in the midazolam group experienced a depressed level of consciousness (91% vs. 74% in the diazepam group; P = 0.0075), but no patient required reversal of sedation or became unresponsive.

Conclusions

We did not find evidence that patients who received midazolam for procedural sedation had clinical outcomes statistically different from those who received diazepam. These findings should be confirmed in prospective studies or in a randomized controlled trial.
The environmental cost of misinformation: why the recommendation to use elevated temperatures for handwashing is problematic
Authors: Carrico Amanda R. , Spoden Micajah , Wallston Kenneth A. , Vandenbergh Michael P.
Published: January 2013

Multiple government and health organizations recommend the use of warm or hot water in publications designed to educate the public on best practices for washing one's hands. This is despite research suggesting that the use of an elevated water temperature does not improve handwashing efficacy, but can cause hand irritation. There is reason to believe that the perception that warm or hot water is more effective at cleaning one's hands is pervasive, and may be one factor that is driving up unnecessary energy consumption and greenhouse gas emissions. We examine handwashing practices and beliefs about water temperature using a survey of 510 adults in the US. The survey included measures of handwashing frequency, duration, the proportion of time an elevated temperature was used and beliefs about water temperature and handwashing efficacy. We also estimate the energy consumed and resultant carbon dioxide equivalent emissions (CO2eq) in the US due to the use of elevated temperatures during handwashing. Participants used an elevated temperature 64% of the time, causing 6.3 million metric tons (MMt) of CO2eq, which is 0.1% of total annual emissions and 0.3% of commercial and residential sector emissions. Roughly 69% of the sample believed that elevated temperatures improve handwashing efficacy. Updating these beliefs could prevent 1 MMt of CO2eq annually, exceeding the total emissions from many industrial sources in the US including the lead and zinc industries. In addition to causing skin irritation, the recommendation to use an elevated temperature during handwashing contributes to another major threat to public health – climate change. Health and consumer protection organizations should consider advocating for the use of a ‘comfortable’ temperature rather than warm or hot water.
Who do you think you are? Pharmacists' perceptions of their professional identity
Authors: Elvey Rebecca , Hassell Karen , Hall Jason
Published: January 2013

Objectives

The aim of this study was to examine pharmacists' perceptions of their professional identity, both in terms of how they see themselves and how they think others view their profession.

Methods

A qualitative study was undertaken, using group and individual interviews with pharmacists employed in the community, hospital and primary care sectors of the profession in England. The data were recorded, transcribed verbatim and analysed using the framework method.

Key findings

Forty-three pharmacists took part in interviews. A number of elements help determine the professional identities of pharmacists, including attributes (knowledge and skills), personal traits (aptitudes, demeanour) and orientations (preferences) relating to pharmacists' work. The study identified the presence of nine identities for pharmacists: the scientist, the medicines adviser, the clinical practitioner, the social carer, the medicines maker, the medicines supplier, the manager, the business person and the unremarkable character. While the scientist was the strongest professional identity to emerge it nevertheless seemed to overlap and compete with other professional identities, such as that of the medicines maker.

Conclusions

The relatively high number of identities may reflect some degree of role ambiguity and lack of clear direction and ownership of what makes pharmacists unique, but also suggests a flexible view of their role.
Schwann cell‐mediated delivery of glial cell line‐derived neurotrophic factor restores erectile function after cavernous nerve injury
Authors: May Florian , Buchner Alexander , Schlenker Boris , Gratzke Christian , Arndt Christian , Stief Christian , Weidner Norbert , Matiasek Kaspar
Published: January 2013

Objectives

To evaluate the time‐course of functional recovery after cavernous nerve injury using glial cell line‐derived neurotrophic factor‐transduced Schwann cell‐seeded silicon tubes.

Methods

Sections of the cavernous nerves were excised bilaterally (5 mm), followed by immediate bilateral surgical repair. A total of 20 study nerves per group were reconstructed by interposition of empty silicon tubes and silicon tubes seeded with either glial cell line‐derived neurotrophic factor‐overexpressing or green fluorescent protein‐expressing Schwann cells. Control groups were either sham‐operated or received bilateral nerve transection without nerve reconstruction. Erectile function was evaluated by relaparotomy, electrical nerve stimulation and intracavernous pressure recording after 2, 4, 6, 8 and 10 weeks. The animals underwent re‐exploration only once, and were killed afterwards. The nerve grafts were investigated for the maturation state of regenerating nerve fibers and the fascular composition.

Results

Recovery of erectile function took at least 4 weeks in the current model. Glial cell line‐derived neurotrophic factor‐transduced Schwann cell grafts restored erectile function better than green fluorescent protein‐transduced controls and unseeded conduits. Glial cell line‐derived neurotrophic factor‐transduced grafts promoted an intact erectile response (4/4) at 4, 6, 8 and 10 weeks that was overall significantly superior to negative controls (P < 0.001). Maximum intracavernous pressure on electrostimulation was significantly elevated using glial cell line‐derived neurotrophic factor‐transduced grafts compared with negative controls (P = 0.018) and unseeded tubes (P = 0.034). Return of function was associated with the electron microscopic evidence of preganglionic myelinated nerve fibers and postganglionic unmyelinated axons.

Conclusions

Schwann cell‐mediated delivery of glial cell line‐derived neurotrophic factor presents a viable approach for the treatment of erectile dysfunction after cavernous nerve injury.
Significant variability in 10‐year cumulative radiation exposure incurred on different surveillance regimens after surgery for pT1 renal cancers: yet another reason to standardize protocols?
Authors: Lin Yu‐Kuan , Gettle Lori , Raman Jay D.
Published: January 2013

What's known on the subject? and What does the study add?

The topic of radiation safety has been hotly debated not only in the mainstream media, but also in the urological literature. Radiation exposure has been examined in urological diseases such as testicular cancer and urinary stone disease, with resultant recommendations for modifying surveillance imaging.

Radiation risk with respect to surveillance regimens after RCC surgery has yet to be examined. We consider this largely to be a result of RCC typically affecting older patients in whom cumulative radiation exposure may be less of a consideration. However, current population data emphasize that RCC diagnosis and therapy have an increasing impact upon younger patients with a longer life expectancy after treatment. Therefore, radiation considerations in this cohort of patients may be significant.

Objective

To determine the 10‐year cumulative radiation exposure incurred on different surveillance imaging protocols after surgery for pT1 renal cell carcinoma (RCC).

Materials and Methods

The PubMed database was queried for surveillance protocols after surgery for RCC.

There were two index lesions that were selected: (i) pT1a 3 cm, Fuhrman 2, clear cell and (ii) pT1b 5 cm, Fuhrman 3, clear cell.

Exposure for single‐phase chest computed tomography (CT), abdominal CT and chest X‐ray were 7, 8 and 0.1 mSV, respectively.

Calculations assumed biphasic CT scans, negative surgical margins and an Eastern Cooperative Oncology Group status of ≤1.

Results

In total, 12 published surveillance regimens were identified.

For the first lesion (pT1a, clear cell, Fuhrman 2), we observed significant variability in the proposed regimens, ranging from no imaging to several CT scans of both chest and abdomen.

Cumulative incurred radiation exposure for this index patient was in the range 0–102 mSv (mean, 34 mSv).

When considering the second tumour (pT1b, clear cell, Fuhrman 3), all studies recommended some form of follow‐up imaging, although regimens once again varied from annual chest X‐ray to multiple CT scans of chest and abdomen.

Cumulative incurred radiation exposure in this scenario was in the range 0.5–450 mSv (mean, 89 mSV).

Conclusions

Surveillance protocols after surgery for early‐stage RCC result in widely divergent levels of radiation exposure.

Such considerations are increasingly paramount given concerns of radiation‐induced secondary malignancies and present another reason to standardize follow‐up protocols.
Removal of Protein‐Bound, Hydrophobic Uremic Toxins by a Combined Fractionated Plasma Separation and Adsorption Technique
Authors: Brettschneider Falko , Tölle Markus , von der Giet Markus , Passlick‐Deetjen Jutta , Steppan Sonja , Peter Mirjam , Jankowski Vera , Krause Alfred , Kühne Sophie , Zidek Walter , Jankowski Joachim
Published: January 2013

Protein‐bound uremic toxins, such as phenylacetic acid, indoxyl sulfate, and p‐cresyl sulfate, contribute substantially to the progression of chronic kidney disease (CKD) and cardiovascular disease (CVD). However, based on their protein binding, these hydrophobic uremic toxins are poorly cleared during conventional dialysis and thus accumulate in CKD‐5D patients. Therefore, we investigated whether hydrophobic and cationic adsorbers are more effective for removal of protein‐bound, hydrophobic uremic toxins than conventional high‐flux hemodialyzer. Five CKD‐5D patients were treated using the fractionated plasma separation, adsorption, and dialysis (FPAD) system for 5 h. A control group of five CKD patients was treated with conventional high‐flux hemodialysis. Plasma concentrations of phenylacetic acid, indoxyl sulfate, and p‐cresyl sulfate were measured. Removal rates of FPAD treatment in comparison to conventional high‐flux hemodialysis were increased by 130% for phenylacetic acid, 187% for indoxyl sulfate, and 127% for p‐cresol. FPAD treatment was tolerated well in terms of clinically relevant biochemical parameters. However, patients suffered from mild nausea 2 h after the start of the treatment, which persisted until the end of treatment. Due to the high impact of protein‐bound, hydrophobic uremic toxins on progression of CKD and CVD in CKD‐5D patients, the use of an adsorber in combination with dialysis membranes may be a new therapeutic option to increase the removal rate of these uremic toxins. However, larger, long‐term prospective clinical trials are needed to demonstrate the impact on clinical outcome.
Testing the Stress‐Gradient Hypothesis During the Restoration of Tropical Degraded Land Using the Shrub Rhodomyrtus tomentosa as a Nurse Plant
Authors: Liu Nan , Ren Hai , Yuan Sufen , Guo Qinfeng , Yang Long
Published: January 2013

The relative importance of facilitation and competition between pairwise plants across abiotic stress gradients as predicted by the stress‐gradient hypothesis has been confirmed in arid and temperate ecosystems, but the hypothesis has rarely been tested in tropical systems, particularly across nutrient gradients. The current research examines the interactions between a pioneer shrub Rhodomyrtus tomentosa (the nurse plant) and seedlings of a transplanted native woody Schima superba (the target species) in a tropical system in which position on a slope corresponds with a nutrient gradient; high soil nutrients at the slope bottom and relatively low soil nutrients at the slope top. In contrast, soil physical traits were more favorable for seedling growth under the shrub than in open spaces. The effect of R. tomentosa on S. superba survival was positive (facilitation) at the top of the slope, as indicated by the relative interaction index (RII), but negative in the bottom (competition). RII indicated a positive effect on seedling height at the top of the slope but was not at the bottom. Seedling survival was positively related to soil nutrient level and negatively related to soil acidity, but seedling growth of S. superba seemed to be enhanced by the shrub canopy. Thus, the results seem to support stress‐gradient hypothesis in terms of target species survival but not growth. We suggest using the shrub as a nurse plant in forest restoration in tropical degraded land with caution because not all of its effects on target species are positive.
Do Rural Students Really Perform Worse than Urban Students Do? Empirical Evidence from a University Entrance Program in Taiwan
Authors: Liao Pei‐An , Chang Hung‐Hao , Wang Jiun‐Hao , Horng Tai‐Hsiung
Published: January 2013

Despite a major expansion in the number of students in higher education, students from rural areas continue to be underrepresented at selective universities. To reduce the urban‐rural imbalance of entry to selective universities, institutions in many countries of the world have implemented admission policies favoring rural students. Previous evidence has shown that rural students have lower academic performance than their urban peers, which leads to concern that rural students will reduce the academic excellence of selective universities. Using the introduction of a university admission policy favoring rural students in Taiwan and a unique administrative data set of students' academic records, we compare the academic performance of students from rural areas with that of their urban counterparts during their college years. The results show that rural students have consistently outperformed urban students in semester grade point averages and class rank percentile across time; however, the differences in academic performance are mainly attributed to the rural students' initial outperformance in the first semester of the freshman year.
Transforming employment relations in Vietnam and Indonesia: case studies of state‐owned enterprises
Authors: Collins Ngan , Sitalaksmi Sari , Lansbury Russell
Published: January 2013

This paper examines the process of transforming employment relations in Vietnam and Indonesia using case studies of two state‐owned enterprises in each country. Three factors are identified as important in the transformation process, although their impacts were different in each country: the role of the state; the influence of management and unions; and the impact of international bodies such as the International Labour Organization, the International Monetary Fund and multinational enterprises. While the role of the central government is stronger in Vietnam, particularly since the end of the Soeharto regime in Indonesia, both countries are increasingly subject to global influences and pressures. The paper utilises ‘new institutionalist’ theory to emphasise the important emergence of new institutions and their interaction with organisational changes in each country. The transformation of employment relations is likely to be an ongoing process in each country although the pace and direction of change will continue to differ, particularly given the stronger roles played by the state and unions in Vietnam compared with Indonesia