bluuebunny/crossref_metadata_2025 huggingface dataset:
Phage display generation of a novel human anti‐CD1A monoclonal antibody with potent cytolytic activity
Authors: Bechan Gitanjali I. , Lee David W. , Zajonc Dirk M. , Heckel Diana , Xian Rena , Throsby Mark , van Meijer Marja , Germeraad Wilfred T.V. , Kruisbeek Anna M. , Maarten Egeler R. , Arceci Robert J.
Published: August 2012

CD1A is a cell surface protein expressed on Langerhans cells and cortical thymocytes that could potentially be used as an immunotherapeutic target in Langerhans Cell Histiocytosis (LCH), the cortical subtype of T‐cell acute lymphocytic leukaemia (T‐ALL) and other CD1A‐positive tumours. The monoclonal antibody (mAb) CR2113 was selected from a panel of six fully human mAbs isolated from a semi‐synthetic phage display library, based on specificity and avidity against cells expressing CD1 antigen variants. CR2113 recognized CD1A in T‐ALL cell lines and patient samples. Confocal microscopy revealed that the CR2113‐CD1A complex was internalized at 37°C. Furthermore, while CR2113 induced moderate complement‐dependent cytotoxicity (CDC), potent antibody‐dependent cell cytotoxicity (ADCC) activity was observed against CD1A expressing cell lines as well as T‐ALL cell lines and T‐ALL patient samples. In vivo experiments showed that CR2113 as a naked antibody has modest but specific anti‐tumour activity against CD1A‐expressing tumours. CR2113 is a high‐affinity human anti‐CD1A mAb with significant ADCC activity. These properties make CR2113 a candidate for clinical diagnostic imaging and therapeutic targeting of LCH as well as potential use in other clinical applications.
Novel missense mutations of WNK1 in patients with hypokalemic salt‐losing tubulopathies
Authors: Zhang C , Zhu Y , Huang F , Jiang G , Chang J , Li R
Published: August 2012

Clinical and genetic studies have suggested that a loss of function and gain of function mutation in the same gene can cause different diseases. The aim of this study was to test the hypothesis that inactivating mutations in WNK1 (with no K (lysine) protein kinase‐1) or WNK4 could be a new candidate for causing hypokalemic salt‐losing tubulopathy (SLT) in those patients with unknown genetic defects because SLT is the opposite phenotype to pseudohypoaldosteronism type II (PHAII). We screened 44 SLTs patients and found that 33 (75%) cases had homozygous or compound heterozygous mutations in CLCNKB or SLC12A3. Two novel missense mutations were identified in WNK1, but not in WNK4, in 2 of the remaining 11 patients. The WNK1 mutations occurred in the protein C‐terminus domain, de novo and inherited, respectively. One of these WNK1 mutations was shown to reduce NCC protein membrane expression in vitro because of impairing the suppressive effect of WNK4‐mediated inhibition. Taken together, our findings suggest that inactivating mutations in WNK1 may cause SLT, a phenotype opposite to that of PHAII caused by WNK1 intronic deletion.
Gender disparity of living donor renal transplantation in East China
Authors: Liu Guangxiang , Li Xiaogong , Liu Tieshi , Zhao Xiaozhi , Zhang Shiwei , Wang Junjun , Ji Changwei , Gan Weidong , Guo Hongqian
Published: August 2012

Gender disparity among living kidney donors is common world wide, which demonstrates different social and economic problems in different countries. However, few data are available for China. Therefore, we retrospectively analyzed all 139 living donor renal transplants performed in our center between 2003 and 2010. The annual number of living donor renal transplants increased from six to 26 cases per year during the observation period. Among them, 69.2% of all kidney donors were females, whereas 79.5% of the recipients were male. The average age of recipients was 34.1 ± 7.6 yr and 94% (110/117) were younger than 44 yr. In contrast, 53% (62/117) of all donors were “middle‐aged” (45–59 yr) with an average donor age of 47.8 ± 9.2 yr. The first‐degree relatives accounted for the majority of the donor pool, as the most common donor‐recipient combination consisted of mother to son. In conclusion, there was a male and young preponderance among recipients, and a female and middle‐aged one among donors of living kidney transplants in our transplant center, which might be related to socio‐cultural as well as economic factors.
Tumor microvasculature with endothelial fenestrations in VHL null clear cell renal cell carcinomas as a potent target of anti‐angiogenic therapy
Authors: Yamasaki Toshinari , Kamba Tomomi , Kanno Toru , Inoue Takahiro , Shibasaki Noboru , Arakaki Ryuichiro , Yamada Tomomi , Kondo Keiichi , Kamoto Toshiyuki , Nishiyama Hiroyuki , Ogawa Osamu , Nakamura Eijiro
Published: August 2012

Vascular endothelial growth factor (VEGF)‐targeted therapies show significant antitumor effects for advanced clear cell renal cell carcinomas (CC‐RCCs). Previous studies using VEGF inhibitors in mice models revealed that VEGF‐dependent capillaries were characterized by the existence of endothelial fenestrations (EFs). In this study, we revealed that capillaries with abundant EFs did exist, particularly in CC‐RCCs harboring VHL mutation. This finding was recapitulated in mice xenograft models, in which tumors from VHL null cells showed more abundant EFs compared to those from VHL wild‐type cells. Importantly, treatment with bevacizumab resulted in a significant decrease of tumor size established from VHL null cells. Additionally, a significant reduction of EFs and microvessel density was observed in VHL null tumors. Indeed, xenograft from 786‐O/mock (pRC3) cells developed four times more abundant EFs than that from 786‐O/VHL (WT8). However, introduction of the constitutively active form of hypoxia‐inducible factor (HIF)‐2α to WT8 cells failed to either augment the number of EFs or restore the sensitivity to bevacizumab in mice xenograft, irrespective of the equivalent production of VEGF to 786‐O/mock cells. These results indicated that HIF‐2α independent factors also play significant roles in the development of abundant EFs. In fact, several angiogenesis‐related genes including CCL2 were upregulated in 786‐O cells in a HIF‐2α independent manner. Treatment with CCL2 neutralizing antibody caused significant reduction of capillaries with EFs in 786‐O xenograft, indicating that they were also sensitive to CCL2 inhibition as well as VEGF. Collectively, these results strongly indicated that capillaries with distinctive phenotype developed in VHL null CC‐RCCs are potent targets for anti‐angiogenic therapy.
Differences between clinical specialist and advanced practitioner clinical practice, leadership, and research roles, responsibilities, and perceived outcomes (the SCAPE study)
Authors: Begley Cecily , Elliott Naomi , Lalor Joan , Coyne Imelda , Higgins Agnes , Comiskey Catherine M.
Published: August 2012

Aim

To report a study designed comparing the roles, responsibilities, and perceived outcomes of Clinical Nurse Specialists, Clinical Midwife Specialists, and Advanced Nurse Practitioners in Ireland.

Background

A clinical career pathway that encompasses progression from staff nurse or midwife through clinical specialist to advanced practitioner level was introduced in Ireland in 2000. Such roles are common internationally, but little evaluation has been conducted and few comparisons have been made between roles.

Design

A mixed‐method case‐study design was used.

Methods

Following Research Ethics Committee Approval, data were collected in 2009–2010, using non‐participant observation (92 hours) of 23 Clinical Specialists and Advanced Practitioners, interviews with 21 clinicians and 13 Directors of Nursing or Midwifery. A survey was completed by 154 service‐users.

Results

A clear difference was seen between Clinical Specialist and Advanced Practitioners, with advanced practice roles providing improved service delivery, greater clinical and professional leadership, increased research, and a clear governance and accreditation structure. Clinical Midwife Specialists were rated at a similar level to Advanced Nurse Practitioners for certain aspects and rated more highly for ‘continuity of care and carer’.

Conclusion

Advanced Practitioners do give a higher level of care, particularly at a strategic level. Existing Clinical Specialists should therefore be encouraged to develop their skills and education to achieve advanced practice level and more specialist and advanced practice posts should be instituted.
Minimizing the risk of intrusion: a grounded theory of intimate partner violence disclosure in emergency departments
Authors: Catallo Cristina , Jack Susan M. , Ciliska Donna , MacMillan Harriet L.
Published: August 2012

Aims

To report a study of processes used by women to disclose intimate partner violence to healthcare professionals in urban emergency department settings.

Background

Women seek emergency care for impairment related to intimate partner violence yet face barriers non‐judgmental and supportive care.

Design

A two‐phase sequential explanatory mixed methods study.

Methods

The study was conducted in Ontario, Canada (May 2006–December 2007). In a sub‐analysis of quantitative data with 1182 participants, 15% of women patients reported intimate partner violence, but only 2% disclosed to a healthcare professional. To understand these results, grounded theory with 19 participants was completed.

Results/findings

Participants identified that the basic social problem was the violence ‘being found out’ by healthcare professionals while receiving care. To address this problem, women undertook a process to minimize intrusion including: deciding to seek care, evaluating the level of trust with the presenting healthcare professional, and establishing personal readiness to disclose. The trajectory of this process was different for each participant with some negotiating all phases leading to violence disclosure. The length of time it took for participants to move through each phase varied across all participants. Common to all participants was the anticipation and the actual experience of intrusion and its influence on women's willingness to disclose intimate partner violence.

Conclusion

The results suggest nurses may be able to facilitate disclosure of intimate partner violence through limiting intrusion. This can include assessment in a private setting, and fewer professionals who interact with the client.
Instrument translation and initial psychometric evaluation of the Chinese version of the Self‐Management of Type 1 Diabetes for Adolescents scale
Authors: Guo Jia , Dixon Jane K. , Whittemore Robin , He Guo‐Ping
Published: August 2012

Aim

To translate the validated measure, Self‐Management of Type 1 Diabetes in Adolescents, into the Mandarin Chinese language and to test the psychometric properties of the Chinese version.

Background

Although research on self‐management of Type 1 diabetes has been increasing over the past 20 years, few health‐related instruments have been available in the Chinese language for youth with Type 1 diabetes.

Design

A two‐phase design was used in this study, including instrument translation and psychometric testing.

Methods

The instrument translation, from October 2008–April 2009, included three steps: forward translation, back translation, and comparison of versions via Translation Validity Index – with multiple rounds, group discussion, and achievement of consensus at each step. Psychometric properties of the Chinese version Schilling's Self‐Management of Type 1 Diabetes for Adolescents scale was assessed in a convenience sample of 136 Chinese youth (ages 8–19) with Type 1 diabetes between June 2009–August 2009.

Results

The internal consistency and test–retest reliabilities indicated generally good consistency and temporal stability of the Chinese version. Evidence of construct validity and criterion‐related validity was obtained via correlations of subscales with established measures of diabetes adherence and quality of life and also with haemoglobin A1c. Results from hypothesis testing also supported construct validity.

Conclusion

The Chinese version of Self‐Management of Type 1 Diabetes for Adolescents scale is sound and will facilitate cross‐cultural studies, while also enabling nurses to monitor and enhance the diabetes self‐management of Chinese youth with Type 1 diabetes.
A randomized controlled trial of the effects of listening to non‐commercial music on quality of nocturnal sleep and relaxation indices in patients in medical intensive care unit
Authors: Su Chiu‐Ping , Lai Hui‐Ling , Chang En‐Ting , Yiin Lih‐Ming , Perng Shoa‐Jen , Chen Pin‐Wen
Published: August 2012

Aim

The purpose was to examine the effects of non‐commercial music on quality of sleep and relaxation indices, including heart rate, mean arterial pressure, and respiratory rate in patients in intensive care units.

Background

There is currently insufficient scientific knowledge for the effects of music on quality of sleep in critically ill patients.

Design

A randomized controlled trial.

Methods

Between January–December 2010, 28 patients aged 39–78 years were randomly assigned to music and control groups. Participants in the music groups listened to non‐commercial music for 45 minutes at nocturnal sleep time. In the control group, participants slept with no music. Participants were assessed using vital signs monitors, standardized questionnaire, and polysomnography. Polysomnography sleep was recorded for the first 2 hours of the nocturnal sleep. General estimating equation was applied to analyse data.

Findings

Participants in the music group had shorter stage N2 sleep and longer stage N3 sleep in the first 2 hours of the nocturnal sleep and improved self‐reported sleep quality, compared with those in the control group. The music group patients also had significantly lower heart rates than those in the control group. The intensive care units patients experienced fragmented sleep with a high frequency of awakenings and severe reduction in random eye movement sleep during the first 2 hours of the nocturnal sleep.

Conclusion

The findings provided evidence for nurses to use soothing music as a research‐based nursing intervention for intensive care unit patients' sleep improvement.
Stress and stressors in the clinical environment: a comparative study of fourth‐year student nurses and newly qualified general nurses in Ireland
Authors: Suresh Patricia , Matthews Anne , Coyne Imelda
Published: August 2012

Aims and objectives.  To measure and compare the perceived levels of job‐related stress and stressors of newly qualified nurses and fourth‐year student nurses in the clinical environment and to explore the participants’ views on stress and stressors.

Background.  Stress in the nursing workplace has significant consequences for the person, the patient and the organisation, such as psychological and physical health deterioration and impaired professional practice. To address this problem, stress and stressors need to be measured and identified.

Design.  This study used a cross‐sectional survey design and self‐reporting questionnaires to measure and compare levels of stress in both groups. Convenience sampling involved all newly qualified nurses (n = 120) and fourth‐year student nurses (n = 128) in Dublin North‐East region in Ireland.

Methods.  The instrument used was ‘The Nursing Stress Scale’ (Gray‐Toft & Anderson 1981, Journal of Behavioral Assessment3, 11–23). Descriptive, qualitative analysis was conducted on an open‐ended question. Data were obtained from newly qualified nurses (n = 31) and fourth‐year student nurses (n = 40) in six acute hospital sites.

Results.  Levels of perceived stress and stressors were high in both groups. Themes identified from the responses to the open question by both groups included excessive workload, difficult working relationships and unmet clinical learning needs. Student nurses also reported the combination of academic demands with clinical placement as a major stressor. There was no significant difference between each group.

Conclusion.  Stress continues to be a problem for nurses in the clinical setting. Excessive workload requires urgent attention by hospital managers in view of widespread retention difficulties. Themes identified could provide a framework for possible interventions for improving the clinical environment for nurses.

Relevance to clinical practice.  These results can help stakeholders in nurse education and practice to develop interventions to reduce stress for both groups and to ease the transition from student to graduate nurse.
Enuresis – children’s predictions of their treatment’s progress and outcomes
Authors: Ronen Tammie , Hamama Liat , Rosenbaum Michael
Published: August 2012

Aims and objectives.  To investigate how nurses can use children’s ability to predict treatment outcomes as a possible feature contributing to successful therapeutic processes targeting enuresis.

Background.  Prediction of outcomes was viewed both as a self‐efficacy component or belief (based on self‐efficacy theory), and also as a skill for actually influencing change.

Design.  The study was conducted in a mental health community center, located in a large city in central Israel, which was well known for treatment of children with enuresis. For the purpose of the study, the children and their parents completed three questionnaires and underwent training to maintain bedwetting records.

Methods.  The study compared three groups of children aged 8–14 years who: made predictions only at baseline (n = 32), predicted progress every week during treatment (n = 38), or did not use prediction at all (n = 31).

Results.  Findings pinpointed the role of practice in improving predictions. Children who predicted weekly showed the highest congruence with outcomes.

Relevance to clinical practice.  Based on self‐efficacy, skills acquisition, and learning and training in the change process, nurses may help children overcome enuresis.
Guidelines for preventing urinary retention and bladder damage during hospital care
Authors: Johansson Rose‐Marie , Malmvall Bo‐Eric , Andersson‐Gäre Boel , Larsson Bruno , Erlandsson Ingrid , Sund‐Levander Märta , Rensfelt Gunhild , Mölstad Sigvard , Christensson Lennart
Published: August 2012

Aims and objectives.  To develop evidence‐based guidelines for adult patients in order to prevent urinary retention and to minimise bladder damage and urinary tract infection.

Background.  Urinary retention causing bladder damage is a well known complication in patients during hospital care. The most common treatment for urinary retention is an indwelling urinary catheter, which causes 80% of hospital‐acquired urinary tract infections. Appropriate use of bladder ultrasonography can reduce the rate of bladder damage as well as the need to use an indwelling urinary catheter. It can also lead to a decrease in the rate of urinary tract infections, a lower risk of spread of multiresistant Gram‐negative bacteria, and lower hospital costs.

Design.  An expert group was established, and a literature review was performed.

Methods.  On the basis of literature findings and consensus in the expert group, guidelines for clinical situations were constructed.

Results.  The main points of the guidelines are the following: identification of risk factors for urinary retention, managing patients at risk of urinary retention, strategies for patients with urinary retention and patient documentation and information.

Conclusion.  Using literature review and consensus technique based on a multiprofessional group of experts, evidence‐based guidelines have been developed. Although consensus was reached, there are parts of the guidelines where the knowledge is weak.

Relevance to clinical practice.  These guidelines are designed to be easy to use in clinical work and could be an important step towards minimising bladder damage and hospital‐acquired urinary tract infections and their serious consequences, such as bacteraemia and the spread of multidrug‐resistant bacteria in hospitals.
Sex‐specific estimates of dispersal show female philopatry and male dispersal in a promiscuous amphibian, the alpine salamander (Salamandra atra)
Authors: Helfer V. , Broquet T. , Fumagalli L.
Published: August 2012

Amphibians display wide variations in life‐history traits and life cycles that should prove useful to explore the evolution of sex‐biased dispersal, but quantitative data on sex‐specific dispersal patterns are scarce. Here, we focused onSalamandra atra, an endemic alpine species showing peculiar life‐history traits. Strictly terrestrial and viviparous, the species has a promiscuous mating system, and females reproduce only every 3 to 4 years. In the present study, we provide quantitative estimates of asymmetries in male vs. female dispersal using both field‐based (mark–recapture) and genetic approaches (detection of sex‐biased dispersal and estimates of migration rates based on the contrast in genetic structure across sexes and age classes). Our results revealed a high level of gene flow among populations, which stems exclusively from male dispersal. We hypothesize that philopatric females benefit from being familiar with their natal area for the acquisition and defence of an appropriate shelter, while male dispersal has been secondarily favoured by inbreeding avoidance. Together with other studies on amphibians, our results indicate that a species' mating system alone is a poor predictor of sex‐linked differences in dispersal, in particular for promiscuous species. Further studies should focus more directly on the proximate forces that favour or limit dispersal to refine our understanding of the evolution of sex‐biased dispersal in animals.
Detection of complement‐fixing and non‐fixing antibodies specific for endothelial precursor cells and lymphocytes using flow cytometry
Authors: AlMahri A. , Holgersson J. , Alheim M.
Published: August 2012

Donor human leukocyte antigen (HLA)‐specific antibodies (Abs) with the ability to activate complement are associated with an increased risk of early Ab‐mediated rejection (AMR) of kidney allografts. In recent years, also non‐HLA Abs‐binding endothelial cells have been shown to elicit early AMR. Donor‐specific anti‐endothelial cell Abs escape detection in the pre‐transplant evaluation if only lymphocytes are used as target cells in crossmatch tests. We addressed whether endothelial precursor cells (EPCs) could be used for detection of complement‐fixing as well as non‐fixing Abs and if complement factor and immunoglobulin G (IgG) deposition on co‐purified T and B cells correlated to the outcome of the T‐ and B‐cell complement‐dependent cytotoxicity assay. Deposition of complement factors C3c and C3d, but not C1q nor C4d, were detected on EPCs and lymphocytes upon incubation with HLA Ab‐positive sera. There was a correlation between the amount of C3c deposition and IgG binding on EPCs (R2 = 0.71, P = 0.0012) and T cells (R2 = 0.74, P = 0.0006) but not for B cells (R2 = 0.34, P = 0.059). The specificity and sensitivity for C3d deposition on endothelial precursor cell crossmatch (EPCXM) T cells vs the T complement‐dependent cytotoxicity (CDC) assay were 69% and 72%, respectively. The EPCXM B‐cell C3d assay had considerably lower sensitivity (39%) than the B CDC assay. Altogether, this novel assay based on the detection of complements factors on EPCs and lymphocytes by flow cytometry may widen the diagnostic repertoire and thereby improve the clinical management of patients undergoing kidney transplantation.
Subcutaneous IgG replacement after pediatric SCT
Authors: Sundin Mikael , Nordin Karin , Jostemyr Yvonne , Winiarski Jacek
Published: August 2012

Sundin M, Nordin K, Jostemyr Y, Winiarski J. Subcutaneous IgG replacement after pediatric SCT.

Abstract:  Hypogammaglobulinemia is common after pediatric SCT and IgG replacement is recommended. Some children will have a prolonged hypogammaglobulinemia but may have poor venous access which impedes further iv IgG replacement. In primary antibody deficiencies, sc IgG replacement, performed by parents at home, has been shown to be efficient and to improve life quality. In this study prolonged hypogammaglobulinemia post‐SCT was observed in 58 of 158 (37%) children transplanted 2003–2010. Iv IgG (n = 46) and sc IgG (n = 12) replacement was compared and in 32 of 35 surviving children, it was possible to assess family attitudes to the treatment. There was no significant difference in numbers of patients reaching IgG ≥4 g/L (64–96%) or IgG trough levels between the two groups. However, the levels were less variable in the sc IgG group. Side effects associated with the IgG replacement occurred more frequently in the iv IgG group (67.4% vs. 16.7%, p = 0.003). The frequency of clinical infections was equal in the groups. No family in the sc IgG group desired change of route of administration in contrast to the iv IgG group. To conclude, sc IgG replacement is a convenient and safe alternative to iv IgG replacement which should be offered to children undergoing SCT.
First global forum on education on organ donation and transplantation for schools
Authors: Cantarovich M. , Birk P. , Ekbeg H. , Delmonico F. , Schoenberg R. , Garcia C. , Manyalich M. , Wall W. , Arbogast H. , Sherry W. , Young‐Kipp S. , Cantarovich F.
Published: August 2012

Cantarovich M, Birk P, Ekbeg H, Delmonico F, Schoenberg R, Garcia C, Manyalich M, Wall W, Arbogast H, Sherry W, Young‐Kipp S, Cantarovich F. First global forum on education on organ donation and transplantation for schools.

Abstract:  The Transplantation Society, in collaboration with the Canadian Society of Transplantation, organized a forum on education on ODT for schools. The forum included participants from around the world, school boards, and representatives from different religions. Participants presented on their countries’ experience in the area of education on ODT. Working groups discussed about technologies for education, principles for sharing of resources globally, and relationships between education, and health authorities and non‐governmental organizations. The forum concluded with a discussion about how to best help existing programs and those wishing to start educational programs on ODT.
Small bowel obstruction caused by inflammatory cytomegalovirus tumor in a renal transplant recipient: report of a rare case and review of the literature
Authors: Papadimitriou G. , Koukoulaki M. , Vardas K. , Florou E. , Argyrakos T. , Lakiotis G. , Apostolou T. , Drakopoulos S.
Published: August 2012

Cytomegalovirus (CMV) infection in renal transplant recipients can present as asymptomatic viremia or CMV syndrome or, in more severe cases, as tissue‐invasive disease. CMV enteritis, a common manifestation of CMV invasive disease, usually presents with fever, abdominal pain, anorexia, nausea, and diarrhea, and can be rarely complicated by colon perforation, hemorrhage, or megacolon. CMV infection occurs primarily in the first 6 months post transplantation, when immunosuppression is more intense.

We describe the case of a female renal transplant recipient with small bowel obstruction caused by CMV disease 7 years post renal transplantation. The patient presented with diarrhea and abdominal pain. Because of elevated CMV viral load, she was initially treated with antiviral therapy with transient response. Endoscopy and imaging tests showed obstruction of the terminal ileum and, subsequently, the patient underwent exploratory laparotomy when a right hemicolectomy was performed. Biopsy results confirmed the diagnosis of CMV enteritis. Epidemiologic characteristics, clinical presentation, diagnostic workup, therapeutic options, and morbidity–mortality rates of CMV infection/disease, in renal transplant recipients, are reviewed.
Development of Hordeum chilense 4Hch introgression lines in durum wheat: a tool for breeders and complex trait analysis
Authors: CALDERÓN MARÍA DEL CARMEN , RAMÍREZ MARÍA DEL CARMEN , MARTÍN ANTONIO , PRIETO PILAR
Published: August 2012

With 3 figures and 2 tables

The wild species Hordeum chilense Roem. et Schult is a valuable genetic resource for durum wheat breeding and genomic research. In this study, an interspecific cross, advanced backcrosses and consecutive selfing strategies were used to develop introgression lines of H. chilense chromosome 4Hch into durum wheat. It is the first time that H. chilense genomic introgressions were obtained in durum background. Substitutions and addition lines for H. chilense chromosome 4 into durum were generated. Alien chromosome segments were reduced in size by further spontaneous translocations between wheat and chromosome 4Hch. Hordeum chilense introgressions were identified in the durum background through several plant generations by fluorescence in situ hybridization (FISH) and simple sequence repeat (SSR) markers. Development of these H. chilense introgression lines constitutes an important advance in durum breeding, proof of concept for the development of new H. chilense introgression lines in durum, and is a valuable tool for plant breeding.
The use of botulinum toxin type A in the management of adult‐onset focal spasticity: A survey of Australian allied health professionals
Authors: Williams Gavin , Olver John , de Graaff Stephen , Singer Barbara J.
Published: August 2012

Background

Recently, the European Journal of Neurology published international consensus statements for the assessment, treatment and aftercare associated with the use of botulinum neurotoxin type A. This survey examined current allied health practice in relation to botulinum neurotoxin type A use in Australia in the light of these guidelines.

Methods

An electronic questionnaire was distributed to members of neurology groups of the Australian Physiotherapy Association and Occupational Therapy Australia. The questionnaire explored assessment processes used, familiarity with pharmaceutical benefits scheme indications for botulinum neurotoxin type A use, goal setting and outcome measurement, follow‐up therapy and access to spasticity management services.

Results

The 123 survey respondents (81 from the Australian Physiotherapy Association – response rate 16.2%, 42 from Occupational Therapy Australia – response rate 6.4%) reported that focal spasticity was a major problem for which botulinum neurotoxin type A was a primary intervention. The Tardieu scale was more frequently used than the modified Ashworth scale (82% vs. 48%). Most therapists (76.3%) reported being confident diagnosing spasticity and its functional implications (84.2%), but fewer were confident discussing referral for botulinum neurotoxin type A with doctors (56.1%). Goals were set in conjunction with the client (93.6%). Barriers to injection and adjunctive therapy (motor training etc.) included waiting times for botulinum neurotoxin type A injection, access to specialist adjunctive therapists and referral for treatment.

Conclusions

Allied health practitioners in Australia report clinical practice to be closely aligned with international guidelines for the use of botulinum neurotoxin type A in adult spasticity. Therapist confidence in advocating for botulinum neurotoxin type A injection, consistent use of objective measures of spasticity and treatment outcomes and barriers to providing adjunctive therapy need to be addressed.
Quality‐of‐life assessment in the treatment of iatrogenic bile duct injuries: hepaticojejunostomy versus end‐to‐end biliary reconstructions
Authors: Jabłońska Beata , Olakowski Marek , Lampe Paweł , Górka Zygmunt , Bułdak Łukasz
Published: August 2012

Background

Assessment and comparison of quality of life (QOL) in patients treated for iatrogenic bile duct injuries (IBDI) with Roux‐en‐Y hepaticojejunostomy (HJ) or end‐to‐end ductal anastomosis (EE).

Methods

The Medical Outcomes Study Short Form 36v2 (SF‐36v2) Health Survey and the Karnofsky score were used. Comparative analysis of QOL was performed in 41 patients following reconstructive surgery for IBDI between 1990 and 2005: 22 – HJ and 21 – EE.

Results

Seven of eight values were comparable in both analysed groups: role‐physical, bodily pain, general health, vitality, social functioning, role‐emotional and mental health index. Physical functioning was significantly better in patients following EE (P = 0.04). Physical component summary (P = 0.11) and mental component summary (P = 0.92) in both groups were comparable. QOL according to the Karnofsky scale was comparable in both groups (P = 0.294).

Conclusions

Physical functioning was significantly better in patients after EE. Other values of QOF according to the SF‐36v2 and the Karnofsky score were comparable in both groups.
Use of outcome events in surgical trials: a systematic review
Authors: Hall Jane L. , Hall John C.
Published: August 2012

Background

Surgical trials sometimes fail to clearly identify the primary outcome events of interest. This results in trials that are diffuse and difficult to interpret.

Objective

The objective of this study was to systematically review the use of outcome events in surgical trials.

Data sources

Surgical trials published between 1 January 2007 and 30 June 2010 in 26 peer‐reviewed journals representing a wide range of specialty interests were used in this study.

Review methods

Copies of all potentially relevant articles were scrutinized to identify the admissible surgical trials. Two investigators experienced in health research methods used a standardized form to extract discrete information (i.e. it was an ‘identifying and counting’ exercise that did not require subjective evaluations). All forms were double‐checked.

Results

Twenty‐four per cent (130 out of 531) of the trials failed to declare the primary outcome events – 11% (56 out of 531) of the trials indicated the primary outcome events in the abstract, but not in the body of the article. The compliant trials used a median of three primary outcome events (interquartile range: 2–5, absolute range: 1–17), and a median of 19 statistical comparisons (interquartile range: 9–32, absolute range: 1–130). Only 2% (11 out of 531) of the trials made an adjustment for the multiple testing of statistical significance (9 of these trials declared a single primary outcome event). Composite outcome events appeared in 9% (48 out of 531) of the trials and these studies contained a median of 24 statistical comparisons.

Conclusions

Many surgical trials fail to clearly define the specific outcome events of interest, and this is often accompanied by a subversive number of statistical comparisons.
Telerheumatology: an idea whose time has come
Authors: Roberts L. J. , LaMont E. G. , Lim I. , Sabesan S. , Barrett C.
Published: August 2012

Australia is a vast country with one‐third of the population living outside capital cities. Providing specialist rheumatologist services to regional, rural and remote Australians has generally required expensive and time‐consuming travel for the patient and/or specialist. As a result, access to specialist care for remote Australians is poor. Rheumatoid arthritis is a common disease, but like many rheumatic diseases, it is complex to treat. Time‐dependent joint damage and disability occur unless best evidence care is implemented. The relatively poor access to rheumatologist care allotted to nonmetropolitan Australians therefore represents a significant cause of potentially preventable disability in Australia. Telehealth has the potential to improve access to specialist rheumatologists for patients with rheumatoid arthritis and other rheumatic diseases, thereby decreasing the burden of disability caused by these diseases. Advances in videoconferencing technology, the national broadband rollout and recent Federal government financial incentives have led to a heightened interest in exploring the use of this technology in Australian rheumatology practice. This review summarises the current evidence base, outlines telehealth's strengths and weaknesses in managing rheumatic disease, and discusses the technological, medicolegal and financial aspects of this model of care. A mixed model offering both face‐to‐face and virtual consultations appears to be the best option, as it can overcome the barriers to accessing care posed by distance while also mitigating the risks of virtual consultation.
Testing the metabolic theory of ecology
Authors: Price Charles A. , Weitz Joshua S , Savage Van M. , Stegen James , Clarke Andrew , Coomes David A. , Dodds Peter S. , Etienne Rampal S. , Kerkhoff Andrew J. , McCulloh Katherine , Niklas Karl J. , Olff Han , Swenson Nathan G.
Published: August 2012

The metabolic theory of ecology (MTE) predicts the effects of body size and temperature on metabolism through considerations of vascular distribution networks and biochemical kinetics. MTE has also been extended to characterise processes from cellular to global levels. MTE has generated both enthusiasm and controversy across a broad range of research areas. However, most efforts that claim to validate or invalidate MTE have focused on testing predictions. We argue that critical evaluation of MTE also requires strong tests of both its theoretical foundations and simplifying assumptions. To this end, we synthesise available information and find that MTE's original derivations require additional assumptions to obtain the full scope of attendant predictions. Moreover, although some of MTE's simplifying assumptions are well supported by data, others are inconsistent with empirical tests and even more remain untested. Further, although many predictions are empirically supported on average, work remains to explain the often large variability in data. We suggest that greater effort be focused on evaluating MTE's underlying theory and simplifying assumptions to help delineate the scope of MTE, generate new theory and shed light on fundamental aspects of biological form and function.
Chemolithoautotrophic denitrification of epsilonproteobacteria in marine pelagic redox gradients
Authors: Bruckner Christian G. , Mammitzsch Kerstin , Jost Günter , Wendt Juliane , Labrenz Matthias , Jürgens Klaus
Published: August 2012

Pelagic marine oxygen‐depleted zones often exhibit a redox gradient, caused by oxygen depletion due to biological demand exceeding ventilation, and the accumulation of reduced chemical species, such as hydrogen sulfide. These redox gradients harbour a distinct assemblage of epsilonproteobacteria capable of fixing carbon dioxide autotrophically in the dark and potentially of utilizing hydrogen sulfide chemolithotrophically by oxidation with nitrate. Together, these two processes are referred to as chemolithoautotrophic denitrification. The focus of this study was the recently isolated and cultivated representative strain of pelagic epsilonproteobacteria, ‘Sulfurimonas gotlandica’ strain GD1, specifically dark carbon dioxide fixation and its substrate turnovers during chemolithotrophic denitrification. By connecting these processes stoichiometrically and comparing the results with those obtained for dark carbon dioxide fixation and nutrient concentrations measured in pelagic redox gradients of the Baltic Sea, we were able to estimate the role of chemolithoautotrophic denitrification in the environment. Evidence is provided for a defined zone where chemolithoautotrophic denitrification of these epsilonproteobacteria allows the complete removal of nitrate and hydrogen sulfide from the water column. This water layer is roughly equivalent in thickness to the average overlapping region of the two substrates, but slightly larger. Such a difference may be explained by a variety of reasons, including, e.g. utilization of substrates present at concentrations below the detection limit, alternative usage of other substrates as thiosulfate or nitrous oxide, or comparable activities of other microbes. However, the combined results of in vitro and in situ studies strongly suggest that epsilonproteobacteria are primarily responsible for hydrogen sulfide and nitrate removal from pelagic Baltic Sea redox gradients.
20‐year survival after radical prostatectomy as initial treatment for cT3 prostate cancer
Authors: Mitchell Christopher R. , Boorjian Stephen A. , Umbreit Eric C. , Rangel Laureano J. , Carlson Rachel E. , Karnes R. Jeffrey
Published: August 2012

Study Type – Therapy (case series)

Level of Evidence 4

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

Despite a lack of randomised controlled trials, most men with locally advanced prostate cancer are recommended to undergo external beam radiotherapy (EBRT), often combined with long‐term androgen‐deprivation therapy (ADT). Many of these men are not offered radical prostatectomy (RP) by their treating urologist. Additionally, it is know that EBRT with long‐term ADT does provide good cancer control (88% at 10 years). We have previously published intermediate‐term follow‐up of a large series of men treatment with RP for cT3 prostate cancer.

We report long‐term follow‐up of a large series of men treated with RP as primary treatment for cT3 prostate cancer. Our study shows that with long‐term follow‐up RP provides excellent oncological outcomes even at 20 years. While most men do require a multimodal treatment approach, many men can be managed successfully with RP alone.

OBJECTIVE

To present long‐term survival outcomes after radical prostatectomy (RP) for patients with cT3 prostate cancer, as the optimal treatment for patients with clinical T3 prostate cancer is debated.

PATIENTS AND METHODS

We identified 843 men who underwent RP for cT3 tumours between 1987 and 1997.

Survival was estimated using the Kaplan–Meier method.

Cox proportional hazards regression models were used to evaluate the association of clinicopathological features with outcome

RESULTS

The median (range) postoperative follow‐up was 14.3 (0.1–23.5) years.

Down‐staging to pT2 disease occurred in 26% (223/843) at surgery.

Local recurrence‐free, systemic progression‐free and cancer‐specific survival for men with cT3 prostate cancer after RP was 76%, 72%, and 81%, respectively, at 20 years.

On multivariate analysis, increasing RP Gleason score (hazard ratio [HR] 1.8; P= 0.01), non‐diploid chromatin content (HR 1.8; P= 0.01), positive surgical margins (HR 2.1; P= 0.007), and seminal vesicle invasion (HR 2.1; P= 0.005) were associated with a significant risk of prostate cancer death, while a more recent year of surgery was associated with a decreased risk of cancer‐specific mortality (HR 0.88; P= 0.01)

CONCLUSIONS

RP affords accurate pathological staging and may be associated with durable cancer control for cT3 prostate cancer, with 20 years of follow‐up presented here.

RP as part of a multimodal treatment strategy therefore remains a viable treatment option for patients with cT3 tumours.
Association between chronic kidney disease and urinary calculus by stone location: a population‐based study
Authors: Keller Joseph J. , Chen Yi‐Kuang , Lin Herng‐Ching
Published: August 2012

Study Type – Disease prevalence study (cohort design)

Level of Evidence 2a

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

Several studies have estimated the potential association of urinary calculus (UC) with chronic kidney disease (CKD). However, previous literature focusing on this issue tended to evaluate the impact of kidney stones alone on incident CKD, with no studies having been conducted investigating the association between CKD and stone formation in other portions of the urological system.

We found that patients with CKD were consistently more likely than comparison subjects to have been previously diagnosed with kidney calculus (odds ratio [OR] 2.10, 95% confidence interval [CI] 1.95–2.27), ureter calculus (OR 1.68, 95% CI 1.51–1.85), bladder calculus (OR 1.49, 95% CI 1.13–1.98), and unspecified calculus (OR 1.89, 95% CI 1.74–2.06). We concluded that there was an association between CKD and UC regardless of stone location.

OBJECTIVE

To explore the association of chronic kidney disease (CKD) with prior kidney calculus, ureter calculus, and bladder calculus using a population‐based dataset in Taiwan. Several studies have estimated the potential association of urinary calculus (UC) with CKD. However, previous literature focusing on this issue tended to evaluate the impact of kidney stones alone on incident CKD, with no studies having been conducted investigating the association between CKD and stone formation in other portions of the urological system.

PATIENTS AND METHODS

We identified 21 474 patients who received their first‐time diagnosis of CKD between 2001 and 2009.

The 21 474 controls were frequency‐matched with cases for sex, age group, and index year.

We used conditional logistic regression analyses to compute the odds ratio (OR) and corresponding 95% confidence interval (CI) as an estimation of association between CKD and having been previously diagnosed with UC.

RESULTS

The results show that compared with controls, the OR of prior UC for cases was 1.91 (95% CI 1.81–2.01, P < 0.001) after adjusting for potential confounders.

Furthermore, cases were consistently more likely than controls to have been previously diagnosed with kidney calculus (OR 2.10, 95% CI 1.95–2.27), ureter calculus (OR 1.68, 95% CI 1.51–1.85), bladder calculus (OR 1.49, 95% CI 1.13–1.98), and unspecified UC (OR 1.89, 95% CI 1.74–2.06).

CONCLUSION

We concluded that there was an association between ckd and UC regardless of stone location.
Temporal Blending for Adaptive SPH
Authors: Orthmann Jens , Kolb Andreas
Published: August 2012

In this paper, we introduce a fast and consistent smoothed particle hydrodynamics (SPH) technique which is suitable for convection–diffusion simulations of incompressible fluids. We apply our temporal blending technique to reduce the number of particles in the simulation while smoothly changing quantity fields. Our approach greatly reduces the error introduced in the pressure term when changing particle configurations. Compared to other methods, this enables larger integration time‐steps in the transition phase. Our implementation is fully GPU‐based to take advantage of the parallel nature of particle simulations.
THE DYNAMICS OF IRONY IN ORGANIZATIONAL CHANGE: COPING WITH A SCHOOL MERGER
Authors: WALLACE MIKE , HOYLE ERIC
Published: August 2012

The potential of an ironic perspective for understanding public service change is portrayed through a re‐analysis of data on a merger between two English primary sector schools, an extreme change involving organizational termination alongside phoenix‐like emergence. The ironic perspective focuses on synchronic dissonance and diachronic divergence in meaning underlying verbal and situational forms of irony respectively, endemic sources of organizational ambiguity, its exacerbation by change which creates conditions favouring irony, and the dynamics of their relationship. The case illustrates how ironic consequences flowed iteratively from diverse sources of ambiguity for those managing the merger, often recursively generating further irony. It is suggested that an ironic perspective can deepen theoretical understanding of the relative unmanageability of public service change, within structural parameters delimiting its scope. This perspective also offers a generic heuristic for organizational analysis with potential to inform efforts to cope with ambiguity and consequent irony in the change process.
POLICY AND GENDER IN ADULT SOCIAL CARE WORK
Authors: ATKINSON CAROL , LUCAS ROSEMARY
Published: August 2012

There are inherent tensions between government policy on adult social care work in England and the practice of that care work. This paper locates these tensions within the masculine model of professionalization contained in English adult social care policy and its interpretation by a largely female workforce. We situate our analysis within critical realism, exploring street – level bureaucracy in manager and care worker policy interpretations. We argue that their exercise of agency draws substantially upon gender structures. Managers espouse policy while reproducing gender to construct care work as low in skill and status. Care workers, whose views are often neglected, transform gender to resist this positioning of their work. Our contribution is to question policy's effectiveness given its disregard of gender and its consequent disconnect from those practising adult social care. In so doing, we also advance understanding of street – level bureaucracy.